How Do The Periodontal Tissues React During The Orthodontic Alignment and Leveling Phase?

Introduction: orthodontic tooth alignment and leveling are usually the first two stages when an orthodontic treatment is to be initiated. The process of alignment is accomplished by uncontrolled tipping of teeth into a smooth arch and the process of leveling is accomplished by intrusion or extrusion of the teeth so that the upper and lower teeth come together. The aim of this study was to find out whether the orthodontic tooth alignment and leveling phase has negative effects on the periodontal tissues. Subjects and Methods: 10 patients having simple to moderate front teeth crowding were recruited in the study with a total of 120 teeth (10 groups of upper and 10 groups of lower front teeth). The frontal crowded teeth were subjected to a conventional orthodontic alignment and leveling movements by means of a round 16 NiTi wire for the first step and gradually into a rectangular 18 NiTi wire for the second step. The status of the periodontal tissues around the examined teeth was determined by clinical periodontal assessments including Plaque Index (PI), Papillary Bleeding Index (PBI), Probing Depth (PD) and Gingival Index (GI). After 6 months, the orthodontic tooth alignment and leveling phase was completed. Results: in the upper jaw, the Plaque Index increased significantly after 6 months at the buccal, mesial and distal sites of the teeth. The probing depth also increased significantly after 6 months at the buccal site. In the lower jaw, the Plaque Index increased significantly after 6 months at the vestibular, mesial and distal sites. The probing depth also increased significantly after 1, 3 and 6 months at the lingual sites and after 1 and 6 months at the mesial sites. The Gingival Index showed an increase after 6 months only at the distal sites. All the periodontal parameters have been shown to be normal, reflecting a healthy status of the periodontal tissues. Conclusions: during the orthodontic tooth alignment and leveling phase, no considerable negative effects on the periodontal tissues could be noted. The good oral hygiene of the patients during the period of study played an important role in keeping the periodontal parameters within normal limits. Further histological studies are needed to examine the tissue alterations during different phases of the orthodontic treatment. Correspondence to: