- Volume 45 Issue 6
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A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis
- Han, Ji-Young (Department of Periodontology, Division of Dentistry, Hanyang University College of Medicine)
- Received : 2015.08.26
- Accepted : 2015.11.07
- Published : 2015.12.31
Purpose: With the increasing prevalence of orthodontic treatment in adults, clear aligner treatments are becoming more popular. The aim of this study was to evaluate the effect of orthodontic treatment on periodontal tissue and to compare orthodontic treatment with fixed appliances (FA) to clear aligner treatment (CAT) in periodontitis patients. Methods: A total of 35 patients who underwent orthodontic treatment in the Department of Periodontology were included in this study. After periodontal treatment with meticulous oral hygiene education, patients underwent treatment with FA or CAT, and this study analyzed patient outcomes depending on the treatment strategy. Clinical parameters were assessed at baseline and after orthodontic treatment, and the duration of treatment was compared between these two groups. Results: The overall plaque index, the gingival index, and probing depth improved after orthodontic treatment (P<0.01). The overall bone level also improved (P=0.045). However, the bone level changes in the FA and CAT groups were not significantly different. Significant differences were found between the FA and CAT groups in probing depth, change in probing depth, and duration of treatment (P<0.05). However, no significant differences were found between the FA and CAT groups regarding the plaque index, changes in the plaque index, the gingival index, changes in the gingival index, or changes in the alveolar bone level. The percentage of females in the CAT group (88%) was significantly greater than in the FA group (37%) (P<0.01). Conclusions: After orthodontic treatment, clinical parameters were improved in the FA and CAT groups with meticulous oral hygiene education and plaque control. Regarding plaque index and gingival index, no significant differences were found between these two groups. We suggest that combined periodontal and orthodontic treatment can improve patients' periodontal health irrespective of orthodontic techniques.
- Gkantidis N, Christou P, Topouzelis N. The orthodontic-periodontic interrelationship in integrated treatment challenges: a systematic review. J Oral Rehabil 2010;37:377-90. https://doi.org/10.1111/j.1365-2842.2010.02068.x
- Turkkahraman H, Sayin MO, Bozkurt FY, Yetkin Z, Kaya S, Onal S. Archwire ligation techniques, microbial colonization, and periodontal status in orthodontically treated patients. Angle Orthod 2005;75:231-6.
- Boyd RL, Leggott PJ, Quinn RS, Eakle WS, Chambers D. Periodontal implications of orthodontic treatment in adults with reduced or normal periodontal tissues versus those of adolescents. Am J Orthod Dentofacial Orthop 1989;96:191-8. https://doi.org/10.1016/0889-5406(89)90455-1
- Chou YH, Du JK, Chou ST, Hu KF, Tsai CC, Ho KY, et al. An interdisciplinary treatment approach combining orthodontic forced eruption with immediate implant placement to achieve a satisfactory treatment outcome: a case report. Clin Implant Dent Relat Res 2013;15:113-20. https://doi.org/10.1111/j.1708-8208.2011.00363.x
- Liu XF, Pan XG, Shu R. A preliminary study of combined periodontal-orthodontic approach for treating labial displacement of incisors in patients with periodontal diseases. Shanghai Kou Qiang Yi Xue 2008;17:264-6.
- Artun J, Urbye KS. The effect of orthodontic treatment on periodontal bone support in patients with advanced loss of marginal periodontium. Am J Orthod Dentofacial Orthop 1988;93:143-8. https://doi.org/10.1016/0889-5406(88)90292-2
- Nelson PA, Artun J. Alveolar bone loss of maxillary anterior teeth in adult orthodontic patients. Am J Orthod Dentofacial Orthop 1997;111:328-34. https://doi.org/10.1016/S0889-5406(97)70192-6
- Re S, Corrente G, Abundo R, Cardaropoli D. Orthodontic treatment in periodontally compromised patients: 12-year report. Int J Periodontics Restorative Dent 2000;20:31-9.
- Bollen AM, Cunha-Cruz J, Bakko DW, Huang GJ, Hujoel PP. The effects of orthodontic therapy on periodontal health: a systematic review of controlled evidence. J Am Dent Assoc 2008;139: 413-22. https://doi.org/10.14219/jada.archive.2008.0184
- Wennstrom JL, Stokland BL, Nyman S, Thilander B. Periodontal tissue response to orthodontic movement of teeth with infrabony pockets. Am J Orthod Dentofacial Orthop 1993;103:313-9. https://doi.org/10.1016/0889-5406(93)70011-C
Boas Nogueira AV, Chaves de Souza JA, Kim YJ, Damiao de Sousa-Neto M, Chan Cirelli C, Cirelli JA. Orthodontic force increases interleukin-1
$\beta$and tumor necrosis factor- $\alpha$expression and alveolar bone loss in periodontitis. J Periodontol 2013;84:1319-26. https://doi.org/10.1902/jop.2012.120510
- van Gastel J, Quirynen M, Teughels W, Carels C. The relationships between malocclusion, fixed orthodontic appliances and periodontal disease. A review of the literature. Aust Orthod J 2007; 23:121-9.
- Miethke RR, Vogt S. A comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed orthodontic appliances. J Orofac Orthop 2005;66:219-29. https://doi.org/10.1007/s00056-005-0436-1
- Miethke RR, Brauner K. A Comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed lingual appliances. J Orofac Orthop 2007;68:223-31. https://doi.org/10.1007/s00056-007-0655-8
- Boyd RL. Periodontal and restorative considerations with clear aligner treatment to establish a more favorable restorative environment. Compend Contin Educ Dent 2009;30:280-2, 4, 6-8 passim.
- Pavoni C, Lione R, Lagana G, Cozza P. Self-ligating versus Invisalign: analysis of dento-alveolar effects. Ann Stomatol (Roma) 2011;2:23-7.
