ABSTRACT
Objective: To evaluate the effectiveness of orthodontic intrusion combined with periodontal regenerative surgery in the treatment of pathologic migration of upper incisors. Methods: Nine patients with chronic periodontitis who had pathologic migration of upper incisors were selected. After periodontal initial therapy, periodontal regenerative surgery was performed on the vertical defect around 11 displaced teeth, and then orthodontic intrusion was performed 3 months after the surgery. The differences between baseline (T0) and end of orthodontic treatment (T1) of the periodontal clinical parameters and bone defects were analyzed. Results: For all patients, the periodontal clinical parameters and bone defects were significantly improved. The average pocket probing depth reduction was 2.81 mm, the average attachment gain was 3.38 mm, the average gingival recession was reduced by 0.56 mm, and the width of keratinized gingival tissue was not decreased. As measured on the X-ray, the depth and width of the vertical bone defect were reduced by an average of 2.20 mm and 0.55 mm, respectively. Conclusion: Orthodontic intrusion combined with periodontal regenerative surgery can effectively treat pathologic migration of the upper incisors with vertical bone defects, and obtain good periodontal soft and hard tissue regeneration.
ABSTRACT
Objective · To evaluate the effectiveness of orthodontic intrusion combined with periodontal regenerative surgery in the treatment of pathologic migration of upper incisors.Methods· Nine patients with chronic periodontitis who had pathologic migration of upper incisors were selected.After periodontal initial therapy,periodontal regenerative surgery was performed on the vertical defect around 11 displaced teeth,and then orthodontic intrusion was performed 3 months after the surgery.The differences between baseline (T0) and end of orthodontic treatment (T1) of the periodontal clinical parameters and bone defects were analyzed.Results · For all patients,the periodontal clinical parameters and bone defects were significantly improved.The average pocket probing depth reduction was 2.81 mm,the average attachment gain was 3.38 mm,the average gingival recession was reduced by 0.56 mm,and the width of keratinized gingival tissue was not decreased.As measured on the X-ray,the depth and width of the vertical bone defect were reduced by an average of 2.20 mm and 0.55 mm,respectively.Conclusion · Orthodontic intrusion combined with periodontal regenerative surgery can effectively treat pathologic migration of the upper incisors with vertical bone defects,and obtain good periodontal soft and hard tissue regeneration.
ABSTRACT
O tratamento ortodôntico em adultos com o periodonto reduzido tem exigido uma cooperação interdisciplinar, objetivando transformar pacientes que apresentam espaços interdentais esteticamente não atraentes, extrusões, ou ainda migração dentária patológica, em pessoas com dentições esteticamente melhoradas e função mastigatória restabelecida. O tratamento do paciente com alterações periodontais pode ser afetado pela Ortodontia de maneira positiva através de uma correta indicação, planejamento e execução conjunta das terapias periodontal e ortodôntica. Este trabalho se propôs a revisar a literatura sobre a inter-relação entre a Ortodontia e a Periodontia, apresentando um caso clínico no qual as terapias conjuntas foram essenciais para o estabelecimento da harmonia entre função mastigatória e estética dentogengival.
The orthodontic treatment for adults with reduced periodontium needs a multidisciplinary action, transforming patients with non-attractive interdental spaces, extrusions, or pathologic migrations into esthetically improved dentitions and still retrieving the masticatory function. There is a positive effect of orthodontic treatment for patients with periodontal problems when correct indication, planning, and execution are made. This paper revises the literature regarding the ortho-perio relationship, presenting a clinical case where both therapies were essential to reestablish harmony and function for dentogingival esthetics.
Subject(s)
Humans , Esthetics, Dental , Orthodontics, Corrective , Periodontics/methods , Tooth MigrationABSTRACT
Pathologic tooth migration (PTM) is a common complication following moderate to severe chronic periodontitis, which lead to the undesirable consequences such as traumatic occlusion and impaired aesthetic appearance. Multidisciplinary approach had been successfully used in overcoming the problem. However, since periodontal tissue support is reduced in PTM, further migration of teeth may occur as they were always subjected to the external forces such as occlusion and soft tissue pressure during function. This case report described a 41 year-old male with a further migration of his upper right central incisor after periodontal therapy. After multidisciplinary approach was carried out to overcome the problem and the tooth was on stable condition, permanent splinting was placed to secure the tooth.
ABSTRACT
PURPOSE: Pathologic tooth migration (PTM) commonly occurs in the anterior region and is associated with periodontal disease. The treatment of PTM of anterior teeth can be complex and time consuming, and a multidisciplinary approach is often required. MATERIALS AND METHODS: The patient was a 38-year-old woman with a chief complaint of saving and realigning her elongated maxillary left central incisor. This paper describes the successful combined periodontal regenerative (guided tissue regeneration) and prosthetic treatment and a 2-year follow-up of maxillary central incisor with pathologic tooth migration, deep intrabony defect, and poor prognosis. RESULTS: The right maxillary central incisor was restored by laminate veneer and the left by all-ceramic crown. The patient had no pain and discomfort and was satisfied with the outcomes of her treatment for 2 years. She has maintained her recall program at the Department of Periodontology at 3 months interval. CONCLUSION: The key step in the successful treatment of PTM in anterior region is to obtain a high level of cooperation from the patient. Maintenance of the treatment result of PTM is dependent on the continuous preservation of periodontal health.