CoChat
Sign Up
Cited by 75Orthodontics and Dentofacial OrthopedicsOral microbiology and periodontitis researchPeriodontal Regeneration and Treatments

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

Open access
Papageorgiou, Spyridon N., Antonoglou, Georgios N., Michelogiannakis, Dimitrios, Kakali, Lydia, Eliades, Theodore, Madianos, Phoebus·2022·Journal of Clinical Periodontology
DOI 10.1111/jcpe.13529PMC PMC9290963
Open this paper in CoChat — free accountOpen PDF

Abstract

Aim: To assess the beneficial and adverse effects on the dental and periodontal issues of periodontal–orthodontic treatment of teeth with pathological tooth flaring, drifting, and elongation in patients with severe periodontitis. Materials and methods: Nine databases were searched in April 2020 for randomized/non‐randomized clinical studies. After duplicate study selection, data extraction, and risk‐of‐bias assessment, random‐effect meta‐analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by subgroup/meta‐regression analyses. Results: A total of 30 randomized and non‐randomized clinical studies including 914 patients (29.7% male; mean age 43.4 years) were identified. Orthodontic treatment of pathologically migrated teeth was associated with clinical attachment gain (−0.24 mm; seven studies), pocket probing depth reduction (−0.23 mm; seven studies), marginal bone gain (−0.36 mm; seven studies), and papilla height gain (−1.42 mm; two studies) without considerable adverse effects, while patient sex, gingival phenotype, baseline disease severity, interval between periodontal and orthodontic treatment, and orthodontic treatment duration affected the results. Greater marginal bone level gains were seen by additional circumferential fiberotomy (two studies; MD = –0.98 mm; 95% CI = –1.87 to −0.10 mm; p = .03), but the quality of evidence was low. Conclusions: Limited evidence of poor quality indicates that orthodontic treatment might be associated with small improvements of periodontal parameters, which do not seem to affect prognosis, but more research is needed.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1111/jcpe.13529

Cites

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Overall, clinical evidence indicates that orthodontic treatment under proper oral hygiene regimens is not associated with clinical attachment loss, even among patients with reduced but healthy periodontium.

    “Overall, clinical evidence indicates that orthodontic treatment under proper oral hygiene regimens is not associated with clinical attachment loss, even among patients with reduced but healthy periodontium [33–35].”

    From Influence of elastomeric and steel ligatures on periodontal health during fixed appliance orthodontic treatment: a systematic review and meta-analysis (2024) · cites this paper as [34]

    The Introduction (Background; page unavailable) says a reduced but healthy periodontium can tolerate orthodontic tooth movement without additional attachment loss. However, the Discussion (Results in context; page unavailable) reports minimal attachment loss in periodontally healthy patients, so the broader statement that orthodontic treatment is not associated with attachment loss is not supported. The paper also does not establish the claim specifically under a proper oral-hygiene regimen. (LLM, conf=0.84)

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

No citation lists for this paper

No citation lists for this paper yet — checked again daily.

