Faculty of Medicine, Department of Periodontology, Preventive Dentistry and Oral Pathology, Institute of Dentistry, Jagiellonian University Medical College, Kraków, Poland.
Faculty of Medicine, Institute of Dentistry, Jagiellonian University Medical College, Chair of Prosthodontics and Orthodontics, Kraków, Poland.
Aust Dent J. 2023 Dec;68(4):238-246. doi: 10.1111/adj.12974. Epub 2023 Sep 8.
Patients with periodontitis often require an inter-disciplinary approach, including orthodontic treatment, for effective rehabilitation of masticatory function, aesthetics and quality of life. The aim of this narrative review was to comprehensively discuss literature focusing on the biology, indications and inter-disciplinary connections related to the orthodontic approach in patients with periodontitis and to present clinical concepts in accordance with valid guidelines. The outcomes of the experimental studies indicate that orthodontic tooth movement (OTM) can be performed safely for teeth with reduced periodontium, provided infection and inflammation are controlled. Orthodontic treatment can correct pathological tooth migration, is not associated with deterioration of clinical periodontal parameters and improves aesthetics. Intrusion is safe when performed with light forces and under a strict oral hygiene regimen. Teeth can be moved either towards or away from the intrabony defect previously subjected to regenerative procedures, and research suggests that OTM has the potential to enhance bone formation after regenerative therapy. The data on orthodontic movement of teeth with furcation involvement are very scarce. The improvement in furcation involvement following either combined periodontal and orthodontic treatment was only documented in animal model studies. Due to bone and tooth loss, special consideration should be given to orthodontic treatment mechanics. © 2023 Australian Dental Association.
牙周炎患者通常需要多学科治疗方法,包括正畸治疗,以有效恢复咀嚼功能、美观和生活质量。本综述旨在全面讨论有关牙周炎患者正畸方法的生物学、适应证和多学科联系的文献,并根据有效指南提出临床概念。实验研究的结果表明,在感染和炎症得到控制的情况下,可以安全地对牙周组织减少的牙齿进行正畸牙齿移动(OTM)。正畸治疗可以纠正病理性牙齿迁移,不会导致临床牙周参数恶化,并改善美观。在轻力作用下,并遵循严格的口腔卫生方案进行内收是安全的。牙齿可以向先前接受再生治疗的骨内缺损方向移动,也可以远离该缺损方向移动,研究表明 OTM 有可能增强再生治疗后的骨形成。关于涉及分叉的牙齿的正畸移动的数据非常有限。在牙周和正畸联合治疗后,分叉受累的改善仅在动物模型研究中得到证实。由于骨和牙齿的丧失,应特别注意正畸治疗力学。© 2023 澳大利亚牙科协会。