Comment l’orthodontie favorise la régénération des lésions parodontales ?

Revue Réalités Cliniques / 26/06/2017
Les migrations dentaires secondaires consécutives aux parodontites représentent un motif de consultation important. Les thérapeutiques orthodontiques peuvent remédier à ces déplacements mais ne peuvent le faire que dans un contexte de parodonte assaini. Ces malpositions sont souvent associées à des lésions intra-osseuses qu’il convient de traiter par des techniques de régénération parodontale. Les processus biologiques mis en jeu dans la cicatrisation des traitements parodontaux sont proches de ceux induits par le remodelage osseux orthodontique. L’association de ces principes thérapeutiques permet d’agir de façon synergique sur la résolution des lésions osseuses et sur le repositionnement correct des structures dentaires. Les différents moyens orthodontiques fixes ou amovibles sont discutés et le moment de leur mise en œuvre sera fonction de la réponse biologique parodontale.

Implication clinique
L’orthodontie a toute sa place dans une thérapeutique parodontale afin d’optimiser le résultat clinique et sa pérennité.


1. Sallum EJ, Nouer DF, Klein MI, Gonçalves RB, Machion L, Wilson Sallum A, Sallum EA. Clinical and microbiologic changes after removal of orthodontic appliances. Am J Orthod Dentofacial Orthop. 2004;126:363-366.
2. Lee SM, Yoo SY, Kim HS, Kim KW, Yoon YJ, Lim SH, Shin HY, Kook JK. Prevalence of putative periopathogens in subgingival plaques from gingivitis lesions in Korean orthodontic patients. J Microbiol. 2005;43(3):260-5.
3. Lauritano D, Caccianiga G. Periodontal aspects in orthodontics. OA Dentistry. 2013 ;1 :1-8
4. Lindhe J, Svanberg G. Influence of trauma from occlusion on progression of experimental periodontitis in the beagle dog. J Clin Periodontol. 1974;1:3-14.
5. Glickman I Clinical significance of trauma from occlusion. J periodontol 1965:70;607-618.
6. Wennström JL, Stokland BL, Nyman S, Thilander B. Periodontal tissue response to orthodontic movement of teeth with infrabony pockets. Am J Orthod Dentofacial Orthop. 1993;103:313-319.
7. Harrel SK, Nunn ME The effect of occlusal discrepancies on periodontitis. II. Relationship of occlusal treatment to the progression of periodontal disease. J Periodontol. 2001 Apr;72(4):495-505.
8. Speer C, Pelz K, Hopfenmuller W, Holtgrave E-A. Investigation on the influencing of the Subgingival Microflora in chronic periodontitis. A study in adult patients during fixed appliance therapy. J Orofac Orthop. 2004;65:34–47.
9. Re S, Corrente G, Abundo R, Cardaropoli D. Orthodontic treatment in periodontally compromised patients: 12-year report. Int J Periodontics Restorative Dent. 2000;20(1):31-9.
10. Listgarten MA. Electron microscopic study of the junction between surgically denuded root surfaces and regenerated periodontal tissues. J Periodontal Res. 1972;7:68-90.
11. Melcher AH. On the repair potential of periodontal tissues. J Periodontol. 1976;47(5):256-60.
12. Nyman S, Lindhe J, Karring T, Rylander H. New attachment following surgical treatment of human periodontal disease. J Clin Periodontol. 1982;9:290-6.
13. Gottlow J, Nyman S, Karring T, Lindhe J. New attachment formation as the result of controlled tissue regeneration. J Clin Periodontol. 1984: 11: 494-503.
14. Needleman IG, Worthington HV, Giedrys-Leeper E, Tucker RJ. Guided tissue regeneration for periodontal infra-bony defects. Cochrane Database Syst Rev 2006: 19: CD001724.
15. Laurell L, Bose M, Graziani F, Tonetti M, Berglundh T. The structure of periodontal tissues formed following guides tissue regeneration therapy of intrabony defects in the monkey. J Clin Periodontol. 2006;33(8):596-603.
16. Sculean A, Nikolidakis D, Schwarz F. Regeneration of periodontal tissues: combinations of barrier membranes and grafting materials - biological foundation and preclinical evidence: a systematic review. J Clin Periodontol. 2008 Sep;35(8 Suppl):106-16.
17. Bosshardt DD. Biological mediators and periodontal regeneration: A review of enamel matrix proteins at the cellular and molecular levels. J Clin Periodontol. 2008;35(Suppl. 8):87-105.
18. Koop R, Merheb J, Quirynen M. Periodontal regeneration with enamel matrix derivative in reconstructive periodontal therapy: a systematic review. J Periodontol. 2012 Jun;83(6):707-20.
19. Heijl L, Heden G, Svärdström C, Ostgren A. Enamel matrix derivate (Emdogain) in the treatment of intrabony periodontal defects. J Clin Periodontol. 1997: 24: 705-714.
20. Yukna R, Mellonig JT. Histologic evaluation of periodontal healing in humans following regenerative therapy with enamel matrix derivative. A 10-case series. J Periodontol. 2000: 71: 752-759.
21. Reynolds MA, Kao RT, Camargo PM, Caton JG, Clem DS, Fiorellini JP, Geisinger ML, Mills MP, Nares S, Nevins ML. Periodontal regeneration - intrabony defects: a consensus report from the AAP Regeneration Workshop. J Periodontol. 2015 Feb;86(2 Suppl):S105-7.
22. Melsen B. Limitations in adult orthodontics. In: Melsen B, ed. Current controversies in orthodontics. Chicago: Quintessence, 1991:147-180.
23. Cattaneo PM, Dalstra M, Melsen B. Strains in periodontal ligament and alveolar bone associated with orthodontic tooth movement analyzed by finite element. Orthod Craniofac Res. 2009;12:120–128.
24. Feller L, Khammissa RA, Schechter I, Thomadakis G, Fourie J, Lemmer J. Biological Events in Periodontal Ligament and Alveolar Bone Associated with Application of Orthodontic Forces. ScientificWorldJournal. 2015;2015:876509.
