Journal of clinical periodontology · 2026
The Effect of Orthodontic Tooth Movement on Intrabony Periodontal Defects After Guided Tissue Regeneration. Part II: The Evaluation of Clinical and Radiological Parameters in a Randomised Controlled Clinical Trial.
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Nagy Pal, Dobos Andrea, Nemes Balint, Kover Krisztian, Windisch Peter
Аннотация
AIM: To clinically and radiologically evaluate the healing capacity of intrabony periodontal defects treated with guided tissue regeneration (GTR) with or without the combination of orthodontic tooth movement (OTM).
MATERIALS AND METHODS: Thirty-four individuals presenting with periodontal intrabony defects (IDs) and pathological tooth migration (PTM) were included in this randomised controlled clinical trial. Extended, coronally advanced flaps and GTR (collagen membrane and bovine bone mineral) were used to treat IDs. After surgery, patients were randomly allocated to either the test group (n = 17) with an early (1 week postoperatively) initiation of OTM or the control group (n = 17) without any tooth movement. Outcome variables comprised changes in clinical attachment level (CAL), probing pocket depth (PPD), gingival recession (GR), probing bone level and intrabony component (IC).
RESULTS: Both groups yielded statistically significant CAL gain (4.0 ± 2.0 mm in the test group and 4.4 ± 1.3 mm in the control group) and PPD reduction (3.9 ± 1.4 and 4.9 ± 1.7 mm, respectively) as well as IC reduction. However, only the control group showed a significant increase in GR and crestal bone loss from baseline to the endpoint. The change in IC was -4.3 ± 2.0 mm in the test group and -4.6 ± 1.8 mm in the control group, corresponding to 66% and 64.5% intrabony fill, respectively. All evaluated parameters showed comparable changes between the two groups, with no evidence of clinically meaningful differences.
CONCLUSIONS: GTR combined with OTM resulted in similar clinical endpoint parameters after 9 months of healing compared with GTR alone. This clinical result confirms the histological findings (Part I article) that early initiation of OTM is feasible.
MATERIALS AND METHODS: Thirty-four individuals presenting with periodontal intrabony defects (IDs) and pathological tooth migration (PTM) were included in this randomised controlled clinical trial. Extended, coronally advanced flaps and GTR (collagen membrane and bovine bone mineral) were used to treat IDs. After surgery, patients were randomly allocated to either the test group (n = 17) with an early (1 week postoperatively) initiation of OTM or the control group (n = 17) without any tooth movement. Outcome variables comprised changes in clinical attachment level (CAL), probing pocket depth (PPD), gingival recession (GR), probing bone level and intrabony component (IC).
RESULTS: Both groups yielded statistically significant CAL gain (4.0 ± 2.0 mm in the test group and 4.4 ± 1.3 mm in the control group) and PPD reduction (3.9 ± 1.4 and 4.9 ± 1.7 mm, respectively) as well as IC reduction. However, only the control group showed a significant increase in GR and crestal bone loss from baseline to the endpoint. The change in IC was -4.3 ± 2.0 mm in the test group and -4.6 ± 1.8 mm in the control group, corresponding to 66% and 64.5% intrabony fill, respectively. All evaluated parameters showed comparable changes between the two groups, with no evidence of clinically meaningful differences.
CONCLUSIONS: GTR combined with OTM resulted in similar clinical endpoint parameters after 9 months of healing compared with GTR alone. This clinical result confirms the histological findings (Part I article) that early initiation of OTM is feasible.