References 67 · Cited by 75

Research works printed but not linked: 56

  1. Aimetti, M., Garbo, D., Ercoli, E., Grigorie, M. M., Citterio, F., & Romano, F. (2020). Long‐term prognosis of severely compromised teeth following combined periodontal and orthodontic treatment: A retrospective study. International Journal of Periodontics and Restorative Dentistry, 40, 95– 102. 10.11607/prd.4523 31815978 · DOI
  2. Almeida, R. C., Capelli, J., & Teles, R. P. (2015). Levels of gingival crevicular fluid matrix metalloproteinases in periodontally compromised teeth under orthodontic forces. The Angle Orthodontist, 85, 1009– 1014. 10.2319/101714-744.1 25751014 PMC8612058 · DOI
  3. Artun, J., & Urbye, K. S. (1988). The effect of orthodontic treatment on periodontal bone support in patients with advanced loss of marginal periodontium. American Journal of Orthodontics and Dentofacial Orthopedics, 93, 143– 148. 10.1016/0889-5406(88)90292-2 3422529 · DOI
  4. Attia, M. S., Hazzaa, H. H., Al‐Aziz, F. A., & Elewa, G. M. (2019). Evaluation of adjunctive use of low‐level diode laser biostimulation with combined orthodontic regenerative therapy. Journal of the International Academy of Periodontology, 21, 63– 73. 31522153
  5. Attia, M. S., Shoreibah, E. A., Ibrahim, S. A., & Nassar, H. A. (2012). Regenerative therapy of osseous defects combined with orthodontic tooth movement. Journal of the International Academy of Periodontology, 14, 17– 25. 22479985
  6. Bollen, A. M., Cunha‐Cruz, J., Bakko, D. W., Huang, G. J., & Hujoel, P. P. (2008). The effects of orthodontic therapy on periodontal health: A systematic review of controlled evidence. Journal of the American Dental Association, 139, 413– 422. 10.14219/jada.archive.2008.0184 18385025 · DOI · Paper page
  7. Boyd, R. L., Leggot, P. J., Quinn, R. S., Eakle, W. S., & Chambers, D. W. (1989). Periodontal implications of orthodontic treatment in adults with reduced or normal periodontal tissues versus those of adolescents. American Journal of Orthodontics and Dentofacial Orthopedics, 96, 191– 198. 10.1016/0889-5406(89)90455-1 2773862 · DOI
  8. Boyer, S., Fontanel, F., Danan, M., et al. (2011). Severe periodontitis and orthodontics: Evaluation of long‐term results. International Orthodontics, 9, 259– 273. 10.1016/j.ortho.2011.06.004 21855438 · DOI
  9. Brunsvold, M. A. (2005). Pathologic tooth migration. Journal of Periodontology, 76, 859– 866. 15948679
  10. Chhibber, A., Agarwal, S., Yadav, S., Kuo, C. L., & Upadhyay, M. (2018). Which orthodontic appliance is best for oral hygiene? A randomized clinical trial. American Journal of Orthodontics and Dentofacial Orthopedics, 153, 175– 183. 10.1016/j.ajodo.2017.10.009 29407494 · DOI · Paper page
  11. Cobb, C. M. (2002). Clinical significance of non‐surgical periodontal therapy: An evidence‐based perspective of scaling and root planing. Journal of Clinical Periodontology, 29(Suppl 2), 6– 16. 12010523
  12. Cortellini, P., Buti, J., Pini Prato, G., & Tonetti, M. S. (2017). Periodontal regeneration compared with access flap surgery in human intra‐bony defects 20‐year follow‐up of a randomized clinical trial: Tooth retention, periodontitis recurrence and costs. Journal of Clinical Periodontology, 44, 58– 66. 10.1111/jcpe.12638 27736011 · DOI
  13. Diedrich, P. R. (1996). Orthodontic procedures improving periodontal prognosis. Dental Clinics of North America, 40, 875– 887. 8886543
  14. El‐Attar, H., El‐Kadi, A., Rabie, A., Ezz‐el‐Arab, A., Salah, N., & Bedair. (2019). Evaluation of the combined orthodontic‐periodontal therapy in the management of extruded anterior teeth in patients with aggressive periodontitis. International Journal of Health Sciences and Research, 9, 25– 38.
  15. Eliasson, L. A., Hugoson, A., Kurol, J., & Siwe, H. (1982). The effects of orthodontic treatment on periodontal tissues in patients with reduced periodontal support. European Journal of Orthodontics, 4, 1– 9. 10.1093/ejo/4.1.1 6950899 · DOI
  16. Ericsson, I., Thilander, B., Lindhe, J., & Okamoto, H. (1977). The effect of orthodontic tilting movements on the periodontal tissues of infected and non‐infected dentitions in dogs. Journal of Clinical Periodontology, 4, 278– 293. 10.1111/j.1600-051x.1977.tb01900.x 271655 · DOI
  17. Figueira, E. A., de Rezende, M. L., Torres, S. A., Garlet, G. P., Lara, V. S., Santos, C. F., Avila‐Campos, M. J., da Silva, J. S., & Campanelli, A. P. (2009). Inhibitory signals mediated by programmed death‐1 are involved with T‐cell function in chronic periodontitis. Journal of Periodontology, 80, 1833– 1844. 10.1902/jop.2009.090057 19905953 · DOI
  18. Freitas, A. O., Marquezan, M., Nojima, M. D. A. C., Alviano, D. S., & Maia, L. C. (2014). The influence of orthodontic fixed appliances on the oral microbiota: A systematic review. Dental Press Journal of Orthodontics, 19, 46– 55. 10.1590/2176-9451.19.2.046-055.oar PMC4296609 24945514 · DOI · Paper page
  19. Garat, J. A., Gordillo, M. E., & Ubios, A. M. (2005). Bone response to different strength orthodontic forces in animals with periodontitis. Journal of Periodontal Research, 40, 441– 445. 10.1111/j.1600-0765.2005.00809.x 16302921 · DOI
