Korean J Orthod.  2022 Nov;52(6):420-431. 10.4041/kjod22.123.

Periodontal parameters in orthodontically tractioned teeth: A systematic review and meta-analysis

• Mattos PMd
• Gonçalves FM
• Basso IB
• Ferraz AX
• Zeigelboim BS
• Stechman-Neto J
• Santos RS
• Araujo CMd
• Guariza-Filho O

• KMID: 2536335
• DOI: http://doi.org/10.4041/kjod22.123

Abstract

Objective
This systematic review aimed to evaluate periodontal parameters in orthodontically tractioned teeth compared with the respective non-tractioned contralateral teeth.
Methods
Search strategies were developed for six electronic databases and gray literature. Random-effects meta-analyses were performed for the outcomes of interest. Furthermore, the certainty of the evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool.
Results
Overall, 2,082 articles were identified, of which 24 were selected for the qualitative synthesis. A significant difference was observed between the impacted and contralateral teeth (mean difference [MD] = 0.25; 95% confidence interval [CI] = 0.10–0.40; I ² = 0%) when the gingival index was evaluated. Additionally, impacted teeth showed a greater probing depth, with a significant mean difference between the groups (MD = 0.14; 95% CI = 0.07–0.20; I ² = 6%). Most studies had a low risk of bias; however, the certainty of the evidence was very low owing to the design of existing studies.
Conclusions
The evidence in the literature indicated that tractioned teeth might show worsening of periodontal parameters related to the gingival index and probing depth; however, the evidence remains uncertain about this outcome. Furthermore, probing depth should be considered regarding its clinical significance because of the small effect size observed.

Keyword

Impacted tooth; Ectopic eruption; Unerupted tooth; Traction

Figure

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  Figure 1 Flowchart of literature search and selection criteria.

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  Figure 2 Comparison of the plaque index between tractioned teeth and their respective contralateral. A, Forest plot showing the risk of bias for each included study. B, Influence analysis. The letters 'a, b' were placed when more than one estimate was extracted from the same study. SD, standard deviation; MD, mean difference; CI, confidence interval.

• 

  Figure 3 Comparison of the gingival index between tractioned teeth and their respective contralateral, showing the risk of bias for each included study. The letters 'a, b' were placed when more than one estimate was extracted from the same study. SD, standard deviation; MD, mean difference; CI, confidence interval.

• 

  Figure 4 Comparison of the periodontal probing depth between tractioned teeth and their respective contralateral, showing the risk of bias for each included study. The letters 'a, b' were placed when more than one estimate was extracted from the same study. SD, standard deviation; MD, mean difference; CI, confidence interval.

• 

  Figure 5 Comparison of the width of the keratinized tissue between tractioned teeth and their respective contralateral, showing the risk of bias for each included study. The letters 'a, b' were placed when more than one estimate was extracted from the same study. SD, standard deviation; MD, mean difference; CI, confidence interval.

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