INFLUENCE OF ORTHODONTIC TOOTH MOVEMENT ON PERIODONTAL HEALTH IN PATIENTS WITH PREEXISTING CONDITIONS: A SYSTEMATIC REVIEW

Abstract

Background: Orthodontic tooth movement (OTM) is widely used to correct malocclusion and improve esthetics, but its effects on periodontal health, particularly in patients with preexisting conditions, remain a clinical concern. This systematic review synthesizes current evidence regarding periodontal outcomes associated with OTM.

Methods: Following PRISMA 2020 guidelines, electronic databases (PubMed, Scopus, Web of Science, Embase, Google Scholar) were searched for studies from 2018–2025. Inclusion criteria comprised human studies evaluating periodontal health during or after orthodontic treatment, including patients with periodontitis or cleft lip/palate. Data extraction included study design, sample characteristics, periodontal parameters, orthodontic interventions, and main findings. Quality was assessed using the Newcastle-Ottawa Scale and Cochrane Risk of Bias Tool.

Results: Ten studies involving 833 participants were included. Gingival phenotype, oral hygiene, and preexisting inflammation were identified as key determinants of recession and attachment loss. Clear aligners and controlled orthodontic forces were associated with improved periodontal outcomes. Patient knowledge and compliance positively influenced clinical indices. Long-term follow-up revealed persistent risk of recession, highlighting the importance of retention and supportive care. In patients with compromised periodontium or cleft lip/palate, integration of periodontal therapy and OTM improved both functional and structural outcomes.

Conclusion: OTM can be performed safely in periodontally stable patients, with risk mitigated through individualized force application, appliance selection, patient education, and multidisciplinary care. Long-term monitoring and maintenance are essential to preserve periodontal health.