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O tratamento ortodôntico em pacientes periodontais: revisão integrativa
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Objetivo: Nesta revisão integrativa da literatura, pretende-se analisar de forma abrangente a relação entre o tratamento ortodôntico e a condição periodontal dos pacientes, tanto em casos de periodonto saudável quanto em indivíduos com comprometimento periodontal. O objetivo é compreender os benefícios e riscos associados à movimentação dentária ortodôntica em diferentes contextos periodontais, e destacar a importância de uma abordagem multidisciplinar para garantir a eficácia e a segurança dos tratamentos.
Materiais e Métodos: Foi realizada uma pesquisa nas bases de dados eletrónicas, PubMed, Scopus, B-On e Online Library. Como critério de inclusão foram considerados apenas os artigos que abordassem em simultâneo a temática Ortodontia e Periodontologia, sendo excluídos todos os artigos que que não respeitassem o tema em estudo. Foram utilizados como filtros de pesquisa: artigos nos idiomas português, francês e inglês, artigos publicados nos últimos 10 anos e artigos free full text. A metodologia utilizada seguiu o modelo PRISMA, resultando na seleção de quinze artigos analisados de forma crítica.
Resultados: A literatura consultada mostra que o tratamento ortodôntico pode oferecer diversos benefícios em pacientes com comprometimento periodontal, como a melhora da distribuição das forças oclusais, correção de migrações dentárias patológicas e aumento da estabilidade periodontal, desde que realizado após o controle da inflamação e dentro de protocolos individualizados. Em contrapartida, o risco de complicações é maior nesses pacientes, incluindo reabsorção radicular, perda de inserção gengival e recessões, especialmente quando forças excessivas são aplicadas ou o controle periodontal é inadequado. Em pacientes com periodonto saudável, os benefícios da ortodontia incluem melhoria estética, funcional e preventiva, favorecendo o alinhamento dentário e a higiene oral. No entanto, também foram observadas complicações como gengivite, recessões e alterações transitórias na microbiota oral, particularmente em tratamentos com aparelhos fixos e sem protocolos de higiene bem monitorizados.
Conclusão: Os dados analisados sugerem que o tratamento ortodôntico pode ser benéfico tanto em pacientes saudáveis quanto periodontais, desde que conduzido com rigor, planeamento cuidadoso e acompanhamento interdisciplinar. A ortodontia, quando integrada numa abordagem periodontal adequada, pode contribuir para a reabilitação funcional e estética. Contudo, os riscos associados à movimentação dentária em tecidos comprometidos exigem vigilância constante e personalização terapêutica. Torna-se evidente a necessidade de mais estudos clínicos bem desenhados e de longo prazo para consolidar diretrizes seguras e eficazes para o tratamento ortodôntico em diferentes condições periodontais.
Objective: In this integrative literature review, we aim to comprehensively analyze the relationship between orthodontic treatment and the periodontal condition of patients, both in cases of healthy periodontium and in individuals with periodontal involvement. The aim is to understand the benefits and risks associated with orthodontic tooth movement in different periodontal contexts, and to highlight the importance of a multidisciplinary approach to ensure the effectiveness and safety of treatments. Materials and Methods: A search was performed in the electronic databases PubMed, Scopus, B-On and Online Library. As inclusion criteria, only articles that simultaneously addressed the themes of Orthodontics and Periodontics were considered, with all articles that did not respect the theme under study being excluded. The following search filters were used: articles in Portuguese, French and English, articles published in the last 10 years and free full text articles. The methodology used followed the PRISMA model, resulting in the selection of fifteen articles that were critically analyzed. Results: The literature consulted shows that orthodontic treatment can offer several benefits in patients with periodontal involvement, such as improving the distribution of occlusal forces, correcting pathological tooth migrations and increasing periodontal stability, as long as it is performed after controlling inflammation and within individualized protocols. In contrast, the risk of complications is greater in these patients, including root resorption, loss of gingival attachment and recessions, especially when excessive forces are applied or periodontal control is inadequate. In patients with healthy periodontium, the benefits of orthodontics include aesthetic, functional and preventive improvements, favoring dental alignment and oral hygiene. However, complications such as gingivitis, recessions and transient changes in the oral microbiota have also been observed, particularly in treatments with fixed appliances and without well-monitored hygiene protocols. Conclusion: The data analyzed suggest that orthodontic treatment can be beneficial in both healthy and periodontal patients, as long as it is conducted with rigor, careful planning and interdisciplinary monitoring. Orthodontics, when integrated with an adequate periodontal approach, can contribute to functional and aesthetic rehabilitation. However, the risks associated with tooth movement in compromised tissues require constant monitoring and therapeutic personalization. The need for more well-designed, long-term clinical studies to consolidate safe and effective guidelines for orthodontic treatment in different periodontal conditions becomes evident.
Objective: In this integrative literature review, we aim to comprehensively analyze the relationship between orthodontic treatment and the periodontal condition of patients, both in cases of healthy periodontium and in individuals with periodontal involvement. The aim is to understand the benefits and risks associated with orthodontic tooth movement in different periodontal contexts, and to highlight the importance of a multidisciplinary approach to ensure the effectiveness and safety of treatments. Materials and Methods: A search was performed in the electronic databases PubMed, Scopus, B-On and Online Library. As inclusion criteria, only articles that simultaneously addressed the themes of Orthodontics and Periodontics were considered, with all articles that did not respect the theme under study being excluded. The following search filters were used: articles in Portuguese, French and English, articles published in the last 10 years and free full text articles. The methodology used followed the PRISMA model, resulting in the selection of fifteen articles that were critically analyzed. Results: The literature consulted shows that orthodontic treatment can offer several benefits in patients with periodontal involvement, such as improving the distribution of occlusal forces, correcting pathological tooth migrations and increasing periodontal stability, as long as it is performed after controlling inflammation and within individualized protocols. In contrast, the risk of complications is greater in these patients, including root resorption, loss of gingival attachment and recessions, especially when excessive forces are applied or periodontal control is inadequate. In patients with healthy periodontium, the benefits of orthodontics include aesthetic, functional and preventive improvements, favoring dental alignment and oral hygiene. However, complications such as gingivitis, recessions and transient changes in the oral microbiota have also been observed, particularly in treatments with fixed appliances and without well-monitored hygiene protocols. Conclusion: The data analyzed suggest that orthodontic treatment can be beneficial in both healthy and periodontal patients, as long as it is conducted with rigor, careful planning and interdisciplinary monitoring. Orthodontics, when integrated with an adequate periodontal approach, can contribute to functional and aesthetic rehabilitation. However, the risks associated with tooth movement in compromised tissues require constant monitoring and therapeutic personalization. The need for more well-designed, long-term clinical studies to consolidate safe and effective guidelines for orthodontic treatment in different periodontal conditions becomes evident.
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Periodontite Implicação ortodôntica Interação entre periodontite e ortodontia Inter-relação ortodontia-periodontia Periodontitis Orthodontic implication Interaction between periodontitis and orthodontics Interrelationship between orthodontics and periodontics