Potential periodontal consequences during orthodontic tooth movement in orthognathic surgery

The purpose of this clinical investigation is to underline the importance which has interdisciplinary consultation and collaboration between specialists in various branches of dentistry, above all in orthodontics and periodontics. The Authors focus on surgical orthodontic treatment possibilities, limitations and risks in patients with periodontal problems. A sample of 53 adult patients with optimal oral hygiene and another one of 50 with bad oral hygiene were considered. In patients with excellent oral hygiene and the absence or the continuous control of periodontal disorders didn’t show significant limitations and periodontal risks. Only during extreme orthodontic expansion or incisor decompensation in orthognatic surgery the crestal bone didn’t follow the connective tissue attachment causing recessions. In the presence of poor oral hygiene and of active periodontal disease with reduced alveolar bone the orthodontic treatment posed a significant risk of periodontal breakdown. The interdisciplinary dental team work between periodontist and orthodontist is very important when planning treatment of dental and skeletal malocclusions. The orthodontic treatment should be terminated if patients are at great risk of developing periodontal breakdown and attachment loss.