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Published on: December 31, 2017
Orthodontic Treatment-Induced Periodontal, Microbiological, and Local Inflammatory Changes: A Systematic Review and
Dragos-Mihai Gavrilescu1, Diana-Maria Mateescu2, Andrei Marginean3
1Department of Orthodontics, Dental District, Strada Zăgazului Nr. 3, One Floreasca Vista, Sector 1, 014261 Bucharest, Romania.
Biomedicines
|June 26, 2026
Summary
Orthodontic treatment with fixed appliances temporarily worsens periodontal health and shifts the oral microbiome toward harmful bacteria. These effects are reversible with proper preventive care and monitoring.
Area of Science:
- Periodontology
- Microbiology
- Biomaterials
Background:
- Orthodontic treatment involves mechanical forces impacting the periodontal environment.
- Changes in oral microbiota and inflammatory pathways occur during orthodontic treatment.
- The full biological impact of orthodontic appliances is not well-quantified.
Purpose of the Study:
- To systematically review and meta-analyze periodontal parameters, oral microbiota, and inflammatory biomarkers during orthodontic treatment.
- To assess the impact of fixed appliances and clear aligners on the periodontal environment.
- To provide a GRADE-rated evidence base for clinical practice.
Main Methods:
- Systematic review and meta-analysis following PRISMA 2020 guidelines.
- Searched PubMed/MEDLINE, Scopus, and Web of Science.
- Included prospective cohort, longitudinal clinical, and randomized controlled trials.
- Performed quantitative synthesis of within-group (pre-post) changes.
Main Results:
- Fixed appliances correlated with increased plaque index, gingival index, and bleeding on probing.
- Microbiota shifts showed increased periodontopathogenic species like S. mutans and Porphyromonas spp.
- Elevated IL-1β and IL-6 levels were observed in gingival crevicular fluid.
- Evidence certainty was moderate for periodontal indices, low for microbiological and inflammatory outcomes.
Conclusions:
- Orthodontic treatment, especially with fixed appliances, causes transient periodontal deterioration and oral dysbiosis.
- These treatment-associated changes are reversible with preventive protocols and monitoring.
- Further research with control groups and standardized measures is needed.
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