Periodontal Problems Research Articles

Treatment of Osseous Defects after Mandibular Third Molar Removal with a Resorbable Alloplastic Grafting Material: A Case Series with 1- to 2-Year Follow-Up.

Mandibular third molar (M3) surgical extraction may cause periodontal complications on the distal aspect of the root of the adjacent mandibular second molar (M2). Patients older than 26 years with periodontal pathology on the distal surface of the M2 and a horizontal/mesioangular impacted M3 may benefit from bone regenerative therapy at the time of surgery. In this prospective case series, an alloplastic fully resorbable bone grafting material, consisting of beta-tricalcium phosphate (β-TCP) and calcium sulfate (CS), was used for the treatment of the osseous defects after the removal of horizontal or mesioangular M3s in 4 patients older than 26 years. On presentation, the main radiological finding in all patients, indicating periodontal pathology, was the absence of bone between the crown of the M3 and the distal surface of the root of the M2. To evaluate the treatment outcome, bone gain (BG) was assessed by recording the amount of bone defect (BD) at the time of surgical removal (T0) and at the time of final follow-up (T1) 1 or 2 years post-operatively. The healing in all cases was uneventful, with no complications associated with the use of the alloplastic grafting material. Clinical and radiological examination at T1 revealed that all extraction sites were adequately restored, with significant BG of 6.07 ± 0.28 mm. No residual pathological pockets on the distal surface of the M2 were detected. Pocket depth (PD) at T1 was 2 ± 0.71 mm. Within the limitations of this case series, the results suggest that β-TCP/CS can support new bone formation at M3 post-extraction sites where bone regeneration methods are indicated, thus reducing the risk of having persistent or developing new periodontal problems at the adjacent M2.

Limits and Possibilities of Orthodontic Treatment of Patients with Skeletal Forms of Sagittal Anomalies

The need to develop and improve methods of diagnos is and treatment of patients with deformities of the jaws is determined primarily by the frequency of it prevalence. Dental anomalies occur in 33.7 - 49% of those examined. To improve the effectiveness of orthodontic treatment of patients with skeletal forms of sagittal anomalies of occlusion of the dentition, it is necessary to conduct additional methods of examination, computer modeling of treatment results, drawing up a comprehensive treatment plan. Clinical case. Patient 33 years old. Skeletal III class, Mesial occlusion of dental arches, Narrow upper jaw, Tooth crowding, periodontal problems, gingival loss. After additional diagnostic methods, computer simulation of treatment was performed, various treatment options were considered.

PREVALENCE OF PERIODONTAL DISEASES IN CHILDREN WITH DOWN SYNDROME

Down syndrome – trisomy of 21 chromosome is the most common chromosome anomaly, which affects children worldwide. The aim of this study is to compare the distribution of periodontal disease among Down syndrome children and healthy children. 60 children and adolescents with Down syndrome and 60 healthy children were examined in the same age group. Plaque index (PI) (Silness&Loe), probing depth (PD) were registered. The plaque index of children with Down syndrome under 6 years is 0.81. For the children between 6-11 years, this index is 1.4 and for the third group it is 1,8. For the healthy children the values of the PI are: under 6 years – 0.9; between 6-11 – 1.2; between 11-15 – 2.2. The measured pocket depths of the children with DS for the three examined are as follows: under 6 years – 3.5; between 6-11 – 4.1; between 11-15 – 4.7. For the healthy children the values of the PPD are: under 6 years – 2.6; between 6-11 – 3.3; between 11-15 – 3.0. Conclusion: There are more frequent periodontal problems for Down syndrome children, which does not correspond with the level of their oral hygiene.

Relationship of Malocclusion with Periodontal Status among Adult Population in Chennai - A Case Control Study

