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Invited Review

The orthodontic periodontal interface: A narrative

review
Gurkeerat Singh, Puneet Batra1
Vice Principal, Professor and Head, Department of Orthodontics and Dentofacial Orthopedics, Sudha Rustagi College of Dental, Sciences and
Research, Faridabad, Haryana, 1Vice Principal, Professor and Head in Orthodontics and PG guide at Institute of Dental Studies and Technologies,
Modinagar, Ghaziabad, Uttar Pradesh, India

ABSTRACT
Access this article online
The purpose of this review is to highlight the orthodontics and periodontics interface in clinical practice for optimized Website: www.jicdro.org
treatment outcomes. Orthodontic treatment aims at providing an acceptable functional and esthetic occlusion. DOI: 10.4103/2231-0754.143481
Tooth movements are strongly related to interactions of teeth with their supportive periodontal tissues. In recent Quick Response Code:
years, due to the increased number of adult patients seeking orthodontic treatment, orthodontists frequently face
patients with periodontal problems.Esthetic considerations, like uneven gingival margins or functional problems
resulting from inflammatory periodontal diseases, should be considered in orthodontic treatment planning.
Potentials and limitations that derive from the interdisciplinary approach of complex orthodontic-periodontal
clinical problems are discussed along with the role of light forces and self-ligating brackets.

Key words: Ortho Perio interface, self ligation, regional accelerated tooth movement

INTRODUCTION the quality of-life. Orthodontic treatment, in addition

The purpose of this review is to highlight the orthodontics
and periodontics interface in clinical practice for optimized
treatment outcomes. Orthodontic treatment aims at providing an
acceptable functional and esthetic occlusion. Tooth movements
are strongly related to interactions of teeth with their supportive
periodontal tissues. In recent years, due to the increased number
of adult patients seeking orthodontic treatment, orthodontists
frequently face patients with periodontal problems.
Esthetic considerations, like uneven gingival margins
or functional problems resulting from inflammatory
periodontal diseases, should be considered in orthodontic
treatment planning. Potentials and limitations that
derive from the interdisciplinary approach of complex
orthodontic-periodontal clinical problems are discussed
along with the role of light forces and self-ligating brackets.
Orthodontic treatment ensures proper alignment of the
teeth and improves the occlusal and jaw relationship, which
aids in better mastication, speech, facial esthetics, which
contributes to general and oral health, thereby improving
to its benefits, has also associated risks and complications.
Periodontal health is an important factor that may be used
to evaluate the success of orthodontic therapy. Periodontal
complications are reported to be one of the most common
side-effects linked to orthodontics.[1] Aligned teeth are easier
to clean, and perhaps correct occlusion may promote healthier
periodontium. It is equally important to recognize that a
number of orthodontic procedures, such as the judicial use
of dental extractions, interproximal enamel reduction, correct
root torque, selective grinding and if indicated treatment
in the mixed dentition can act to retain the roots within
the alveolar bone and thereby reduce root prominence and
the risk of gingival recession. They may also allow creeping
attachment and if planned, a better future surgical site. The
reported benefits of orthodontic treatment in relation to
gingival recession are as follows: Self-maintaining oral hygiene,
crown alignment within the dento-alveolar envelope, removal
of occlusal trauma, root alignment within the bone, A hopeless
tooth is not a useless tooth-the value of a periodontal opinion
is important, as such teeth can be utilized to enhance bone
and/or soft tissue anatomy before insertion of implants.

Address for correspondence: The most common orthodontic problems found in a

Dr. Gurkeerat Singh, Department of Orthodontics and Dentofacial
Orthopedics, Sudha Rustagi College of Dental, Sciences
and Research, Faridabad, Haryana, India.
E-mail: gurkeerats@hotmail.com
periodontally compromised patient include proclination
of the maxillary anterior teeth, irregular interdental
spacing, rotation, overeruption, migration, loss of teeth

