The clinical benefits of orthodontic treatment to pathologically migrated teeth: A systematic review

Abstract

The present systematic review aimed to assess the evidence related to the periodontal benefits of orthodontic treatment of pathologically migrated teeth in combination with periodontal therapy with or without a regenerative procedure.

Electronic databases (PubMed, Embase and Cochrane) were searched up to March 21, 2019. Selection criteria included human studies in which pathologically migrated maxillary teeth were repositioned with orthodontic fixed appliances after periodontal therapy. Clinical trials not reporting a quantitative measurement of clinical attachment gain were excluded.

The search strategy identified 90 relevant articles. After selection according to the inclusion/exclusion criteria, 15 articles qualified for the final analysis of which five were clinical trials and 10 were case series or reports. Five studies could be classified as providing a moderate level of evidence (33%), while 10 were classified as low levels of evidence (67%). None of the studies were classified as providing a high-level of evidence,

Based on the limited available evidence, orthodontic treatment had a fundamental role in the resolution of anterior pathologic tooth migration. Gains were seen in clinical attachment levels with accompanying improved aesthetic and functional final results. However, it was not possible to make any recommendations regarding the use of a specific regenerative procedure to improve the clinical results obtained by a combination of periodontal and orthodontic therapies. The most recurrent sources of bias were the absence of a control group and limited adequate examinations before and after treatment.