Spyridon Papageorgiou; Georgios Antonoglou; Theodore Eliades; Conchita Martin; Mariano Sanz
Journal of the World Federation of Orthodontists, Volume 14, Issue 6, 2025, Pages 578-579, ISSN 2212-4438, Published: December 2025
https://doi.org/10.1016/j.ejwf.2025.07.562
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Abstract:
Background & Aim
Periodontitis stage IV patients are often characterized by pathologic tooth migration, including posterior bite collapse pathologically migrated teeth, posterior bite collapse, secondary occlusal trauma, drifting, or flaring—and many patients present secondary malocclusions that require interdisciplinary treatment with orthodontics. This study investigated if combining periodontal anti-inflammatory treatment for stage IV periodontitis with orthodontic correction is beneficial to the patient.
Methods
Nine databases were searched up to November 2024. After duplicate study selection, data extraction, and risk-of-bias assessment, random-effect meta-analyses of mean differences (MDs) / Standardized Mean Differences (SMDs) / Odds Ratios (ORs) and 95% confidence intervals (CIs) were performed.
Results
Forty studies were included, covering a total of 1608 patients, 38.9% male, and with average age of 44.8 years. Compared to periodontal treatment alone, the combined periodontal-orthodontic treatment was associated with improved clinical attachment level (MD:-0.35; 95%-CI:-0.55 to -0.14; P<0.001), pocket probing depth (MD:-0.67; 95-CI:-1.07 to -0.27; P=0.001), gingival inflammation (SMD:-2.17; 95-CI:-2.71 to -1.63; P<0.001), radiographic bone level (MD:-0.06; 95-CI:-0.11 to -0.01; P=0.01), tooth mobility (OR:0.20; 95-CI:0.08 to 0.52; P<0.001), treatment failure (OR:0.14; 95-CI:0.05 to 0.42; P<0.001), and patient-reported mastication / esthetics / comfort (MDs:0.41-0.71; P<0.001).
Conclusions
Orthodontic management of these patients is complex and requires coordination between the periodontal and orthodontic specialist, while careful considerations pertaining to appliance choice and mechanotherapy, as well as post-treatment maintenance protocols are needed. Orthodontic treatment is beneficial in the treatment of adult patients with severe (stage IV) periodontitis in terms of periodontal outcomes, patient satisfaction, and long-term stability.
Utilisation des équipements
Cette revue systématique avec méta-analyse compare le traitement parodontal–orthodontique combiné au traitement parodontal seul chez des patients atteints de parodontite de stade IV. Elle synthétise des données cliniques plutôt que de décrire une expérience originale utilisant un appareil. Le résumé disponible ne précise aucun rôle du Mach-1 Mechanical Tester ni protocole d’essai instrumental.