Journal of the International Clinical Dental Research Organization | July-December 2014 | Vol 6 | Issue 2 77
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Singh: Ortho-perio inter-relationship
or traumatic occlusion. Those changes in the dentition are
a consequence of the diminished support provided by the
compromised periodontium, and they can sometimes hinder
periodontal treatment by reducing the conditions for good
oral hygiene and impairing function and aesthetics of the
stomatognathic system. The periodontal complications
associated with orthodontic therapy mainly include
gingivitis, periodontitis, gingival recession or hypertrophy,
alveolar bone loss, dehiscences, fenestrations, interdental
fold, and dark triangles.[2-5] Presence of microbial plaque is
reported to be the most important factor in the initiation,
progression, and recurrence of periodontal disease in a
reduced periodontium.[6] The presence of plaque is the
considered as one of the main factors in the development
of gingivitis.[7,8] Orthodontic brackets and elastics might
interfere with effective removal of dental plaque, thereby
increasing the risk of gingivitis. As a result of the orthodontic
treatment, a shift in the composition and type of bacteria
can be expected.[9] Orthodontic treatment is known to affect
the equilibrium of oral microflora by increasing bacteria
retention. Furthermore, in patients with active periodontal
disease, the presence of traumatic occlusion may inhibit
bone apposition that can occur following periodontal
treatment.[10,11]
Orthodontic treatment may inhibit complete oral hygiene
procedures[12-14] and create the possibility of transition of
the subgingival plaque to a more aggressive periopathogenic
flora[15,16] (converting gingivitis into periodontitis). If a
thorough oral hygiene regime is applied before and during
orthodontic treatment, minimal or no increase in gingival
bleeding index[17] or a plaque quantity will be evident.[18]
After appliance removal, there is a significant improvement
on plaque index and bleeding index.[19] With adequate plaque
control, patients with reduced but healthy periodontium can
undergo orthodontic treatment without aggravating their
periodontal conditions.[20,21] However, when inflammation
is not fully controlled orthodontic treatment may trigger
inflammatory processes and accelerate the progression of
periodontal destruction leading to further loss of attachment,
even in patients with sound oral hygiene.[22-24] Specific long-
term clinical and radiographic findings support the fact that
periodontal disease develops in regions where orthodontic
bands are placed and leads to statistically significant loss of
attachment.[25]
There is no contraindication for orthodontic treatment in
adults with severe periodontal condition. On the contrary,
sometimes orthodontics may be necessary to improve the
possibilities of restoring a deteriorated dentition.[22] In
periodontally compromised teeth, the center of resistance is
displaced apically following the anatomical elements of the
78 Journal of the International Clinical Dental Research Organization | July-December 2014 | Vol 6 | Issue 2
periodontium, thus resulting in the expression of greater
moments during force application and an increase in the
extrusion component of the applied force[26] [Figures 1 and 2].
Skeletal anchorage devices such as orthodontic mini-screws,
mini-plates or even dental implants that serve as anchorage
units are used especially when the present teeth are
inappropriate. The use of occlusal forces (e.g., bite plates
or occlusal splints) may sometimes be a valuable help
for vertical control of the position of teeth, as well as for
anchorage enhancement or for dissocclusion of selected
teeth facilitating planned tooth movement. One precaution
is to avoid using wire loops and elastomeric ligatures and
remove immediately the excess of bonding material during
bracket placement. Self-ligating brackets or wire ligatures are
considered preferable, instead of elastomeric ligatures, as the
latter favor plaque accumulation.[27] Despite the inconclusive
results presented in the literature, bonding instead of
banding the molars appears to be a safer solution for reasons
previously stated. In patients with an intact periodontium,
treatment with the aligners seems to be more favorable for
periodontal reasons compared to labially or lingually fixed
appliances.[28] Movement of teeth with infrabony defects can
be successfully accomplished in the absence of inflammation
and adequate control of the bacterial plaque. Although there
is little evidence in humans, a well-designed recent clinical
trial has shown that orthodontic tooth movement (OTM)
toward the infrabony defect combined with intrusion and
surgical periodontal therapy results in significant clinical
attachment gain and in radiographic bone fill. Appliance
of orthodontic forces was almost immediate 10 days after
surgical periodontal treatment.[29]
GINGIVAL RECESSION IN ORTHODONTICS
The development of gingival recession during or after
orthodontic treatment would be a significant clinical
Figure 1: Normal versus teeth which are periodontally compromised with altered
antes law (altered crown root clinical ratio)
