Orthodontic, periodontal and prosthodontic treatment for a periodontally compromised patient with a deep overbite

Wanlu Ouyang,Yufen Qian

doi:10.21307/aoj-2020-026

Abstract

Abstract Background Periodontitis may result in displacement, overeruption and the tilting of teeth, which can lead to occlusal prematurities and accelerate the loss of periodontal structures. Orthodontic treatment is needed to correct displaced tooth positions, but inappropriate force and tooth movement can lead to further loss of supporting tissues. Aim To describe the treatment of a deep overbite in a 32-year-old male with a history of periodontitis, gingival recession and missing premolars. Methods After evaluation, fixed appliances applying light forces were chosen as the appropriate treatment approach. A segmental arch and a utility arch technique were applied. Periodontal therapy was conducted before and throughout orthodontic care. Results After 28 months of treatment, a normal overbite and overjet were restored. A displaced premolar was repositioned. Space needed for the prosthetic replacement of the missing teeth was obtained and dental implants were planned after orthodontic treatment. The height of the alveolar bone increased in some areas. After 18 months of retention, the attachment level of the upper left incisor increased approximately 1 mm. Conclusion For patients with a compromised periodontium, adequate management of the tissues is the basis of orthodontic care. Appropriate orthodontic treatment may be beneficial to periodontal health in the long term.

Highlights

A malocclusion can cause greater susceptibility to periodontal disease, either by hampering adequate oral hygiene practice or by causing occlusal trauma.[1]
Inappropriately directed and applied orthodontic force can lead to the further loss of supporting structures
To correct a malocclusion in a patient affected by periodontal disease whilst improving the periodontal condition is a challenge for orthodontists

Summary

Introduction

A malocclusion can cause greater susceptibility to periodontal disease, either by hampering adequate oral hygiene practice or by causing occlusal trauma.[1] Periodontal disease, in turn, leads to the loss of supporting structures and pathologic tooth migration, often seen as proclination of the maxillary anterior teeth, irregular interdental spacing, inclination, rotation, overeruption and extrusion.[2] In the treatment of affected patients, orthodontic movement is needed to correct tooth displacement. Inappropriately directed and applied orthodontic force can lead to the further loss of supporting structures. Periodontitis may result in displacement, overeruption and the tilting of teeth, which can lead to occlusal prematurities and accelerate the loss of periodontal structures. Orthodontic treatment is needed to correct displaced tooth positions, but inappropriate force and tooth movement can lead to further loss of supporting tissues. Appropriate orthodontic treatment may be beneficial to periodontal health in the long term. (Aust Orthod J 2020; 36: 228-237)

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Results

Conclusion