  20. Gkantidis, N., Christou, P., & Topouzelis, N. (2010). The orthodontic periodontic interrelationship in integrated treatment challenges: A systematic review. Journal of Oral Rehabilitation, 37, 377– 390. 10.1111/j.1365-2842.2010.02068.x 20202098 · DOI
  21. Guyatt, G. H., Oxman, A. D., Schünemann, H. J., Tugwell, P., & Knottnerus, A. (2011). GRADE guidelines: A new series of articles in the Journal of Clinical Epidemiology. Journal of Clinical Epidemiology, 64, 380– 382. 10.1016/j.jclinepi.2010.09.011 21185693 · DOI · Paper page
  22. Han, J.‐Y. (2015). A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patients with periodontitis. Journal of Periodontal and Implant Science, 45, 193– 204. 10.5051/jpis.2015.45.6.193 26734489 PMC4698945 · DOI
  23. Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta‐analyses. BMJ, 327, 557– 560. 10.1136/bmj.327.7414.557 12958120 PMC192859 · DOI · Paper page
  24. Higgins, J. P. T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M. J., & Welch, V. A. (Eds.). (2020). Cochrane handbook for systematic reviews of interventions version 6.1. Cochrane www.training.cochrane.org/handbook
  25. Hoffmann, T., Al‐Machot, E., Meyle, J., Jervøe‐Storm, P. M., & Jepsen, S. (2016). Three‐year results following regenerative periodontal surgery of advanced intrabony defects with enamel matrix derivative alone or combined with a synthetic bone graft. Clinical Oral Investigations, 20, 357– 364. 10.1007/s00784-015-1522-4 26174080 · DOI
  26. Kaldahl, W. B., Kalkwarf, K. L., Patil, K. D., Molvar, M. P., & Dyer, J. K. (1996). Long‐term evaluation of periodontal therapy: I. Response to 4 therapeutic modalities. Journal of Periodontology, 67, 93– 102. 10.1902/jop.1996.67.2.93 8667142 · DOI
  27. Kassebaum, N. J., Bernabé, E., Dahiya, M., Bhandari, B., Murray, C. J., & Marcenes, W. (2014). Global burden of severe periodontitis in 1990‐2010: A systematic review and meta‐regression. Journal of Dental Research, 93, 1045– 1053. 10.1177/0022034514552491 25261053 PMC4293771 · DOI · Paper page
  28. Kwok, V., & Caton, J. G. (2007). Commentary: Prognosis revisited: A system for assigning periodontal prognosis. Journal of Periodontology, 78, 2063– 2071. 10.1902/jop.2007.070210 17970671 · DOI
  29. Liu, X. F., Pan, X. G., & Shu, R. (2008). A preliminary study of combined periodontal‐orthodontic approach for treating labial displacement of incisors in patients with periodontal diseases. Shanghai Kou Qiang Yi Xue, 17, 264– 266. 18661066
  30. Martin, C., Celis, B., Ambrosio, N., Bollain, J., Antonoglou, G. N., & Figuero, E. (2021). Effect of orthodontic therapy in periodontitis and non‐periodontitis patients: A systematic review with meta‐analysis. Journal of Clinical Periodontology. 10.1111/jcpe.13487 33998045 · DOI
  31. Martinez‐Canut, P., Carrasquer, A., Magán, R., & Lorca, A. (1997). A study on factors associated with pathologic tooth migration. Journal of Clinical Periodontology, 24, 492– 497. 10.1111/j.1600-051x.1997.tb00217.x 9226390 · DOI
  32. McKiernan, E. X., McKiernan, F., & Jones, M. L. (1992). Psychological profiles and motives of adults seeking orthodontic treatment. The International Journal of Adult Orthodontics and Orthognathic Surgery, 7, 187– 198. 1291613
  33. Nibali, L., Koidou, V. P., Nieri, M., Barbato, L., Pagliaro, U., & Cairo, F. (2020). Regenerative surgery versus access flap for the treatment of intra‐bony periodontal defects: A systematic review and meta‐analysis. Journal of Clinical Periodontology, 47(Suppl 22), 320– 351. 10.1111/jcpe.13237 31860134 · DOI
  34. Ogihara, S., & Wang, H. L. (2010). Periodontal regeneration with or without limited orthodontics for the treatment of 2‐ or 3‐wall infrabony defects. Journal of Periodontology, 81, 1734– 1742. 10.1902/jop.2010.100127 20629545 · DOI
  35. Papageorgiou, S. N. (2014a). Meta‐analysis for orthodontists: Part I—How to choose effect measure and statistical model. Journal of Orthodontics, 41, 317– 326. 10.1179/1465313314Y.0000000111 25404668 · DOI
  36. Papageorgiou, S. N. (2014b). Meta‐analysis for orthodontists: Part II—Is all that glitters gold? Journal of Orthodontics, 41, 327– 336. 10.1179/1465313314Y.0000000110 25404669 · DOI
  37. Papageorgiou, S. N., Antonoglou, G. N., Michelogiannakis, D., Kakali, L., Eliades, T., & Madianos, P. (2020). Orthodontic treatment of teeth with pathological tooth flaring, drifting, and elongation among periodontitis patients: A systematic review with meta‐analysis [dataset]. Zenodo. 10.5281/zenodo.3992750 PMC9290963 34327710 · DOI
  38. Papageorgiou, S. N., Gölz, L., Jäger, A., Eliades, T., & Bourauel, C. (2016). Lingual vs. labial fixed orthodontic appliances: Systematic review and meta‐analysis of treatment effects. European Journal of Oral Sciences, 124, 105– 118. 10.1111/eos.12250 26916846 · DOI