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Singh: Ortho-perio inter-relationship
problem. A number of predisposing and precipitating factors
include anatomical and morphological characteristics, such
as alveolar bone dehiscence, gingival biotype, skeletal
pattern, narrow symphysis and ectopic tooth eruption or
morphology. Precipitating factors lead to an acceleration
of the defect, such as traumatic tooth brushing, traumatic
overbite, age, smoking, parafunctional habits, pregnancy
and piercing. In addition and perhaps equally important are
inappropriate treatment mechanics, such as arch expansion,
with excessive proclination and the use of RME in adult
patients. Care should also be taken when decompensating
a class III incisor relationship in preparation for surgery and
aligning ectopic/transposed teeth. One could consider the
acronym ABEF to help take into account the risk factors: A:
Anatomy of the alveolar bone and proximity of the root to
the cortical plates B: Biotype E: Environment (oral hygiene,
habits, poor brushing, poor orthodontic mechanics, active
lingual retainers) F: Functional matrix.
To minimize the risk of gingival recession and maximize the
benefit of the orthodontic treatment, the orthodontist must
take some universal precautions as tabulated in Table 1.[30]
Table 1: Universal precautions to minimise risk of periodontic
implications during orthodontic treatment
Maintain good oral hygiene throughout orthodontic treatment
and identify potential risk factors
Eliminate potential causes of recession (piercing, smoking,
traumatic toothbrushing)
Avoid uncontrolled dento-alveolar expansion and maintain arch form
Customize bonding and mechanics
Modify tooth anatomy whenever indicated
Consider segment arch mechanics
Create space before using it and use it wisely
Consider atypical extractions, e.g., compromised teeth
Avoid jiggling because it may cause periodontal problems
Treat early (interceptive procedures and treatment in mixed dentition)
Re-educate the patient in their oral hygiene technique after the end
of treatment
Figure 2: The different location of the center of resistance for periodontally
compromised teeth
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In patients requiring pre-surgical decompensation,
preprosthetic preparation or where a non-extraction
approach is judged as necessary: The importance of ensuring
optimal oral hygiene and using a free gingival graft prior
to the planned OTM should be considered. The preferred
approach in these susceptible patients should be to again
ensure optimal oral hygiene, align the roots within the
alveolar envelope, avoiding proclination and to re-evaluate
the need for a mucogingival graft after treatment.
ORTHODONTIC EXTRUSION AND INTRUSION
A recent clinical study on orthodontically treated patients
with intact periodontium concluded that extrusion of
mandibular incisors resulted in displacement of the gingival
margin and the mucogingival junction by 80% and 52.5%,
respectively, of the total amount of extrusion.[31] Thus, in
cases where movement of bone margin and attachment along
with the tooth is not desirable (as in crown-root fractures),
there is a need for periodical circumferential supracrestal
fiberotomy at the start and every 2 weeks during orthodontic
extrusion.[32] According to experimental studies and clinical
reports, orthodontic extrusion of teeth with one or two
wall-infrabony defects results in a more favorable position
of the connective tissue attachment and reduction in the
defect.[33,34] Orthodontic extrusion of non-restorable teeth
prior to implant placement appears to be a viable alternative
for conventional bone augmentation procedures in implant
recipient sites.
During orthodontic intrusion of lower incisors in patients
with an intact periodontium, the gingival margin and the
mucogingival junction moves apically 79% and 62% of total
intrusion, respectively.[35] Regarding periodontally affected
teeth, sufficient clinical data suggest that the intrusion of
teeth can considerably improve the level of attachment
when there is absolute control of inflammation and bacterial
biofilms.[36,37] The use of light forces is recommended to move
teeth efficiently and probably reduce the amount of root
resorption.[38] This is of capital importance in teeth with a
reduced periodontium as the specific implication results in
further loss of periodontal support and increase in crown-
root ratio.
MOLAR UPRIGHTING
Orthodontic uprighting of mesially tipped molars is
accompanied by the elimination of osseous defects,
improvement in pocket probing depth and in crown-root
ratio.[39] However, in molars with furcation involvement,
there is an increased risk of aggravation of the periodontal
problem during the orthodontic uprighting procedure.[40,41]
Orthodontic movement of teeth in edentulous areas with
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Singh: Ortho-perio inter-relationship
reduced alveolar ridge height is, usually, possible with
minimal loss of alveolar bone.[42] The movement should be
parallel and performed with low orthodontic forces.
LABIAL TOOTH MOVEMENTPROCLINATION
These movements represent the most viable method
to resolve crowding and are frequently considered to
produce gingival recession especially in the region of lower
