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Comprehensive treatment for severe periodontitis with pathologic tooth migration−related bimaxillary protrusion

医学 牙科 牙周炎 闭塞 口腔正畸科 牙齿活动度 前牙 上颌骨 植入 外科
作者
Mitsuhiro Iwata,Atsushi Saitô,Yoshiaki Kuroda,Takehiro Shinohara,Daishi Arai,Hirofumi Horie,Eiji Tanaka
出处
期刊:Journal of the American Dental Association [Elsevier]
卷期号:152 (6): 471-482.e2 被引量:1
标识
DOI:10.1016/j.adaj.2021.02.017
摘要

Patients with severe periodontitis often experience pathologic tooth migration (PTM), which impairs esthetics and leads to occlusal disharmony (for example, premature contacts and traumatic occlusion) that can further exacerbate periodontitis. The authors describe a patient who exhibited severe periodontitis with PTM-related bimaxillary protrusion. This report includes 3-year clinical outcomes after periodontal regenerative therapy, implant-anchored orthodontic therapy, and implant prosthodontics intended to achieve both functional and esthetic improvements.A 63-year-old woman sought treatment with the chief complaint of maxillary 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 6 and 9 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.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.
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