Interrelationships between orthodontics and periodontics

Abstract

At the present time, periodontists have no evidence to indicate that orthodontic treatment in the child will either enhance or detract from the periodontal health of the patient or that it will increase or decrease the longevity of the teeth. Many periodontists believe that much orthodontic treatment is undertaken on an esthetic or empirical basis. Proper emphasis on plaque control procedures prior to initial banding, altered and reinforced during the entire period of orthodontic treatment, may well minimize the inflammatory lesion often found during therapy. Gingival, periodontal, and mucogingival problems should be treated as soon as they are diagnosed. Limiting our orthodontic objectives in adult patients because of the possibility of inducing supporting alveolar bone loss and other problems that did not previously exist may be a worthwhile compromise. Orthodontic movement in periodontally healthy adults, and especially in those with periodontally involved teeth, constitutes a problem distinct from routine orthodontics. When periodontal disease has already produced significant destruction of supporting tissue and secondary occlusal trauma is a complicating factor, orthodontic treatment may possibly serve as another mode of treatment to reestablish the correct occlusal plane and alter bony deformities. Various methods can be used to try and place teeth into better bone. One should make certain that teeth are being moved into a greater volume of bone. The bite plane is of great value in allowing continuous eruption of the teeth and their supporting structures and in eliminating additional trauma by enabling the teeth to move into their correct cusp-fossa relationships unimpeded by the inclined planes of the opposing teeth. Since little is known about the interrelationships between orthodontic treatment and periodontal health and disease, there is still a great deal to learn. In spite of this lack of knowledge, the general practitioners and the various specialists of dentistry, each seeking a rationale for his preventive and therapeutic procedures, subject the patient to treatment based on concepts of the occlusion which have yet to be corroborated. In addition to the need for research in this field, a common language between the periodontist and the orthodontist must be established to eliminate the existing communications barrier. Once basic principles can be determined, elucidated, and applied correctly, the movement of teeth in periodontal cases will be limited only by the imagination of the operator.