Malocclusion is defined as an irregularity of the teeth or an incorrect placement of the dental arches that is outside the ideal range. Besides this irregularity of the teeth or jaws, malocclusion may cause periodontal problems, disturbances of oral function such as mastication, swallowing, and speech, and psychosocial problems related to impaired dentofacial aesthetics. Hence this study was conducted to find the relationship between orthodontic malocclusion with periodontal status among the adult population visiting private dental college in Chennai. A retrospective study was conducted using case records of patients attending private dental college from July 2019- March 2020. A total of 932 case sheets of patients who had recorded for Russell’s periodontal index were retrieved and used for statistical analysis. Descriptive statistics, chi-square and Pearson’s correlation was used to analyze the data. Out of 932 participants class I malocclusion-96.24%, class 2 Div I - 1.82%, class division 2, class 2 subdivision, class 3 malocclusion, class 3 subdivision was 0.32%, 0.42%, 0.855 and 0.32% respectively.10.73% of the study population have terminal disease which is a surprising finding when compared with other studies. The results of the study were subjected to statistical analysis. Negligible negative correlation was found between malocclusion and periodontal status and were statistically insignificant. No statistically significant association was found between orthodontic malocclusion and periodontal status and a negligible negative correlation was obtained, which shows that there was no relationship between malocclusion and periodontal status in this study population.

Oral Hygiene in Patients with Fixed Partial Dentures

Fixed prosthodontics is the area of prosthodontics focused on permanently attached dental prosthesis. Patientswith FPD require regular lifelong professional maintenance with repeated interventions and reinstructionsregarding maintenance of proper oral hygiene around fixed prosthesis. The aim of the study is to evaluatethe oral hygiene in patients with Fixed Dental Prosthesis. A total 86000 patients data were analysed and thesamples were taken from the patients who checked into the hospital from June 2019 to April 2020. A totalof 958 patients were taken and analysed for oral hygiene status. Data collection was done from the dentalarchives of the patient management software system patented by Saveetha dental college.The data wasobtained from the category fixed dental prosthesis. The results were analysed using SPSS software version20 by IBM. The results observed was that the patients with FPD were prevalent to gingival inflammationand periodontal problems. Noticeable lack of awareness about oral hygiene after the fixed partial denture isfound among patients wearing Fixed Partial Denture.

Effects of Fixed and Removable Space Maintainers on Dental Plaque and DMFT/dft Values

Purpose: Space maintainers are important for the health and placement of children’s primary and permanent teeth. However, plaque and caries levels can be negatively affected when a dental appliance is in the mouth. This study aims to evaluate the oral health of pediatric patients that have space maintainers applied as a result of early tooth loss. Methods: This study included 100 systemically healthy patients between the ages of 4-15 years that were treated with space maintainers due to early loss of teeth. Decayed, missing, filled tooth index values and dental plaque status of the participants were recorded. Controls were performed in the 6th and 12th month. The index results were compared and evaluated statistically using ANOVA and paired-t-tests. Results: A total of 116 space maintainers, including 36 band and loops, 16 lingual arches, 21 palatal arches, 43 removable appliances, were evaluated in the study. Statistically significant differences were found between the pre-treatment and post-treatment index values (p<0.001). In the group of band and loops and removable space maintainers; the increases in DMFT/dft values of 6th month and 12th month according to initial DMFT/dft values were statistically significant (p<0.05). For plaque index, the increase in 12th month of all types of appliances were found statistically significant (p<0.001). The greatest increase in plaque index level was seen in the teeth of patients that had been treated with a lingual arch. Conclusions: Incompatible space maintainers can lead to caries, increased plaque accumulation, demineralized areas, and periodontal problems. The accumulation of plaque and difficulty of cleaning the teeth, especially in the fixed space maintainers, negatively affects the health of teeth. For this reason, good oral hygiene should be provided to patients and controls should be regularly performed.

Comparison of the Effects Caused by Three Different Mandibular Advancement Devices on the Periodontal Ligaments and Teeth for the Treatment of Osa: A Finite Element Model Study

AIM: The purpose of this study is to compare the stress effects developed on the periodontal ligaments and teeth by three different types of mandibular advancement devices (MADs) using a finite element method (FEM) analysis. Introduction: Obstructive sleep apnea (OSA) is a disease with a high prevalence and, in recent years, the use of MADs as an alternative or support treatment to the continuous positive airway pressure (CPAP) has spread. Their use finds relative contraindications in the case of partial edentulism and severe periodontal disease. Given the widespread of periodontal problems, it is essential to know the effects that these devices cause on the periodontal ligament of the teeth. Materials and methods: Starting from the computed tomography (CT) scan of a patient’s skull, 3D reconstructions of the maxilla and mandible were implemented. Three different MADs were prepared for the patient, then 3D scanned, and lastly, coupled with the 3D models of the jaws. The devices have two different mechanics: One has a front reverse connecting rod (OrthoapneaTM), and two have lateral propulsion (SomnodentTM and HerbstTM). A FEM analysis was performed to calculate the stress applied on periodontal ligaments, on every single tooth and the displacement vectors that are generated by applying an advancement force on the mandible. Results: HerbstTM and SomnodentTM devices present very similar stress values, mainly concentrated on lateral teeth, but in general, the forces are very mild and distributed. The maximum stresses values are 3.27 kPa on periodontal ligaments and 287 kPa on teeth for SomnodentTM and 3.56 kPa on periodontal ligaments and 302 kPa on teeth for HerbstTM. OrthoapneaTM has, instead, higher and concentrated stress values, especially in the anterior maxillary and mandibular area with 4.26 kPa and 600 kPa as maximum stress values, respectively, on periodontal ligaments and teeth. Conclusions: From the results, it is concluded that devices with a bilateral mechanism generate less and more distributed stress than an anterior connecting rod mechanism. Therefore, they may be advisable to patients with compromised periodontal conditions in the anterior area.