  39. Papageorgiou, S. N., Koletsi, D., Iliadi, A., Peltomaki, T., & Eliades, T. (2020). Treatment outcome with orthodontic aligners and fixed appliances: A systematic review with meta‐analyses. European Journal of Orthodontics, 42, 331– 343. 10.1093/ejo/cjz094 31758191 · DOI
  40. Papageorgiou, S. N., Koretsi, V., & Jäger, A. (2017). Bias from historical control groups used in orthodontic research: A meta‐epidemiological study. European Journal of Orthodontics, 39, 98– 105. 10.1093/ejo/cjw035 27129869 · DOI
  41. Papageorgiou, S. N., Papadelli, A. A., & Eliades, T. (2018). Effect of orthodontic treatment on periodontal clinical attachment: A systematic review and meta‐analysis. European Journal of Orthodontics, 40, 176– 194. 10.1093/ejo/cjx052 29106513 · DOI · Paper page
  42. Papageorgiou, S. N., Xavier, G. M., & Cobourne, M. T. (2015). Basic study design influences the results of orthodontic clinical investigations. Journal of Clinical Epidemiology, 68, 1512– 1522. 10.1016/j.jclinepi.2015.03.008 25910911 · DOI · Paper page
  43. Papageorgiou, S. N., Xavier, G. M., Cobourne, M. T., & Eliades, T. (2018). Effect of orthodontic treatment on the subgingival microbiota: A systematic review and meta‐analysis. Orthodontics and Craniofacial Research, 21, 175– 185. 10.1111/ocr.12237 30028077 · DOI · Paper page
  44. Papapanou, P. N., Sanz, M., Buduneli, N., Dietrich, T., Feres, M., Fine, D. H., Flemmig, T. F., Garcia, R., Giannobile, W. V., Graziani, F., Greenwell, H., Herrera, D., Kao, R. T., Kebschull, M., Kinane, D. F., Kirkwood, K. L., Kocher, T., Kornman, K. S., Kumar, P. S., … Tonetti, M. S. (2018). Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. Journal of Periodontology, 89(Suppl 1), S173– S182. 10.1002/JPER.17-0721 29926951 · DOI · Paper page
  45. Re, S., Cardaropoli, D., Abundo, R., & Corrente, G. (2004). Reduction of gingival recession following orthodontic intrusion in periodontally compromised patients. Orthodontics & Craniofacial Research, 7, 35– 39. 10.1111/j.1601-6343.2004.00277.x 14989753 · DOI
  46. Reynolds, M. A., Kao, R. T., Camargo, P. M., Caton, J. G., Clem, D. S., Fiorellini, J. P., Geisinger, M. L., Mills, M. P., Nares, S., & Nevins, M. L. (2015). Periodontal regeneration ‐ Intrabony defects: A consensus report from the AAP Regeneration Workshop. Journal of Periodontology, 86, S105– S107. 10.1902/jop.2015.140378 25315019 · DOI
  47. Roccuzzo, M., Marchese, S., Dalmasso, P., & Roccuzzo, A. (2018). Periodontal regeneration and orthodontic treatment of severely periodontally compromised teeth: 10‐year results of a prospective study. International Journal of Periodontics and Restorative Dentistry, 38, 801– 809. 10.11607/prd.3756 30304070 · DOI
  48. Sanz, I., Alonso, B., Carasol, M., Herrera, D., & Sanz, M. (2012). Nonsurgical treatment of periodontitis. The Journal of Evidence‐Based Dental Practice, 12, 76– 86. 10.1016/S1532-3382(12)70019-2 23040340 · DOI
  49. Serio, F. G., & Hawley, C. E. (1999). Periodontal trauma and mobility. Diagnosis and treatment planning. Dental Clinics of North America, 43, 37– 44. 9929798
  50. Shi, J., Zhou, Y., & Fu, M. (2003). Computer tomograghy study on periodontal patients with anterior displaced teeth before and after combined orthodontic‐periodontal treatment. Beijing Da Xue Xue Bao. Yi Xue Ban, 35, 659– 662. 14710266
  51. Sideri, S., Papageorgiou, S. N., & Eliades, T. (2018). Registration in the international prospective register of systematic reviews (PROSPERO) of systematic review protocols was associated with increased review quality. Journal of Clinical Epidemiology, 100, 103– 110. 10.1016/j.jclinepi.2018.01.003 29339215 · DOI · Paper page
  52. Wennström, J. L., Lindhe, J., Sinclair, F., & Thilander, B. (1987). Some periodontal tissue reactions to orthodontic tooth movement in monkeys. Journal of Clinical Periodontology, 14, 121– 129. 10.1111/j.1600-051x.1987.tb00954.x 3470318 · DOI
  53. Weston, P., Yaziz, Y. A., Moles, D. R., & Needleman, I. (2008). Occlusal interventions for periodontitis in adults. Cochrane Database of Systematic Reviews, 3. 10.1002/14651858.CD004968.pub2 18646117 · DOI
  54. Zasciurinskiene, E., Lund, H., Lindsten, R., Jansson, H., & Bjerklin, K. (2019). Outcome of periodontal‐orthodontic treatment in subjects with periodontal disease. Part II: a CBCT study of alveolar bone level changes. European Journal of Orthodontics, 41, 565– 574. 31276583
  55. Zasciurinskiene, E., Baseviciene, N., Lindsten, R., Slotte, C., Jansson, H., & Bjerklin, K. (2018). Orthodontic treatment simultaneous to or after periodontal cause‐related treatment in periodontitis susceptible patients. Part I: Clinical outcome. A randomized clinical trial. Journal of Clinical Periodontology, 45, 213– 224. 10.1111/jcpe.12835 29106749 · DOI
  56. Zhang, J., Zhang, A.‐M., Zhang, Z.‐M., Jia, J.‐L., Sui, X.‐X., Yu, L.‐R., & Liu, H.‐T. (2017). Efficacy of combined orthodontic‐periodontic treatment for patients with periodontitis and its effect on inflammatory cytokines: A comparative study. American Journal of Orthodontics and Dentofacial Orthopedics, 152, 494– 500. 10.1016/j.ajodo.2017.01.028 28962734 · DOI

