Orthodontic treatment in a patient with severe periodontitis

This is the authors' abstract. We don't add key points for this paper.

In advanced periodontal disease, collapse of the dental arch often occurs with increased tooth mobility. The situation worsens if there is an anterior crossbite. The traumatic occlusion could cause further breakdown of the periodontium as toothbrushing and maintaining oral hygiene become difficult. Consequently, the situation further exacerbates the periodontal destruction. Reconstruction of the occlusion and alignment of the malposed teeth with orthodontic treatment become necessary not only to prevent disease progression, but also to satisfy patients' functional, esthetic, and communication demands. This case report describes the favorable outcome of orthodontic and periodontal management for treating a patient with severe periodontitis, anterior crossbite, and collapse of the occlusion. We report the case of a 50-year-old man who had a skeletal Class III, protruded chin, spacing and chronic generalized advanced periodontitis. Before orthodontic treatment, the patient received periodontal treatment. The patient choose lingual orthodontic appliances for aesthetic reasons. After leveling and alignment, we corrected anterior crossbite, managed space and improved occlusion. Class I canine and molar relationship and proper facial profile was achieved. In patients with periodontal disease, appropriate periodontal treatment before orthodontic treatment is necessary. It is difficult to prep anchorage in patients with periodontal diseases, so temporary anchorage devices could be considered. Under the premise that appropriate periodontal treatment is preceded, oral health can be restored through orthodontic treatment in patients whose occlusion is collapsed due to periodontal disease. All outcomes of the patients were stable after 3 years, and further periodic follow up should be done for retention check.