incisors.[43] The most important predisposing factor for
the development of gingival recession during or following
orthodontic treatment is the reduced thickness of soft tissue
and bone in the region.[44] No correlation was found between
the orthodontic labial inclination of mandibular central
incisors and age with gingival recession (except in excessive
proclination >10 mm of mandibular incisors).
MISSING INTERDENTAL PAPILLA
Usually, when the papilla is lost as a result of advanced
periodontal disease which involves loss of interdental alveolar
crest, the aesthetic improvement in the situation requires
a combination of enameloplasty (interproximal reduction),
tooth movement and selective addition of composite resin. If
this is not enough for the remodeled tissue to cover the area
of the papilla, direct-bonding resin can be added to lower the
contact point and create the illusion of a healthier papilla.
Interproximal enamel reduction along with the closure of
the resultant diastema is sufficient in most cases to restore
the missing papilla.[45]
GUMMY SMILE
In conformity to the present esthetic standards, maxillary
gingival display in an attractive adult smile will range
between 1 and 2 mm. Increased gingival exposure may
be attributed to different causes, which designate the
appropriate management: Vertical growth of the maxilla,
retardation of the physiological apical migration of gingival
margins, extrusion of maxillary anterior teeth and anatomical
considerations.[46]
Patients with excessive vertical growth of the maxilla, usually,
present clinical crowns with normal dimensions and healthy
gingiva. In growing patients, growth modification should
be considered to inhibit vertical growth with orthopedic
forces, while management of this condition in adults possibly
demands orthognathic surgery including LeFort I osteotomy
and maxillary impaction.[47]
Certain patients present significant retardation of the
physiological apical migration of gingival margins, with thick
gingival biotype or fibroid gingival tissues and probing depth
of gingival sulcus of approximately 3-4 mm, sometimes even
without clinical signs of inflammation. Main clinical features
80 Journal of the International Clinical Dental Research Organization | July-December 2014 | Vol 6 | Issue 2
of this type of a gummy smile are the short clinical crowns
and the apparently increased labiolingual thickness of gingival
tissues. This condition is an indication for mucogingival
aesthetic surgery.[45]
Sometimes a gummy smile may be attributed to extrusion of
maxillary anterior teeth. It frequently happens in Angle class
II, division 2 malocclusions. The indicated treatment, usually,
includes orthodontic intrusion of maxillary incisors, which
is expected to eliminate the gummy smile.[48] According to
Sarver and Ackerman[49] gummy smile caused by decreased
philtrum height of the upper lip may be effectively corrected
by V-Y cheiloplasty, practically covering the gummy smile with
the upper lip. Polo[50] recommends the use of Botox for the
neuromuscular correction of excessive gingival display on
smiling achieving satisfactory, but transitory results.
PREVENTION OF RELAPSE
Remodeling of supra-alveolar fibers continues to take place
even after a period of 4-6 months.[51] It seems that after the
end of orthodontic treatment, the retention period should
exceed 12 months to provide appropriate time for remodeling
of the periodontal fibers.[52] Relapse can be prevented by
orthodontic overcorrection, adjunctive periodontal surgery[53]
and long-term fixed retention.
Surgical removal of the stressed interdental soft tissues after
closure of the diastema seems to prevent relapse.[54] In cases
of maxillary midline diastema, it is often advisable to perform
a frenectomy after the orthodontic closure to alleviate
relapse. The circumferential fiberotomy of supracrestal
gingival fibers has been proposed for preventing relapse
of teeth that were severely rotated prior to treatment. This
procedure alleviates relapse without harmful long term
effects in periodontal health.[55] Permanent retention of the
result of orthodontic treatment is indispensable in patients
with significantly reduced periodontal support. Probably,
the most appropriate method for retention is the coaxial
multistranded stainless steel wire retainer bonded to the
lingual side of each tooth. This retainer is easy to fabricate,
not visible, and it allows teeth to retain their physiological
mobility. There is a possibility of gingival recession due to
active multistranded lingual retainers.[56,57]
PERIODONTAL TREATMENT SCHEDULE
When planning orthodontic treatment in adults with a history
of periodontal disease, it is suggested to allow 2-6 months
from the end of periodontal therapy until bracket placement,
for periodontal tissue remodeling, restoration of health and
evaluation of patients compliance. The patient should fully
understand the potential risks in case of noncompliance.[58]
It should be kept in mind that the critical pocket depth for
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Singh: Ortho-perio inter-relationship
maintaining periodontal health with ordinary oral hygiene
is 5-6 mm.[59] If the presence of dehiscence or fenestration is