Authors
Papageorgiou, S. N., Antonoglou, G. N., Michelogiannakis, D., Kakali, L., Eliades, T., & Madianos, P.
Affiliations
  • University of Zurich (CH)
  • Universidad Complutense de Madrid (ES)
  • University of Rochester Medicine (US)
  • National and Kapodistrian University of Athens (GR)
Corresponding author
Papageorgiou, Spyridon N.
ORCID
Venue
Journal of Clinical Periodontology
Publisher
Wiley
Published
2021-08-18
Volume
49
Issue
S24
Pages
102-120
ISSN
  • 0303-6979 (ISSN-L)
  • 1600-051X
DOI
10.1111/jcpe.13529
PMC
PMC9290963
OpenAlex
W3185424257
Cited by
75
References
67
Citations by year
2026: 16 · 2025: 18 · 2024: 15 · 2023: 18 · 2022: 7 · 2021: 1
FWCI
2.57
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal Of Clinical Periodontology (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by-nc)
  • Zurich Open Repository and Archive (University of Zurich)
Topics
  • Health Sciences › Dentistry › Orthodontics › Orthodontics and Dentofacial Orthopedics
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
Keywords
severe periodontitis, orthodontic treatment, clinical attachment level gain, probing depth, marginal bone level, papilla height, gingival phenotype, sex differences
MeSH terms
Female, Humans, Male, Periodontitis

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review