Benefit of orthodontic treatment for patients with a pre-existing periodontal compromise

 # A key benefit of orthodontic treatment for patients with a pre-existing periodontal compromise (e.g., reduced but healthy periodontium) is:

A. Elimination of all PDL forces in the compromised teeth

B. Complete regeneration of lost alveolar bone and attachment

C. Increased tooth mobility for better functional adaptation

D. Optimization of axial loading to distribute occlusal forces more favorably

The correct answer is D. Optimization of axial loading to distribute occlusal forces more favorably

In patients with pre-existing periodontal compromise (e.g., reduced but stable attachment levels), orthodontic treatment aligns malpositioned teeth—such as flared or tipped incisors—to promote more vertical (axial) force transmission during occlusion, minimizing deleterious lateral or eccentric loads that exacerbate mobility, attachment loss, or alveolar stress in weakened areas. This biomechanical optimization, achieved via controlled intrusion and torque control with light forces (5–15 g/tooth), enhances long-term periodontal stability and function without regeneration, as evidenced by systematic reviews showing probing depth reductions (avg. 3.31 mm) and clinical attachment gains (avg. 5.28 mm) through improved force distribution and hygiene access. Options A (impossible, as PDL forces drive movement), B (not achievable orthodontically alone), and C (contraindicated, as mobility worsens prognosis) are inaccurate.