25. Krishnan V, Davidovitch Z. On a path to unfolding the biological mechanisms of orthodontic tooth movement. J Dent Res. 2009 Jul;88(7):597-608.
26. Zhang P, Wu Y, Jiang Z, Jiang L, Fang B. Osteogenic response of mesenchymal stem cells to continuous mechanical strain is dependent on ERK1/2-Runx2 signaling. Int J Mol Med. 2012;29(6):1083-9.
27. Niklas A, Proff P, Gosau M, Römer P. The role of hypoxia in orthodontic tooth movement. Int J Dent. 2013;2013:841840.
28. Boas Nogueira AV, Chaves de Souza JA, Kim YJ, Damião de Sousa-Neto M, Chan Cirelli C, Cirelli JA. Orthodontic force increases interleukin-1b and tumor necrosis factor-a expression and alveolar bone loss in periodontitis. J Periodontol. 2013 Sep;84(9):1319-26.
29. Nogueira AVB, de Molon RS, Nokhbehsaim M, Deschner J, Cirelli JA. Contribution of biomechanical forces to inflammation-induced bone resorption. J Clin Periodontol 2017; 44:31-41.
30. Ingber JS. Forced eruption. I. A method of treating isolated one and two wall infrabony osseous defectsrationale and case report. J Periodontol. 1974;45:199-206.
31. Brown IS. The effect of orthodontic therapy on certain types of periodontal defects. I. Clinical findings. J Periodontol. 1973;44:742-756.
32. Melsen B, Agerbaek N, Markenstam G. Intrusion of incisors in adult patients with marginal bone loss. Am J Orthod Dentofacial Orthop. 1989;96:232-241.
33. Corrente G, Abundo R, Re S, Cardaropoli D, Cardaropoli G. Orthodontic movement into infrabony defects in patients with advanced periodontal disease: A clinical and radiological study. J Periodontol. 2003;74:1104-1109.
34. Ogihara S, Wang HL. Periodontal regeneration with or without limited orthodontics for the treatment of 2- or 3-wall infrabony defects. J Periodontol. 2010;81:1734-1742.
35. Cardaropoli D, Re S, Manuzzi W, Gaveglio L, Cardaropoli G. Bio-Oss collagen and orthodontic movement for the treatment of infrabony defects in the esthetic zone. Int J Periodontics Restorative Dent. 2006;26:553-559.
36. Cirelli JA, Cirelli CC, Holzhausen M, Martins LP, Brandao CH. Combined periodontal, orthodontic, and restorative treatment of pathologic migration of anterior teeth. A case report. Int J Periodontics Restorative Dent. 2006;26:501-506.
37. Ghezzi C, Masiero S, Silvestri M, Zanotti G, Rasperini G. Orthodontic treatment of periodontally involved teeth after tissue regeneration. Int J Periodontics Restorative Dent. 2008;28:559-567.
38. Schenk RK, Buser D Hardwick WR, Dahlin C Healing pattern of bone regeneration in membrane-protected defects: a histologic study in the canine mandible. Int J Oral Maxillofac Implants. 1994;9:13-29.
39. Diedrich P, Fritz U, Kinzinger G, Angelakis J. Movement of periodontally affected teeth after guided tissue regeneration (GTR) An experimental pilot study in animals. J Orofac Orthop. 2003;64:214-227.
40. Re S, Corrente G, Abundo R, Cardaropoli D. Orthodontic movement into bone defects augmented with bovine bone mineral and fibrin sealer: a reentry case report. Int J Periodontics Restorative Dent. 2002;22(2):138-45.
41. Ahn HW, Ohe JY, Lee SH, Park YG, Kim SJ. Timing of force application affects the rate of tooth movement into surgical alveolar defects with grafts in beagles.Am J Orthod Dentofacial Orthop. 2014;145:486-495.
42. Attia MS, Shoreibah EA, Ibrahim SA, Nassar HA. Histological evaluation of osseous defects combined with orthodontic tooth movement. J Int Acad Periodontol. 2012 Jan;14(1):7-16.
43. Attia MS, Shoreibah EA, Ibrahim SA, Nassar HA. Regenerative therapy of osseous defects combinedwith orthodontic tooth movement. J Int Acad Periodontol. 2012 Jan;14(1):17-25.
44. Ghezzi C, Viganò VM, Francinetti P, Zanotti G, Masiero S. Orthodontic Treatment After Induced Periodontal Regeneration in Deep Infrabony Defects. Clinical Advances in Periodontics. 2013;3:24-31.
45. Cao T, Xu L, Shi J, Zhoud Y.Combined orthodontic-periodontal treatment in periodontal patients with anteriorly displaced incisors. Am J Orthod Dentofacial Orthop. 2015;148:805-13.
46. Han JY. A comparative study of combined periodontal and orthodontic treatment with fixed appliances and clear aligners in patinet with periodontitis. J Periodontal Implant Sci. 2015;45: 193-204.
47. Gkantidis N, Christou P, Topouzelis N. The orthodontic-periodontic interrelationship in integrated treatment challenges: A systematic review. J Oral Rehabil 2010;37:377-390.
48. Nakao K, Goto T, Gunjigake KK, Konoo T, Kobayashi S,Yamaguchi K. Intermittent force induces high RANKL expression in human periodontal ligament cells. J Dent Res. 2007;86:623-628.
49. Proffit WR, Fields HW Jr. Contemporary Orthodontics. 3rd edition. Mosby; 2000:296-361, 594-614.
52. Castroflorio T, Gamerro EF, Caviglia GP, Deregibus A. Biochemical markers of bone metabolism during early orthodontic tooth movement with aligners. Angle Orthod. 2017;87:74–81
50. Kuncio D, Maganzini A, Shelton C, Freeman K. IInvisalign and traditional orthodontic treatment postretention outcomes compared using the American Board of Orthodontics objective grading system. Angle Orthod. 2007 Sep;77(5):864-9.
51. Rossini G, Parrinia S, Castroflorio T, Deregibus A, Debernardi CL. Efficacy of clear aligners in controlling orthodontic tooth movement: A systematic review Angle Orthod. 2015;85(5):881-9.
53. Karkhanechi M, Chow D, Sipkin J Sherman D, Boylan RJ, Norman RG, Craig RG, Cisneros GJ. Status of adult patients treated with fixed buccal appliances and removable aligners over one Year of active orthodontic therapy. Angle Orthod. 2013;83:146-151.

