Orthodontic-periodontic Interrelationship

Literature Review from the year 2004 in the subject Medicine - Dentistry, Rajiv Gandhi University (A B shetty memorial institute of dental sciences), course: master of dental surgery, language: English, abstract: Team work is the essence for the success of any venture. A multidisciplinary approach is often necessary to treat and prevent dental problems in a patient. Orthodontics and periodontics are interrelated in a variety of ways. Orthodontic treatment is based on the principle that if prolonged pressure is applied to a tooth, tooth movement will occur as the bone around the tooth remodels. Bone is selectively removed in same areas and added in others. In essence, the tooth moves through the bone carrying its attachment apparatus with it, as the socket of the tooth migrates. Since the bony response is mediated by the periodontal ligament, tooth movement is primarily a periodontal ligament phenomenon.
Orthodontic tooth movement, which is the basis of the orthodontic treatment, is possible because of the inherent nature of the periodontium. Many advances have been made in understanding the mechanisms involved in the process of tooth movement. However, there are many pathologic conditions affecting the periodontium which may affect these mechanisms of tooth movement and alter the end result of the orthodontic treatment. Similarly awareness of the pathologic changes or other undesirable changes which can occur in the periodontium as a result of ideal or less than ideal orthodontic procedures would help in better treatment procedure and management of the patients. Altered tooth position may affect periodontal health. Placement of orthodontic appliances causes microbiological changes as well as changes in the periodontium. With the success, in the recent decades of the fixed multi banded appliance, orthodontic treatment in adults has continuously grown in the United States and Europe. It is in connection with adult orthodontics that periodontal factors are becoming more important to the orthodontist.
Orthodontics in the adult patient, specially the periodontally compromised patient requires adequate periodontal considerations to maintain the periodontium in a healthy condition during and after treatment. Minor periodontal surgery may be required to prevent relapse after orthodontic treatment. In addition, since periodontal diseases can secondarily cause malocclusion, very often orthodontic treatment would be an essential adjunct if the periodontal therapy is to succeed.