THE IMPACT OF ORTHODONTIC MOVEMENT ON PERIODONTAL HEALTH

Abstract

Introduction: The high demand for orthodontic treatments combined with the rising prevalence of periodontal diseases, particularly among adults, underscores the relevance of executing orthodontic tooth movement through careful and interdisciplinary planning, especially in patients with prior periodontal compromise. Lack of knowledge regarding the biological limits of the periodontium, coupled with inadequate force application, can contribute to significant complications such as root resorption, bony dehiscences, and fenestrations, the latter two being predisposing factors for gingival recession. Aim: This literature review aims to critically analyze the impacts of orthodontic tooth movement on periodontal health, highlighting the biological mechanisms involved, the associated risk factors, and the importance of integrating Orthodontics and Periodontics for safe and scientifically grounded clinical planning. Materials and Methods: This study is a qualitative literature review conducted between August and November 2025, utilizing scientific publications available on PubMed and Google Scholar. Articles published in English and Portuguese between 2014 and 2025 were included. Results: The impact of orthodontic movement on the periodontium is a complex interaction, directly related to factors such as the intensity, direction, and duration of the forces applied, as well as the individual tissue response. The movement itself promotes the remodeling of the periodontal ligament and alveolar bone. However, excessive or prolonged forces can exceed the periodontium’s adaptation capacity, leading to hyalinization, local necrosis, and root resorption. Inappropriate movements, such as excessive labial tipping, can predispose to gingival recession, particularly when a thin vestibular bone plate is present. Conversely, well-planned and executed orthodontics, using light and continuous forces and interdisciplinary collaboration (perio-ortho), does not compromise periodontal health and can be beneficial, potentially eliminating occlusal trauma and providing clinical attachment gain in specific circumstances. Conclusion: Orthodontic tooth movement is an essentially physiological process that requires stringent clinical management. The success of the treatment depends on biomechanical control and respecting the individual anatomical and biological limits, thereby preventing damage and allowing orthodontics to contribute positively to long-term periodontal health.