suspected; two potential options exist: Avoid over-expansion
of the arch, that is, attempt to maintain the teeth within the
dentoalveolar envelope by considering dental extractions
or interproximal enamel reduction. In situations where
we absolutely need to expand orthodontically out of the
envelope, it would be wise to ask for soft tissue augmentation
prior to treatment.
Regenerative periodontal techniques (periodontal therapy
with guided tissue regeneration or enamel matrix derivatives
[EMDs]) are usually implemented before orthodontic treatment
(10 days-4 months) to create favorable preorthodontic
conditions in complex clinical scenarios. In case of thin
periodontal tissues, the width of soft periodontal tissues
must be enhanced prior to labial OTM, when it is estimated
that otherwise the planned movement will result in the
development of bone dehiscence.[60] During orthodontic
treatment, professional cleaning and examination of
periodontal tissues should be performed routinely. If
the patient fails to maintain a high level of oral hygiene,
orthodontic treatment should be interrupted. Elective
periodontal treatment should be implemented during the
final stages of orthodontic treatment or even later, when
the final position of hard and soft tissues can be safely
determined. After the end of active orthodontic treatment
and appliance removal, the patient should receive renewed
oral hygiene instructions for reducing the risk of recession
because plaque removal and tooth cleaning will be more
easily performed. The importance of re-educating the patient
in respect of their brushing technique in conjunction to
considering adjunct interdental cleaning aids, such as an oral
irrigator, dental floss and interdental toothbrushes.
TREATMENT OF GINGIVAL RECESSION
A number of specific surgical considerations were also
identified as being important to success: flap thickness (1.1
mm), post-surgical position of the gingival margin (the higher
the better) and maintaining a stable flap under low tension
provided optimal wound healing. The importance of using
biological agents (e.g., EMD) in conjunction with flap surgery
is shown to be beneficial.[61,62] The use of a modified coronally
advanced tunnel flap approach in treating gingival recession
was demonstrated, with the advantage of optimizing tissue
blending and aesthetics.[63]
In terms of what is the best method(s) for recession coverage,
there is a need to distinguish between single and multiple
recessions. In respect of single gingival recession, a number
of options exist for recession coverage, an EMD (Emdogain)
with or without a connective tissue graft in conjunction with
Journal of the International Clinical Dental Research Organization | July-December 2014 | Vol 6 | Issue 2
a coronally positioned flap.[61,62] Good long-term (5 years)
outcomes have been reported with connective tissue grafts
and a coronally advanced flap.[64] Alternative methods include
the envelope technique with connective tissue graft[65] or the
laterally positioned flap with or without connective tissue
graft. In the case of multiple recessions, the modified coronal
advancement flap with or without graft is preferred in the
maxilla,[66] whilst in the mandible, its use in conjunction to a
connective tissue graft should be considered.[67] In regard to
the Millers class III defect, the modified coronal advancement
tunnel technique with connective tissue graft should be
considered. Whilst a free gingival graft can be used in both
single and multiple gingival recessions, it is associated with
high morbidity due to graft removal from the palate and
sometimes necrosis of the graft.
POSSIBLE COMBINED FUTURE RESEARCHES IN THE
FIELD OF ORTHODONTICS AND PERIODONTICS
Salivary biomarkers
Orthodontic tooth movement is a process of paradental
remodeling mediated by inflammatory mediators like PGE2s,
cytokines, neuropeptides, MMPs, etc. These inflammatory
mediators are also present in periodontitis and periodontal
diseases. Hence the detection of these inflammatory
mediators is of paramount importance in detection and
screening of periodontal diseases as well as demonstrating
OTM. GCF markers have several shortcomings like long
collection times, easily prone to contamination, thick
viscosity, questionable accuracy, etc. Salivary biomarkers
are rapidly gaining increasing popularity over GCF markers
these days.
Advantages
Inexpensive, non-invasive and easy-to-use.
Ease of collection, storing and shipping.
Easier handling as it does not clot.
Disadvantages
Informative analytes generally present in lower amounts
than in serum.
Dilution of biomarkers common.
An increase in salivary levels of Cathepsin G, Elastase,
Elastase inhibitors and C-reactive proteins correlated
with increased periodontal breakdown. [68] Salivar y
biomarkers Interleukin-1 and MMP-8 specific for three
aspects of periodontitis that is inflammation, collagen
degradation and bone turnover were significantly higher
in subjects with periodontal breakdown.[69] The activity
of creatine kinase, Lactate dehydrogenase, Aspartate
aminotransferase, Alanine aminotransferase, Gamma
glutamil transferase, acid phosphatase and alkaline
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Singh: Ortho-perio inter-relationship