Awareness on Applications of Potodynamic Therapy in Dentistry Among Undergraduate Dental Students - A Questionnaire Survey

Photodynamic therapy is a light-based therapy that uses photosensitizers as an activating substance which has an inducing and therapeutic effect. It can be used to treat many periodontal and orthodontic problems in dentistry. It is used widely in treating many problems related to periodontics, oral lesions and to treat cariogenic bacteria. The aim of the study was to analyse the awareness on applications of photodynamic therapy in dentistry among undergraduate dental students. A questionnaire was prepared and administered to 100 participants through Google forms - an online survey platform. The study population included undergraduate dental students. Results were collected and generated in SPSS software. The results showed that the majority of participants were aware about the photodynamic therapy and its various uses in dentistry to treat patients. Photodynamic therapy is a light-based therapy which is used to treat various periodontal problems and it is used in gingival curettage and melanin pigmentation removal in dentistry. Within the limitations of the study, we conclude that the undergraduate dental students were well informed about the various uses of photodynamic therapy in dentistry.

Racial inequality and periodontal condition in Brazilian adolescents

Abstract Background Oral health, such as other health conditions, reflects social inequalities. These inequalities are fed back by oral diseases, generating a vicious and sustainable circle. Racial issues play a prominent role, once they are associated with oral diseases as risk markers. Among the different oral diseases, periodontal disease associated with racial inequalities in adolescents is emblematic. Thus, this study aimed to analyse the race differentials associated with the levels of periodontal disease, regardless of other risk factors. Methods Data from the 2010 national epidemiological survey on oral health were used, with 5445 adolescents (15 to 19 years old). Multinomial logistic regression models were used. Dependent variable was the Community Periodontal Index. Independent variable was self-declared race/colour, categorized as white, pardo (mixed-race identity) and preto (black). The effect of race was controlled in the presence of the covariates sex, years of study, decayed, missing and filled permanent teeth (DMFT index), toothache and self-reported need for dental treatment. Odds Ratio (OR) was estimated and sample weights were considered. Results The simple model showed preto with 2.7 (p < 0.05) and 8 (p < 0.05) times more likely to have shallow and deep periodontal pockets, respectively, compared to white. Pardo was 1.5 (p < 0.05) times more likely to have periodontal calculus. In the multiple model, even in the presence of all independent covariates, preto showed association with shallow pockets (OR = 2.51, p < 0.05) and pardo showed association with the presence of calculus (OR = 1.37, p < 0.05). Conclusions Regardless of sex, education, perception of pain and need for treatment and the DMFT index, race/colour was associated with periodontal problems. It should be noted that skin colour is not a biological risk factor for periodontal disease. However, the findings of this study revealed racial inequities regardless of socioeconomic variables. Key messages Raises the need to guarantee health as a resource for social development, with science having a fundamental role in recovering the citizenship of this historically forgotten population. The findings of this study revealed racial inequities regardless of socioeconomic variables.

