Clinical Update

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Each month, the clinical update is published online and in the Victorian Dentist. There are 11 clinical updates per year, corresponding with the distribution of the Victorian Dentist from February to December. This service is available to ADAVB and ADATas members only. Members can log in to view and answer the clinical update questions. If you answer at least eight out of 10 questions correctly, you will receive one hour of scientific CPD.

Please note: Each new clinical update will be available from the first business day of each month.

Effect of periodontal-orthodontic treatment: A systematic review with meta-analysis

Full title: Effect of periodontal-orthodontic treatment of teeth with pathological tooth flaring, drifting, and elongation in patients with severe periodontitis: A systematic review with meta-analysis.

Papageorgiou SN, Antonoglou GN, Michelogiannakis D, Kakali L, Eliades T, Madianos P. J Clin Periodontol 2021 Jul 29. doi: 10.1111/jcpe.13529.

Compiled by Dr Sarah Chin

Introduction

Affecting function, aesthetics and prognosis, pathologic tooth migration is one of the serious side effects of severe periodontal disease. Tooth migration occurs with occlusal trauma and loss of periodontal support, which worsens the severity of the periodontitis and the mobility of the teeth. There is no association between occlusal trauma and

non-carious cervical lesions and gingival recession. Patients may wish to treat the pathologic tooth migration with orthodontics to improve aesthetics and function.

Orthodontic treatment can be performed on a reduced healthy periodontium with no additional attachment loss. Orthodontic movement of periodontally compromised, inflammation-free teeth was not followed by an increase in matrix metalloproteinases. Orthodontic correction of pathologically malpositioned teeth can reduce occlusal trauma, stabilise the dentition and improve the periodontal status. Light intrusive forces can be used to correct pathological extrusion and migration. Periodontal maintenance, and the direction and strength of orthodontic force may complicate orthodontic treatment. It is unclear whether orthodontic treatment can be performed safely on pathologically migrated teeth, and the short- and long-term implications on the prognosis of the teeth.

The aim of this systematic review was to assess the periodontal effects of orthodontic treatment on stage IV periodontitis patients to correct pathologically migrated teeth.

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