During orthodontic treatment, diverse cytokines, enzymes, and osteolytic mediators produced within the teeth surrounding periodontal tissues determine the rate of alveolar bone remodeling and consequent teeth movement. In patients with teeth presenting reduced periodontal support, periodontal stability should be ensured during orthodontic treatment. Thus, therapies based on the application of low-intensity intermittent orthodontic forces are recommended. To determine if this kind of treatment is periodontally well tolerated, this study aimed to analyze the production of receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG), interleukin (IL)-6, IL-17A, and matrix metalloproteinase (MMP)-8 in periodontal tissues of protruded anterior teeth with reduced periodontal support and undergoing orthodontic treatment. Patients with periodontitis-associated anterior teeth migration received non-surgical periodontal therapy and a specific orthodontic treatment involving controlled low-intensity intermittent orthodontic forces. Samples were collected before periodontitis treatment, after periodontitis treatment, and at 1 week to 24 months of the orthodontic treatment. During the 2 years of orthodontic treatment, no significant differences were detected in the probing depth, clinical attachment level, supragingival bacterial plaque, and bleeding on probing. In line with this, the gingival crevicular levels of RANKL, OPG, IL-6, IL-17A, and MMP-8 did not vary between the different evaluation time-points of the orthodontic treatment. When compared with the levels detected during the periodontitis, the RANKL/OPG ratio was significantly lower at all the analyzed time-points of the orthodontic treatment. In conclusion, the patient-specific orthodontic treatment based on intermittent orthodontic forces of low intensities was well tolerated by periodontally compromised teeth with pathological migration.

Due to the fact that people live longer, population ageing has occurred, thus manifesting chronic diseases that have a multidimensional implication. The different diseases that a person may present can cause frailty and involve the oral health of the elderly. Oral health is related to general health as there is a link that is being analysed today. Thus, the concepts of functionality, geriatric syndromes, general frailty and oral frailty in the elderly must be internalized to carry out timely health care and improve the quality of life of the elderly. Therefore, there is a challenge that dentistry must face, mainly in the Latin American and Caribbean region.

Introduction: Orthodontic treatment in patients with a reduced periodontium (RP) poses a clinical challenge due to alterations in periodontal support-bone loss, dental migration, and a displacement of the center of resistance. These conditions increase the risk of tissue damage when conventional orthodontic forces are used. Finite element analysis (FEA) has emerged as a useful tool for studying stress distribution in supporting tissues and optimizing biomechanical planning in such cases. Objective: To review the available scientific evidence on the application of FEA in orthodontic biomechanics for patients with a reduced periodontium, assessing its clinical utility for therapeutic decision‑making. Methodology: A literature search was conducted in PubMed, Web of Science and Scopus using terms related to “finite element analysis,” “orthodontics,” and “reduced periodontium.” Original studies using FEA in three‑dimensional (3D) orthodontic models with simulated reduced periodontium, published between 2020 and 2025, were included. Animal studies, in vitro studies without clinical correlation, and duplicates were excluded. Results: Eleven studies were included, with models constructed using cone‑beam computed tomography (CBCT) or 3D scans. In all cases, FEA allowed the identification of critical stress areas, especially in the cervical region of the periodontal ligament (PDL). Forces exceeding 60g and movements such as rotation, tipping and bodily translation were associated with an increased risk of surpassing the physiological hydrostatic threshold, favoring resorption. Biomechanical approaches such as cantilevers, segmented arches and aligners with controlled displacements showed more favorable outcomes. Limitations: considerable methodological heterogeneity in models and the magnitudes of the forces, together with limited direct clinical validation, prevented quantitative synthesis. Conclusion: FEA is an effective tool for evaluating and predicting tissue responses to orthodontic forces in a reduced periodontium. Its clinical application enables personalized treatment planning, minimizes iatrogenic risks, and promotes an evidence‑based interdisciplinary approach. However, FEA should complement, not replace, clinical evaluation and judgment.

Este reporte de caso muestra un paciente atendido en el Postítulo de Periodoncia de la Facultad de Odontología de la Universidad de Chile con diagnóstico de Agrandamiento Gingival influenciado por ciclosporina y nifedipino. El abordaje terapéutico consideró la fase sistémica, la fase higiénica con el tratamiento periodontal no quirúrgico para lograr la eliminación de la infección periodontal antes y después de la fase quirúrgica, y la fase de terapia de soporte periodontal. Se logró así la eliminación de los agrandamientos gingivales influenciados por ciclosporina y nifedipino.

Wire syndrome is an under-recognised complication associated with post-orthodontic fixed retainers, characterised by unplanned dental movements and gingival recession. This article reports two cases of wire syndrome with gingival recession, highlighting a management strategy that combines compensatory orthodontics and periodontal plastic surgery. The discussion emphasizes the importance of recognizing the risk factors that predispose to Wire Syndrome, its early detection to prevent it and the most appropriate treatment.