The influence of the oral microbiome, local inflammation and oral health on orthodontic tooth movement, particularly in cleft lip and palate patients - OrthoCleftBiome

• Applicant: Privatdozentin Dr. Corinna Seidel
• Subject Area: Dentistry, Oral Surgery
• Term: since 2025
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 566085831

Cleft lip and palate (CLP) are the second most common congenital malformation in humans. Orthodontic treatment of CLP patients in adolescence focuses on treatment of the malocclusion, which requires complex orthodontic tooth movements, e.g., movement of severly rotated or displayed teeth. In CLP malformations involving the palate, the nasal and oral cavities are connected. In the case of lip (and jaw) involvement, the oral cavity is insufficiently shielded from the outside world. Our own preliminary studies have shown a dysbiotic microbiome (imbalance with an increase in pathogenic microorganisms) and increased oral concentrations of pro-inflammatory cytokines in CLP patients with different phenotypes and severities shortly after birth. CLP patients have an increased prevalence for dental plaque, caries, gingivitis, bone resorption, tooth loosening and tooth loss, which could be related to changes in the oral microbiome and oral inflammation. Dysbiosis of the oral microbiome in combination with oral inflammation leads to oral diseases. Dysbiosis of the gut microbiome is associated with altered bone metabolism and a tendency to osteoporosis. Dysbiosis of the oral microbiome and oral inflammation could influence bone metabolism and orthodontic tooth movement and thus worsen the prognosis of orthodontic treatment. This results in a greater probability for prolonged orthodontic treatment in CLP patients, as well as a higher risk of tooth loss, bone resorption, root resorption and additional surgical intervention. There is evidence that increased gingival inflammatory correlates with an altered orthodontic tooth movement rate. However, studies that have investigated potential correlations between the oral microbiome and local cytokine concentrations with the orthodontic tooth movement rate in general are lacking, i.e., neither in patients without CLP nor in the presence of CLP. The project aims at longitudinal, clinical, prospective investigation of the oral microbiome, local cytokine concentrations, oral health and three-dimensional tooth movement during orthodontic therapy in children and adolescents without CLP compared to CLP patients. The overall aim is to detect microbial-immunological factors influencing the extent and rate of orthodontic tooth movement, especially in patients with CLP. More precise knowledge of oral dysbiosis in CLP will help to promote tooth and bone preservation and reduce the duration of orthodontic treatment in the future. In addition, new biomechanically individualized, biologized, orthodontic treatment strategies with individual force and moment adjustments for patients with CLP can be developed. At the same time, new preventive, interdisciplinary treatment concepts can be developed, paving the way for future interdisciplinary, multi-center studies.

• DFG Programme: Research Grants