Orthodontic treatment in patients with diabetes mellitus: literature review

Orthodontic tooth movement is achieved by remodeling of the alveolar bone in response to mechanical loading. A change in metabolic state that interferes with bone remodeling may result in a different rate of tooth movement. Diabetes mellitus (DM) may adversely affect bone remodeling and tooth movement during the application of orthodontic forces. The aim of this literature review was to evaluate the implementation of orthodontic therapy in patients with DM. Orthodontic treatment and DM, between 1986 and 2019. There are currently few studies on orthodontics and dental movement in patients with DM in animals and humans. Bone response in diabetic rats after the application of orthodontic forces show a significant decrease in bone formation. Given that orthodontics is based on the principle that prolonged application of forces on the tooth results in tooth movement, which is a consequence of the surrounding bone remodeling, the success of this treatment lies mainly in the response of the bone to the applied forces. There is no treatment preference over fixed or removable appliances, being of good importance good oral hygiene and postponing orthodontic treatment in uncontrolled diabetics, until they are compensated by the endocrinologist. There is a lack of studies evaluating orthodontic treatment in patients with DM, the vast majority are animal studies and single case reports that do not allow extrapolating the results to clinical practice. Biofilm control is essential and will avoid major tissue and bone complications, which would interfere with orthodontic therapy.