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Relação da ortodontia e periodontologia : revisão narrativa
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Introdução: A relação entre ortodontia e periodontia em pacientes com periodontite estádio IV representa um desafio terapêutico significativo. A severidade da perda de inserção, as alterações funcionais e estéticas, e a necessidade de estabilidade a longo prazo exigem uma abordagem multidisciplinar cuidadosamente coordenada.
Objetivo: Avaliar, com base em evidência científica de alta qualidade, a segurança, eficácia e limitações da terapia ortodôntico-periodontal combinada em pacientes com periodontite avançada, respondendo a quatro questões clínicas fundamentais.
Metodologia: Realizou-se uma revisão narrativa baseada exclusivamente em revisões sistemáticas e ensaios clínicos randomizados e controlados publicados nos últimos anos, focando pacientes diagnosticados com periodontite estádio IV submetidos a tratamento ortodôntico.
Resultados: O tratamento ortodôntico deve ser iniciado apenas após controle completo da inflamação periodontal e estabilização óssea. Movimentos dentários em tecidos instáveis estão associados a risco aumentado de complicações. O uso de forças leves e controle rigoroso são essenciais para evitar efeitos adversos. O tempo de espera recomendado entre cirurgia regenerativa e ortodontia varia entre 1 e 6 meses. A estabilidade pós-tratamento depende de contenção prolongada, manutenção periodontal contínua e protocolos individualizados.
Conclusão: A combinação da ortodontia com a periodontia é viável e eficaz em pacientes com periodontite estádio IV, desde que baseada em critérios clínicos rigorosos, integração interdisciplinar e adesão ativa do paciente ao tratamento e à manutenção.
The relationship between orthodontics and periodontics in patients with stage IV periodontitis represents a significant therapeutic challenge. The severity of attachment loss, functional and aesthetic alterations, and the need for long-term stability require a carefully coordinated multidisciplinary approach. Objective: To evaluate, based on high-quality scientific evidence, the safety, effectiveness, and limitations of combined orthodontic-periodontal therapy in patients with advanced periodontitis, by addressing four key clinical questions. Methodology: A narrative review was conducted based exclusively on systematic reviews and randomized controlled clinical trials published in recent years, focusing on patients diagnosed with stage IV periodontitis who underwent orthodontic treatment. Results: Orthodontic treatment should only be initiated after complete control of periodontal inflammation and bone stabilization. Tooth movements in unstable tissues are associated with an increased risk of complications. The use of light forces and strict control is essential to avoid adverse effects. The recommended waiting time between regenerative surgery and orthodontic treatment varies between 1 and 6 months. Post-treatment stability depends on prolonged retention, continuous periodontal maintenance, and individualized protocols. Conclusion: The combination of orthodontics and periodontics is feasible and effective in patients with stage IV periodontitis, provided it is based on strict clinical criteria, interdisciplinary integration, and active patient adherence to treatment and maintenance.
The relationship between orthodontics and periodontics in patients with stage IV periodontitis represents a significant therapeutic challenge. The severity of attachment loss, functional and aesthetic alterations, and the need for long-term stability require a carefully coordinated multidisciplinary approach. Objective: To evaluate, based on high-quality scientific evidence, the safety, effectiveness, and limitations of combined orthodontic-periodontal therapy in patients with advanced periodontitis, by addressing four key clinical questions. Methodology: A narrative review was conducted based exclusively on systematic reviews and randomized controlled clinical trials published in recent years, focusing on patients diagnosed with stage IV periodontitis who underwent orthodontic treatment. Results: Orthodontic treatment should only be initiated after complete control of periodontal inflammation and bone stabilization. Tooth movements in unstable tissues are associated with an increased risk of complications. The use of light forces and strict control is essential to avoid adverse effects. The recommended waiting time between regenerative surgery and orthodontic treatment varies between 1 and 6 months. Post-treatment stability depends on prolonged retention, continuous periodontal maintenance, and individualized protocols. Conclusion: The combination of orthodontics and periodontics is feasible and effective in patients with stage IV periodontitis, provided it is based on strict clinical criteria, interdisciplinary integration, and active patient adherence to treatment and maintenance.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Tratamento ortodôntico Periodontite Migração dentária patológica Relação ortodontia-periodontologia