Salient Periodontal Issues for the Modern Biologic Orthodontist

The term synergy refers to the interaction between many agents acting in concert to create an effect greater than the sum of the separate parts; in other words the whole is greater than the sum of the parts. This definition helps one understand the biologic basis of periodontal orthodontic relationships in either therapy or disease. Synergistic collaborative treatment between the specialists also helps develop the harmony that results in less damage to both components of the periodontium, the soft tissue “gingival unit” around the crown, and the “attachment apparatus” that connects the root to bone. Orthodontists should recognize possible periodontal risks to patients undergoing orthodontic treatment and any “damage” to the periodontium or enlargement of the gingiva is often an inevitable and reversible side effect. The goal is to minimize any harmful effects as any good surgeon seeks to minimize an inevitable scar. This is best done by interdisciplinary collaboration in controlling infection with chemicals, erupting teeth through keratinized gingiva, empowering patients with modern regenerative surgery, and using orthodontic therapy to minimize the amount of bone that is removed during periodontal osseous surgery. Thus, with synergistic collaboration, orthodontic therapy can enhance periodontal health and periodontal therapy can enhance the orthodontic outcome.