Consulter cet article

Mot de passe oublié / Aide
Devenir membre
12/03/2018 - PRATICIENS - OFFRES D'EMPLOIS - Paris et banlieue Cabinet ODF, cherche collaborateur salarié temps partiel. Email :
16/04/2018 - CABINETS VENTES LOCATIONS - Province et communauté Vends cabinet 35, dans une maison médicale 13km sud de Rennes,commune en pleine expansion, Logo sw, pas de salarié, pas de leasing, matériel ...
18/04/2018 - CABINETS VENTES LOCATIONS - Paris et banlieue Cause retraite, vend cabinet dentaire indépendant à Champs sur Marne, local 94m2 plus garage pour le prix des murs. Tél. 06 70 36 71 37. Email: ...
24/04/2018 - PRATICIENS - OFFRES D'EMPLOIS - Province et communauté Beauvais Oise, cabinet cherche collaborateur, libre de suite. Renseignements au 06 13 43 47 52.
10/04/2018 - ASSOCIATIONS CREATIONS Narbonne centre-ville (11), bord de mer, très proche montagne, à 45mn de Montpellier, à 60mn de Toulouse. Urgent cause départ, carrière ...
Toutes les annonces

Dernière parution

Gestion ortho-chirurgicale des dents incluses Sommaire Je m'abonne