Micromorphological analysis and bond strength comparison of two adhesives for different degrees of dental fluorosis

The objective of this study was to analyze morphologically the all-etching bonding system and self-etching bonding system for enamel with different degrees of fluorosis and evaluate the bond strength of each system. Teeth that were indicated for extraction owing to orthodontic or periodontal problems were selected. According to Dean’s index and the Thylstrup-Fejerskov index, 180 extracted teeth were divided into three groups of mild, moderate, and severe dental fluorosis (DF), with 60 teeth in each group. The teeth in each group were randomly divided into two subgroups (n = 30), which were then subjected to the all-etching bonding system (Prime & Bond NT) and self-etching bonding system (SE-Bond). Each group of adhesives was used to bond Z350 universal resin (3 M) to the etched dental enamel. Tensile and shear tests were conducted to determine the bond strength. Subsequently, the fractured specimens were investigated using scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM). The Prime & Bond NT was statistically significant for the tensile and shear strength of enamel with mild fluorosis (P < 0.05) but did not exhibit a significant difference for moderate and severe DF (P > 0.05). The SE-Bond was not statistically significant for the tensile and shear strength of mild, moderate, or severe DF (P > 0.05). The SEM and CLSM results reveal that the mild fluorosis enamel crystals were relatively dense, and a small amount of resin remained. The moderate fluorosis enamel crystals were loosely arranged, and the gaps were widened. The severe fluorosis enamel crystals were irregularly arranged. The disorder was aggravated, and the dentinal orifice was exposed by partial enamel exfoliation. The bonding strength of mild fluorosis enamel with the Prime & Bond NT was better than that with the SE-Bond, and cohesive failure was the most common mode of failure. Because there was no difference in the bonding strength of the SE-Bond for different degrees of DF, we recommend the use of the all-etching adhesive system in the clinical treatment of teeth with mild fluorosis.

Keterkaitan Antara Bidang Orthodonti dan Periodonti dalam Perawatan Estetika Rongga Mulut

Background: Orthodontic Treatment aims to correct occlusion functional and aesthetics as well as achieving the health of supporting structure. Orthodontists frequently treat patients with periodontal problems both from aesthetic considerations as discrepancy gingival margin and functional considerations due to periodontal disease. Review: The relationship between orthodontics and periodontics is very important in establishing the diagnosis and treatment plan, and this relationship often resembles symbiosis. In many cases periodontal health can be improved with orthodontic movements, and orthodontic tooth movement is often facilitated by periodontal therapy. But on the other hand orthodontic treatment can also cause periodontal problems such as gingival inflammation, recession, bone dehiscence. Conclusion: This paper summarizes the literature to provide a basic understanding of interrelationship between periodontics and orthodontics for optimized treatment outcomes.

Evaluation of the position of mandibular third molar hidden teeth and its effect on second adjacent molar teeth in panoramic radiography in patients referring to Birjand Dental School in 2018-19

Background and Aim: The third molar tooth lies with symptoms such as periodontal problems, caries, crowding, root resorption, cyst and tumor formation of the adjacent second molar. This study was to evaluate the position of mandibular third molar teeth and its effect on second adjacent molar teeth. Materials and Methods: Panoramic radiography was obtained from 264 patients with mandibular third molar hidden teeth referred to the Birjand School of Dentistry in 2018. The material and direction of their placement and the vertical position of the third molar tooth (based on the PELL &amp; Gregory classification) and its placement angle (based on Winter classification) were determined. Also, the prevalence of distal caries, external root resorption, the amounts of displacement, t inflammatory lesions and the cystic was examined in the adjacent second molar tooth. Data were analyzed using SPSS software (Version 19), and Chi-square statistical test, p-values less than 0.05 were considered as statistically significant. Results: The data from this study showed that most of the wisdom hidden teeth were in Class B and III of Pell and Gregory classification, had Mesial angle based on Winter classification. In 20.8% of patients with caries, there was 3% root canal resorption and 1.1% displacement of the second molar tooth, while no cases of inflammatory and cystic lesions in the second molar tooth were found due to the hidden third molar tooth. The Mesial and horizontal angles of impacted wisdom teeth were associated with increased risk of caries and root resorption of the second molar. Also, Class B's third molar teeth increased caries in second molar teeth. Conclusion: Most pathological problems were observed in Mesial, horizontal, and class B impaction. According to the observed relationship, it seems that the angle and depth of the hidden third molar should be taken into account c when deciding whether or not to extract it.

Is the corticotomy assisted orthodontic treatment efficient in the expansion of narrow arches in adult patients?

