Orthodontic-Periodontics: An Interdisciplinary Approach

*Shreya Kishore, Vanita Barai, Suvetha Siva and Keerthi Venkatesan*

### **Abstract**

Periodontal pathogenesis is a multi-factorial process and the orthodontist must recognize the clinical forms of inflammatory periodontal disease. Orthodontics is the most conservative and predictable treatment to improve numerous local etiological factors that contribute to periodontal disease including periodontal breakdown. Proper occlusal function and masticatory function are stimulatory to the gingival tissue and the attachment apparatus, while, conversely, a lack of function predisposes to disease that increases plaque retention and calculus formation along with gingival inflammation leading to increased loss of bony support. No matter how talented the orthodontist, a magnificent orthodontic correction can be destroyed by failure to recognize periodontal susceptibility. Therefore, identifying periodontally susceptible patients is critical for the outcome of the treatment. This chapter will highlight the importance of the short-term and long-term outcomes of orthodontic treatment, which are influenced by the patient's periodontal status before, during and after active orthodontic therapy.

**Keywords:** Bio-relationship, Interdisciplinary approach, Adjunctive periodontal procedures, Periodontium, Orthodontia, Periodontal healing

#### **1. Introduction**

Periodontal care should be directed towards eliminating the bacterial infection and preventing reinfection. This involves creating an environment which encourages self-cleansing and is less conducive to harboring pathogenic bacteria. Appropriate therapy for each individual depends on the type, severity and morphology created by the specific disease, along with cooperation from the patient. Regardless, elimination of as many plaque-retentive areas should always be the primary objective of a treatment. Large number of teeth are extracted to eliminate periodontal defects (that act as bacterial reservoirs) that can be corrected by simple tooth eruption [1].

Although orthodontic treatment may not be considered preventive or corrective of periodontitis, it is one of the solutions to reduce the local factors. Patients with predisposing periodontal health tend to experience movement in teeth, as there will be comparatively lesser periodontal support. Commonly occurring movements of teeth include migration of teeth, intrusion, extrusion and flaring of teeth. In such cases, orthodontic treatment helps in eliminating the malposition of teeth but also aids in long term maintenance [2].
