The relationships between malocclusion, fixed orthodontic appliances and periodontal disease. A review of the literature.

AIMS: To review the literature on the periodontal implications of malocclusion and fixed orthodontic appliances.

METHODS

The PubMed database was searched for original articles on 'orthodontics and gingivitis/periodontology/plaque/ microbiology/histology', 'bracket and gingivitis/periodontology/plaque/microbiology/histology', 'crowding/spacing/overbite/overjet/open bite/crossbite traumatic occlusion and gingivitis/periodontology/plaque/microbiology/histology'. Only articles published between 1970 and 30 April 2007 were used. The search was augmented by screening the references cited in each paper for additional articles that might have been missed by the electronic search.

RESULTS/

CONCLUSIONS

Dental plaque is the primary cause of gingival inflammation and periodontitis. Conditions that encourage the growth and retention of dental plaque result in a localised gingivitis, which rarely progresses to periodontal disease. Only a few studies report attachment loss during orthodontic treatment. The contradictory findings on the impact of malocclusion and orthodontic appliances on periodontal health may be partly due to the selection of materials and differences in the research methods employed.