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ID 117205
Author
Iwata, Mitsuhiro Sakura Dental Clinic
Saito, Atsushi Tokyo Dental College
Kuroda, Yuko Kuroda Dental Office
Shinohara, Takehiro Shinohara Orthodontic Clinic
Arai, Daishi Tokushima University
Horie, Hirofumi Sakura Dental Clinic
Keywords
Interdisciplinary therapy
pathologic tooth migration
periodontal regenerative therapy
implant-anchored orthodontic treatment
implant anchored orthodontic treatment
guided bone regeneration
severe periodontitis
bimaxillary protrusion
Content Type
Journal Article
Description
Background: Patients with severe periodontitis often experience pathologic tooth migration (PTM), which impairs esthetics and leads to occlusal disharmony (e.g., premature contacts and/or traumatic occlusion) that can further exacerbate periodontitis. Here, we describe a patient who exhibited severe periodontitis with PTM-related bimaxillary protrusion. This report includes 3-year clinical outcomes following periodontal regenerative therapy, implant-anchored orthodontic therapy, and implant prosthodontics intended to achieve both functional and esthetic improvements.
Case Description: A 63-year-old woman presented with the chief complaint of upper anterior tooth mobility. Clinical examination revealed excessive tooth mobility, deep periodontal pockets, and infrabony defects in all teeth. All teeth exhibited PTM; the mandibular anterior teeth exhibited marked protrusion caused by the progression of periodontitis. After initial periodontal therapy, periodontal regenerative therapy was performed in all molar regions. At 9 and 6 months postoperatively, comprehensive orthodontic treatment was initiated for the mandible and maxilla, respectively, using orthodontic anchorage devices to achieve acceptable functional occlusion. After orthodontic treatment, staged guided bone regeneration was performed and dental implants were placed in the severely resorbed maxillary anterior ridge. This comprehensive treatment yielded favorable periodontal conditions, stable occlusion, and good esthetic outcomes.
Practical Implications: Favorable esthetics, stable occlusion, and highly cleansable periodontal tissues were achieved with well-planned interdisciplinary and comprehensive treatment, although the patient had severe periodontitis and PTM-related bimaxillary protrusion.
Journal Title
The Journal of the American Dental Association
ISSN
00028177
NCID
AA00692690
AA12301848
Publisher
American Dental Association|Elsevier
Volume
152
Issue
6
Start Page
471
End Page
482.e2
Published Date
2021-05-24
Rights
© 2021. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
EDB ID
DOI (Published Version)
URL ( Publisher's Version )
FullText File
language
eng
TextVersion
Author
departments
Oral Sciences