Orthodontic Management of Periodontal Defects:
Adult patients with reduced periodontium often present with drifting of teeth leading to development, or worsening of malocclusion. Orthodontics is not an easy choice of treatment for many dentists. There is ample evidence that if optimal hygiene is maintained after appropriate periodontal therapy despite clinical attachment loss, orthodontic fixed mechanotherapy is a viable option. Apart from correction of malocclusion, orthodontics can also facilitate improvement in periodontal health. For this reason, most surgical periodontal procedures are deferred until the completion of orthodontic treatment. Orthodontic application in patients with reduced periodontium ranges from correction of hemiseptal defects, furcation involvement, open gingival embrasures, forced extrusion, 2 walled defects and implant site development1.
A tooth with hopeless prognosis due to advanced bone loss may likely be extracted. When replacing missing teeth treatment options include removable partial …show more content…
This method takes advantage of residual periodontal attachment to generate bone which follows tooth movement. Tension at apical fibers leads to a deposition of bone at the area. The ability to affect the environment through mechanical manipulation is maintained along the entire attachment surface of the root, as long as the residual apical attachment is still fairly healthy. The ultimate aim is achieving predictable implant placement and avoid the need for further augmentive surgical interventions3. A typical protocol involves 4-28 weeks of active extrusion using 15-50gm of force (rate of tooth movement at 2mm/month) depending on amount of remaining bone with at least 1 month of retention7. Since the new bone formation is physiologic and not a regenerate bone, implant can be placed immediately after
Adult patients with reduced periodontium often present with drifting of teeth leading to development, or worsening of malocclusion. Orthodontics is not an easy choice of treatment for many dentists. There is ample evidence that if optimal hygiene is maintained after appropriate periodontal therapy despite clinical attachment loss, orthodontic fixed mechanotherapy is a viable option. Apart from correction of malocclusion, orthodontics can also facilitate improvement in periodontal health. For this reason, most surgical periodontal procedures are deferred until the completion of orthodontic treatment. Orthodontic application in patients with reduced periodontium ranges from correction of hemiseptal defects, furcation involvement, open gingival embrasures, forced extrusion, 2 walled defects and implant site development1.
A tooth with hopeless prognosis due to advanced bone loss may likely be extracted. When replacing missing teeth treatment options include removable partial …show more content…
This method takes advantage of residual periodontal attachment to generate bone which follows tooth movement. Tension at apical fibers leads to a deposition of bone at the area. The ability to affect the environment through mechanical manipulation is maintained along the entire attachment surface of the root, as long as the residual apical attachment is still fairly healthy. The ultimate aim is achieving predictable implant placement and avoid the need for further augmentive surgical interventions3. A typical protocol involves 4-28 weeks of active extrusion using 15-50gm of force (rate of tooth movement at 2mm/month) depending on amount of remaining bone with at least 1 month of retention7. Since the new bone formation is physiologic and not a regenerate bone, implant can be placed immediately after