Effect of orthodontic therapy in periodontitis and non-periodontitis patients: a systematic review with meta-analysis.

AIM: To answer these PICO questions: #1: In adult patients with malocclusion, what are the effects of orthodontic tooth movement (OTM) on clinical attachment level (CAL) changes in treated periodontitis patients with a healthy but reduced periodontium compared to non-periodontitis patients? #2: In adult patients with treated periodontitis and malocclusion, which is the efficacy of skeletal anchorage devices compared to conventional systems in terms of orthodontic treatment outcomes? MATERIAL AND METHODS: Seven databases were searched until June 2020 looking for randomized, non-randomized trials and case series. Mean effects (ME) and 95% confidence intervals (CIs) were calculated. RESULTS: Twenty-six studies with high risk of bias were included. PICO#1: In 26 patients without periodontitis and in 69 treated periodontitis patients, minimal changes in periodontal outcomes were reported after orthodontic therapy (p > 0.05). A significant CAL gain (mm) (ME = 3.523; 95% CI [2.353; 4.693]; p < 0.001) was observed in 214 patients when periodontal outcomes were retrieved before a combined periodontal and orthodontic therapy. PICO#2: Orthodontic variables were scarcely reported, and objective assessment of the results on orthodontic therapy was missing. CONCLUSIONS: Based on a small number of low-quality studies, in non-periodontitis and in stable treated periodontitis patients, OTM had no significant impact on periodontal outcomes.