phosphatase significantly increased in the saliva of patients

with periodontal breakdown.[70] Elevated mean salivary
levels of TNF- in subjects having periodontal diseases.[71]
The mean myeloperoxidase activity in both GCF and saliva
increased 2 h after orthodontic appliance activation.[72] The
salivary concentrations of deoxypyridinoline (DPD) and
bone-specific alkaline phosphatase (BAP) as detected with
four consecutive visits may be linked with different phases
of tooth movement.[73] Results showed that although DPD
values revealed an increasing nature after force application
and BAP values showed a decreasing trend, only the former
showed significant changes over time which implied that
DPD dominates the earlier phases of tooth movement
while BAP serves as an indicator of bone formation as Figure 3: Full thickness buccal flap raised to expose the buccal cortex
soon as tooth movement stops. Thus, qualitative changes
in the composition of saliva biomarkers used in estimating
OTM mediated by paradental remodeling could have
significance in diagnosis and treatment of periodontal
disease as well.

PERIODONTALLY ACCELERATED OSTEOGENIC

ORTHODONTICS (PAOO)
Surgically accelerated modalities like selective alveolar
decortication (SAD) and periodontally accelerated
osteogenesis orthodontics can be used as an adjunct
to conventional approaches to accelerate OTM with
fewer adverse effects. SAD is a procedure where linear
and punctuate decortications are made after reflecting
the flap. [74-76] The decortications should not impinge
on root-PDL-cribriform plate complex and not extend Figure 4: Buccal corticotomy initiated with round burs to do the initial scoring

to the alveolus crest. Accelerated OTM occurs due to

inflammation and wound healing processes that are evoked
by surgical trauma to the alveolar bone. In addition,
alveolar bone surgery may also stimulate the production
of MSCs in marrow cavities that function synergistically
with neighboring PDL and alveolar bone cells resulting
in accelerated OTM. Addition of bone graft to a teeth
moving through a surgical wound increases bone mass
and enhances long-term stability. [76] The term popular
is the regional acceleratory phenomenon with normal
metabolic rate of inflammation and wound healing process
is accelerated [Figures 3-5].[78-80]

CONCLUSION
Harmonious cooperation between the periodontist and the
orthodontist offers great possibilities for the treatment of
combined orthodonticperiodontal problems. Orthodontic
treatment along with patients compliance and absence
of periodontal inflammation can provide satisfactory
results without causing irreversible damage to periodontal
tissues. Orthodontic treatment can expand the possibilities
Figure 5: Buccal corticotomy cuts made joining the initial scoring points
of periodontal therapy in certain patients, contributing
to better control of microbiota, reducing the potentially
hazardous forces applied to teeth and finally improved
the overall prognosis. Participation of the periodontist
is also essential, either in management of orthodontic

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Singh: Ortho-perio inter-relationship
periodontal problems or in specific interventions aiming
to prevent orthodontic treatments relapse.
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Cite this article as: Singh G, Batra P. The orthodontic periodontal interface:
A narrative review. J Int Clin Dent Res Organ 2014;6:77-85.
Source of Support: Nil. Conflict of Interest: None declared.
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Singh: Ortho-perio inter-relationship

About the Authors

Dr. Gurkeerat Singh, is a graduate and postgraduate from the Mangalore College of Dental Surgery, a constituent of the
Manipal Academy of Higher Education, Manipal. He did his M. Orth in 2001 and is registered with the Royal College of
Surgeons, London as well as the Royal College of Physicians and Surgeons of Glasgow. He is a diplomate of the Indian
Board of Orthodontics. Dr. Singh has over two dozen publications in various Indian and foreign journals to his credit as
well as The Textbook of Orthodontics, the first full-color textbook by an Indian author on the subject and a Mini Atlas on
Orthodontics. He is professor and head of the department of orthodontics and dentofacial orthopedics at Sudha Rustagi
College of Dental Sciences and Research, Faridabad, Haryana. He is also the Editor of the Journal of the Indian Orthodontic
Society.

Dr. Puneet Batra completed his BDS 1996 and did his MDS in Orthodontics from All India Institute of Medical Sciences
New Delhi. He did his M. Orth from the Royal College of Surgeons in Edinburgh in the year 2003 and FFD Orth from the
Royal College of Surgeons in Ireland in 2005. He was awarded DNB in Orthodontics from the ministry of health and family
welfare. He has been awarded the prestigious commonwealth scholarship (Great Ormond Street London) and TC White
award (Dunddee Dental School Scotland). He has been awarded the PP Jacob award and the JG Kannapan award by the
Indian Orthodontic Society. He has more than 70 publications in peer reviewed national and international journals. He is
the Vice Principal and Professor and Head in Orthodontics and PG guide at Institute of Dental Studies and Technologies
Modinagar.

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