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The interface between orthodontics and periodontolgy is as broad as any between two disciplines in clinical dentistry. Controlled tooth movements utilize the dynamic nature of the periodontium which remodels actively when external forces are applied. Periodontal tissues are also continuously at risk from plaque-induced diseases that compromise the support of the dentition. The accumulation of plaque is enhanced when patients wear orthodontic appliances and the dental hygienist has a vital role to play before, during, and after orthodontic treatment. Changes in tooth relationships are often a consequence of periodontal disease. When the condition has been controlled orthodontic treatment may be indicated to, for example, align drifted incisors, or to upright molars that have tipped into extraction spaces. The objective of this book is to explore fully the interrelationships between the periodontium in both health and disease, and orthodontics. It is not a text that is aimed purposely towards the specialist management of orthodontic or periodontal cases. We have instead examined exhaustively the common ground upon which the orthodontist and periodontist are often called upon to meet and collaborate on cases that demand multi-disciplinary care. The text is presented in two parts. Part I comprises three chapters covering the basic sciences. Chapter 1 deals with the anatomy and physiology of the peridontium and investigates the role of dental anatomy in the initiation and progression of periodontal disease. Chapter 2 summarizes the microbiology and pathogeneisis of periodonatla disease and it is evident that many of the biological mediators which are involved in the perpetuation of disease are also implicated in the day-to-day remodelling of the supporting tissues. Chapters 3 studies the histological aspects of orthodontic tooth movements and looks at the biological mechanisms involved. Part II comprises the remaining six chapters. Chapter 4 discusses the exmaination and treatment planning for the orthodontic management of patients who have a history of periodontal disease. Chapter 5 deals with different concepts of occlusion and how common occlusal problems can initiate periodontal problems. The importance of controlling periodontal disease before orthodontic treatment is explained in Chapter 6. Aids to oral hygiene for the orthodontic patient and the periodontal complications of orthodontic treatment are described. Chapter 7 covers the orthodontic management of specific periodontal problems and the periodontal effects of surgical adjuncts to orthodontic therapy are outlined in Chapter 8. The final chapter discusses aspects of relapse, the need for retention, and the soft tissue procedures that have been advocated in the prevention of relapse. This book will serve as a helpful volume for all specialists in the orthodontic and periodontal disciplines. It is also directed towards postgraduate students and practitioners with a special interest in these subjects.
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