- Drake CT, McGorray SP, Dolce C, Nair M, Wheeler TT. Orthodontic tooth movement with clear aligners. ISRN Dent 2012;2012: 657973.
- Kravitz ND, Kusnoto B, Agran B, Viana G. Influence of attachments and interproximal reduction on the accuracy of canine rotation with Invisalign. A prospective clinical study. Angle Orthod 2008;78:682-7. https://doi.org/10.2319/0003-3219(2008)078[0682:IOAAIR]2.0.CO;2
- Savage A, Eaton KA, Moles DR, Needleman I. A systematic review of definitions of periodontitis and methods that have been used to identify this disease. J Clin Periodontol 2009;36:458-67. https://doi.org/10.1111/j.1600-051X.2009.01408.x
- Silness J, Loe H. Periodontal Disease in Pregnancy. Ii. Correlation between Oral Hygiene and Periodontal Condtion. Acta Odontol Scand 1964;22:121-35. https://doi.org/10.3109/00016356408993968
- Loe H, Silness J. Periodontal Disease in Pregnancy. I. Prevalence and Severity. Acta Odontol Scand 1963;21:533-51. https://doi.org/10.3109/00016356309011240
- Kim TS, Obst C, Zehaczek S, Geenen C. Detection of bone loss with different X-ray techniques in periodontal patients. J Periodontol 2008;79:1141-9. https://doi.org/10.1902/jop.2008.070578
- Proffit WR, Fields HW. Contemporary orthodontics. 2nd ed. St. Louis: Mosby; 1992. p. 554-606.
- Stanaityte R, Trakiniene G, Gervickas A. Do wisdom teeth induce lower anterior teeth crowding? A systematic literature review. Stomatologija 2014;16:15-8.
- Bishara SE, Treder JE, Damon P, Olsen M. Changes in the dental arches and dentition between 25 and 45 years of age. Angle Orthod 1996;66:417-22.
- Krishnan V, Davidovitch Z. Cellular, molecular, and tissue-level reactions to orthodontic force. Am J Orthod Dentofacial Orthop 2006;129:469.e1-32.
- Davidovitch Z, Nicolay OF, Ngan PW, Shanfeld JL. Neurotransmitters, cytokines, and the control of alveolar bone remodeling in orthodontics. Dent Clin North Am 1988;32:411-35.
- Bonafe-Oliveira L, Faltin RM, Arana-Chavez VE. Ultrastructural and histochemical examination of alveolar bone at the pressure areas of rat molars submitted to continuous orthodontic force. Eur J Oral Sci 2003;111:410-6. https://doi.org/10.1034/j.1600-0722.2003.00067.x
- Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Efficacy of clear aligners in controlling orthodontic tooth movement: a systematic review. Angle Orthod 2015;85:881-9. https://doi.org/10.2319/061614-436.1
- Cattaneo PM, Dalstra M, Melsen B. Strains in periodontal ligament and alveolar bone associated with orthodontic tooth movement analyzed by finite element. Orthod Craniofac Res 2009;12: 120-8. https://doi.org/10.1111/j.1601-6343.2009.01445.x
- Nakao K, Goto T, Gunjigake KK, Konoo T, Kobayashi S, Yamaguchi K. Intermittent force induces high RANKL expression in human periodontal ligament cells. J Dent Res 2007;86:623-8. https://doi.org/10.1177/154405910708600708
- Diedrich PR. Guided tissue regeneration associated with orthodontic therapy. Semin Orthod 1996;2:39-45. https://doi.org/10.1016/S1073-8746(96)80038-7
- Cardaropoli D, Re S, Manuzzi W, Gaveglio L, Cardaropoli G. Bio-Oss collagen and orthodontic movement for the treatment of infrabony defects in the esthetic zone. Int J Periodontics Restorative Dent 2006;26:553-9.
- Ogihara S, Marks MH. Enhancing the regenerative potential of guided tissue regeneration to treat an intrabony defect and adjacent ridge deformity by orthodontic extrusive force. J Periodontol 2006;77:2093-100. https://doi.org/10.1902/jop.2006.003159
- Passanezi E, Janson M, Janson G, Sant'Anna AP, de Freitas MR, Henriques JF. Interdisciplinary treatment of localized juvenile periodontitis: a new perspective to an old problem. Am J Orthod Dentofacial Orthop 2007;131:268-76. https://doi.org/10.1016/j.ajodo.2005.03.025
- Rossini G, Parrini S, Castroflorio T, Deregibus A, Debernardi CL. Periodontal health during clear aligners treatment: a systematic review. Eur J Orthod 2015;37:539-43. https://doi.org/10.1093/ejo/cju083
- Araujo MG, Carmagnola D, Berglundh T, Thilander B, Lindhe J. Orthodontic movement in bone defects augmented with Bio-Oss. An experimental study in dogs. J Clin Periodontol 2001;28: 73-80. https://doi.org/10.1034/j.1600-051x.2001.280111.x
- Ahn HW, Ohe JY, Lee SH, Park YG, Kim SJ. Timing of force application affects the rate of tooth movement into surgical alveolar defects with grafts in beagles. Am J Orthod Dentofacial Orthop 2014;145:486-95. https://doi.org/10.1016/j.ajodo.2013.12.021
- Roberts WE, Chase DC. Kinetics of cell proliferation and migration associated with orthodontically-induced osteogenesis. J Dent Res 1981;60:174-81. https://doi.org/10.1177/00220345810600021501
- Melsen B, Agerbaek N, Eriksen J, Terp S. New attachment through periodontal treatment and orthodontic intrusion. Am J Orthod Dentofacial Orthop 1988;94:104-16. https://doi.org/10.1016/0889-5406(88)90358-7