Survey of Iraqi Orthodontists on the Frequency, Periodontal Effects, and Clinical Management of Patients Receiving Systemic Isotretinoin Therapy

Isotretinoin is considered one of the major treatment options for resistant acne vulgaris. Concerns have been raised about its effect on periodontal health and orthodontic tooth movement since retinoids affect bone metabolism; however, evidence regarding this topic is still insufficient. To assess the knowledge, attitudes, perceptions and clinical practices of Iraqi orthodontists regarding the orthodontic management of patients receiving isotretinoin therapy. A cross-sectional questionnaire-based study that utilized a 44-item survey. Licensed Iraqi orthodontists were invited to complete the questionnaire within a certain timeline, and 110 valid responses were included in the final analysis. Knowledge varied considerably across individual items. The mean core knowledge score, derived from eight evidence-based items, was 4.44 ± 1.59 out of 8, corresponding to an overall accuracy of 55.5%. Knowledge scores did not differ significantly according to academic qualification, years of orthodontic practice, or previous clinical experience with isotretinoin-treated patients (all p-values> 0.05). Although 70.9% of respondents reported modifying orthodontic treatment on a case-by-case basis, only 0.9% routinely collaborated with dermatologists. The belief that isotretinoin adversely affects periodontal health was significantly associated with treatment modification (χ² = 35.46, p-value < 0.001), and previous clinical experience with isotretinoin-treated patients was associated with modification of treatment strategies (p-value = 0.049). Iraqi orthodontists demonstrated moderate overall knowledge regarding isotretinoin therapy. There were no significant differences in knowledge according to professional qualification or clinical experience. The findings highlight the need for evidence-based guidelines and the development of recommendations to support the orthodontic management of patients receiving isotretinoin therapy.