Corticotomy assisted orthodontic treatment (CAOT) is a technique which, performing surgical cuts on the cortical alveolar bone around the teeth, induces a faster rate of orthodontic tooth movement. The development CAOT offers solutions to overcome many of limitations in adult orthodontic treatment, such as risk of hyalinization, root resorption, periodontal problems, lack of bone growth and a long therapy time due to slower tooth movement compared to adolescents. The purpose of this systematic review was to identify if CAOT is also useful for expanding narrow arches in adult orthodontic patients. An electronic research on PubMed until June 2020 was made with the combined search terms "corticotomy expansion," "corticotomy orthodontic expansion" and "corticotomy orthodontic." Six studies were included in this systematic review. The authors found discordant results in literature; however, it seems that CAOT can have better results than conventional expansion, but it cannot be considered as an alternative therapy for severe posterior cross-bite. CAOT have a greater predictability if done with bone grafting. The evidence of corticotomy as a help to palatal expansion in adult orthodontic treatment has not been well described in literature and only few published reports are available. Further testing in human beings are still necessary to confirm the validity of this technique.

Nutrition and oral health

Diet assumes a significant job in anticipating oral illnesses including dental caries, dental erosion, developmental deformities, oral mucosal disease and, to a lesser degree, periodontal problem. Undernutrition builds the seriousness of oral mucosal and periodontal ailments and is a contributing variable to dangerous noma. Under nutrition is related with formative imperfections of the lacquer which increment helplessness to dental caries. Dental erosion is seen to increase. Proof recommends that soda gas, a significant wellspring of acids in the eating routine in nations, are a signi?cant causative factor. Persuading proof from test, creature, human observational and human mediation contemplates shows that sugars are the principle dietary factor related with dental caries. Dietary advice for the prevention of oral diseases has a part of routine patient education. This review paper suggests that the nutrition training has to be given by dentist for patients to reduce the illness related to oral mucosa. Keywords: Nutrition, vitamin A and D, dental caries, periodontal disease.

SEVERE DENTAL CALCULUS AND NON-SURGICAL PERIODONTAL TREATMENT: A CASE REPORT

Abstract Poor oral hygiene, combined with adverse local and systemic factors, may lead to more severe periodontal diseases. A 17-year-old girl with tooth and gum problems was admitted to our clinic. Intraoral examination revealed that oral hygiene was inadequate and there was a severe calculus extending up to the occlusal surface (approximately 20 mm x 12 mm). Her medical anamnesis showed no significant findings, but she had oral respiration and had difficulty in communicating with her environment. Oral hygiene education was given and debridement was performed at regular intervals. Follow-up sessions, it was observed that she was satisfied with treatment, paid attention to her oral hygiene and her self-confidence increased. The patient was referred to the Orthodontics and Ear-Nose-Throat clinics to prevent recurrence of problems after satisfactory recovery. Even with good oral hygiene training and initial periodontal treatment, severe periodontal problems can be solved and quality of life can be recovered. Keywords: calculus, mouth breathing, oral hygiene

An Innovative Approach for Accelerated Orthodontic Tooth Movement Stimulated by Corticotomy and Alveolar Grafting withAutogenous Demineralized Dentin Graft of Extracted Premolar- A Case Report

In today's era, there is an increased demand for orthodontic treatment, especially among young patients. The greatest concern amongst the patients undergoing orthodontic treatment is the increased treatment time. The fixed orthodontic treatment lasts up to 2 to 3 years which further increases the risk of complications associated with the treatment such as external root resorption, periodontal problems, and patient compliance [1]. Clinicians are constantly striving towards developing strategies to enhance the rate of orthodontic tooth movement and decreasing the treatment time. Numerous surgical modalities found to be highly effective in reducing the treatment time for orthodontic therapy include corticotomy, corticision, peizocision, periodontal distraction, dentoalveolar distraction etc. [2]. Wilcko et al. [3] introduced the combined approach corticotomy surgery with alveolar grafting in a technique referred to as Accelerated Osteogenic Orthodontics (AOO) and recently known as Periodontally accelerated osteogenic orthodontics (PAOO). Many studies dictated that PAOO is an extremely predictable, safe, effective technique. The risk of root resorption and the duration of treatment time is considerably reduced [3-5]. The present article focuses on accelerating the orthodontic tooth movement using a Demineralized dentin matrix (DDM) graft, alloplast and PRF membranes to reduce the treatment time and improves soft and hard tissue healing outcomes.

