Evidence-based care in orthodontics and periodontics: a review of the literature.
BACKGROUND
In this article, the author reviews the evidence-based literature in the fields of periodontics and orthodontics to clarify the relationship between orthodontic tooth movement and various types of common periodontal disorders.


METHODS
The first section is a review of the literature on common periodontal disorders. The second is a review of evidence-based studies in the combined fields of orthodontics and periodontics, with a focus on orthodontic treatment possibilities, limitations and risks inherent in patients with periodontal disorders, particularly active periodontal disease.


RESULTS
The literature on orthodontic tooth movement as it relates to periodontal disease shows that proper orthodontic treatment in patients with excellent oral hygiene and the absence of significant periodontal disorders should not pose any significant periodontal risk. In the presence of poor oral hygiene, however, and under circumstances of certain types of periodontal disorders, fixed orthodontic appliances and tooth movement can contribute to significant deleterious periodontal consequences.


CONCLUSIONS
This review provides a clear understanding of what is known about orthodontic treatment possibilities, limitations and inherent risks in patients who may have certain types of periodontal disorders. It also underscores the importance of teamwork among the restorative dentist, periodontist and orthodontist when planning treatment for these patients. The author also offers a specific patient management protocol for this interdisciplinary dental team to follow.
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D002985:Clinical Protocols; D000075202:Contraindications; D019317:Evidence-Based Medicine; D006801:Humans; D008310:Malocclusion / Q000150:complications; D009910:Oral Hygiene; D009967:Orthodontic Appliances; D009971:Orthodontics, Corrective / Q000009:adverse effects; D010348:Patient Care Team; D010510:Periodontal Diseases / Q000150:complications / Q000209:etiology; D012307:Risk Factors; D012308:Risk Management