Orthodontic Management of Different Stages and Grades of Periodontitis According to the 2017 Classification of Periodontal Diseases.

Abstract

Background/Objectives: The 2017 Periodontal Classification offers a comprehensive framework for the diagnosis and management of periodontitis based on staging and grading criteria. Orthodontic therapy is increasingly incorporated into the management of periodontitis to rectify malocclusion, pathological tooth migration, and occlusal stability. Nonetheless, few data directly correspond with this revised classification scheme. The objective of this systematic review is to figure out the influence of orthodontic therapy on periodontal outcomes in patients with Stage III and IV periodontitis, as categorized by the 2017 framework. Methods: A systematic review was performed in accordance with the PRISMA 2020 principles. The databases examined were PubMed, Web of Science, Scopus, and Google Scholar. The evaluation focuses on research published from 2012 to 2024. Seventeen studies were assessed after the application of the inclusion criteria. Key outcomes included clinical attachment level (CAL) improvement, probing depth (PD) decrease, and radiographic bone fill. Results: The integration of orthodontic treatment with periodontal therapy markedly enhanced CAL (mean gain: 4.35-5.96 mm), decreased PD (mean reduction: 3.1-6.3 mm), and facilitated radiographic bone regeneration (mean vertical fill: 4.89 mm). Patients with Stage IV Grade C periodontitis had the most significant improvement, especially with early orthodontic intervention subsequent to regenerative treatment. Prolonged follow-ups (up to 10 years) validated consistent results. Conclusions: Orthodontic intervention, as a supplementary measure to periodontal therapy, improves results in severe periodontitis, especially in Stage III and IV patients. These results underscore the need for multidisciplinary teamwork and defined protocols for including orthodontics in periodontitis therapy.