Oral health disparities among Brazilian self-identified indigenous individuals

This article aimed to use epidemiological constructs to describe and analyze the oral health burdens among self-identified indigenous individuals in Brazil and to compare the findings with the oral health status within the non-indigenous population. The study utilized secondary data from the Oral health Brazil database (SB Brasil 2003) to address the null hypothesis that there were no oral health differences between self-identified indigenous and non-indigenous individuals in Brazil. Indigenous individuals had 3.17 (95% C.I.:2.44--4.13) greater odds of never having visited a dentist’s office than non-indigenous individuals. Indigenous persons had 1.55 (95% C.I.:1.20--2.00) greater odds of having periodontal problems than non-indigenous persons. Indigenous children had 1.71 (95% C.I.:1.37--2.14) higher odds of having a decayed, missing, and filled teeth score different from zero than non-indigenous children. Finally, indigenous persons were found to have 1.24 (95% C.I.:1.07--1.45) greater odds of not being a caries free individual than a non-indigenous person. The results lend credence to the suspicions that in Brazil there are unequal and unfair differences in oral health status and access to dental care between self-identified indigenous individuals and their respective national counterpart.

THE BACTERIUM Fusobacterium sp. MAY INTERFERE WITH CONCEPTION

This study was aimed to investigate microbiological and molecular markers of periodontal problems and its association with conception in 101 Iraqi women, 50 primary infertile while 27 secondary infertile and 24 pregnant as control group. Major periodontal pathogen in the subgingival plaque and cervical vaginal swab specimens was detected, and molecular marker (16SrRNA) gene used for detection of Fusobacterium in our study. Fusobacterium sp. isolates from oral samples were examined biochemically and confirmed by molecular detection, they were also subjected to antibiotic sensitivity test and were shown to be resistant to β-lactamase family of antibiotics and were mostly resistant to Ciprofloxacin. Four Fusobacterium sp samples were identified in both Oral samples and vaginal-cervical specimens of the same four women from the primary infertile group. Fusobacterium sp. was significantly (P&lt;0.01) more frequently detected in the Oral samples and vaginal-cervical specimens among primary infertile group (38.7%) than pregnant (9.1%) as so among secondary (30.0%) than pregnant (9.1%). Analysis identified a model of a significant predictive factor of presence of Fusobacterium sp.: primary infertile [Odd ratio (OR) = 6.3 at 95% CI = 1.33-25.1] and secondary infertile OR = 4.2 at 95% CI = 1.84-12.22. this can show that infertalty state can be more risked than pregnant women to have the Fusobacterium sp and be effected by it.

Implant–supported crowns insertion in patient receiving chemotherapy

The clinical results of a case demonstrating dental implant insertion in a patient receiving chemotherapy is the focus of this report. A 74-year-old male patient came on his own accord because five units of porcelain long bridge in his right mandibular region were loosened. The one abutment tooth had a severe problem due to the periodontal problem (tooth 47), and teeth 43 and 44 were treated with root canal treatment, intrapulp post and porcelain crowns. After insertion of the fixture bone level implant, the patient is diagnosed with lymphoma and chemotherapy is performed for treatment. Clinically, the implants had no mobility, with no apparent exudate or bleeding upon probing 1 year after. At the time second procedures were performed, the dental implants had provided support for the abutments. One of the abutments was changed with anatomic abutment due to realignment of prosthesis position. Finally, three crowns porcelain fused to metal were used as final restorations and harmonized occlusion was achieved. The following is a discussion of the purposes and technique used for the insertion of these dental implants.

Rotating a Segmental Maxilla to Close a Serious Vertically Displaced Alveolar Cleft

In recent years, alveolar bone grafting has emerged as the first treatment choice for space closure in the secondary dentition. Despite this, a high possibility of failure still exists for patients with a vertical discrepancy of cleft segments. This is attributed to the absence of valid contact between the grafted bone and the surfaces of bone segments in the cleft region. In cases of minor discrepancies, the vertical distance can be reduced orthodontically, allowing for subsequent alveolar bone grafting.1 However, in severe cases, isolated orthodontic treatment is not viable due to a high risk of periodontal problems and increased tooth mobility. Under the circumstances, surgical intervention is essential. Herein, we report a case in which the alveolar segment is aligned using a novel application of segmental maxillary osteotomy to rotate the segment with a subperiosteal tunnel. Rigid fixation of the segment in the desired position is then performed with concurrent bone grafting. Therefore, performing segmental maxillary osteotomy before bone grafting could be an alternative to correcting the vertical discrepancy encountered in cleft patients.