Guided Tissue Regeneration and Orthodontics. A Review of the Literature

Abstract

Guided tissue regeneration is a common form of treatment in dentistry nowadays. The orthodontist will inevitably have to deal with patients needing such therapy more often in the future. This review of the literature addresses the question of whether and if so, how patients with these medical requirements can be treated. We have systematically reviewed the current literature for recommendations, guidelines and problems associated with this treatment. Our data evaluation led us to conclude that such treatment is possible, and that it delivers promising results. However, more basic research on this interdisciplinary therapy should be carried out to identify and reduce risks and offer the patient greater safety during orthodontic treatment.

Effect of orthodontic treatment on the periodontal tissues

“…The clinical outcomes of this combined approach are promising, with increased connective tissue attachment levels reported in selected cases . A recent review of the literature, however, identified significant methodological heterogeneity and a lack of high‐quality studies in this area . Encouragingly, the use of bone substitutes to treat localized periodontal defects and augment atrophied alveolar ridges does not seem to have an adverse effect on orthodontic tooth movement in animals .…”

Orthodontic Treatment After Induced Periodontal Regeneration in Deep Infrabony Defects

“…Moreover, the literature revealed that light continuous forces (5 to 15 g) were recommended in a compromised periodontum, and the range of the commencement of tooth movement after periodontal surgery ranged from 7 days to 1 year 20‐29 . Lack of information about the effective and safe timing in which to start the movement probably justified this huge range; in fact, severe root and bone resorption could be the major negative effects of moving teeth in immature bone.…”

Optimization of the periodontal attachment before orthodontic treatment

“…Melsen et al, on the other hand, show that decreased periodontal orthodontic movement may promote periodontal regeneration and bone apposition in intrusion movements with low and constant periodontal pressures 11,12 These clinical findings are confirmed by animal experiments 2,15 . Tissue regeneration techniques induced with EMD allow attachment gains of 1.08 mm compared to the control group at 1 year and of 1.2 mm when EMD is added to autogenous bone 18 , which represents a significant gain at the root level.…”