Orthodontic treatment of periodontally involved teeth after tissue regeneration.
In this consecutive series, 14 patients with severe intrabony defects and pathologic tooth migration were treated with guided tissue regeneration (GTR) and subsequent orthodontic therapy in an attempt to evaluate the validity of this multidisciplinary approach. Probing pocket depths (PPD), clinical attachment levels (CAL), and gingival recessions were assessed at baseline, 1 year after GTR, and at the end of orthodontic therapy. Radiographs were obtained at all time points. Esthetic parameters were recorded with the papilla presence index (PPI). Statistical analyses were carried out to compare the data at each time point. From baseline to 1 year after GTR, the mean PPD reduction was 5.57 mm, with a residual mean PPD of 2.71 mm; mean CAL gain was 5.86 mm. Both differences were statistically significant. There were no statistically significant differences between 1 year after GTR and the end of orthodontic therapy (mean PPD reduction 0.07 mm; mean CAL gain 0.43 mm). The reduction in PPI reflected the enhancement of papilla height that was observed in 9 of the 14 patients. Within the limits of this research, this study affirms the possibility of a combined orthodontic-periodontal approach that prevents damaging the regenerated periodontal apparatus and produces esthetic improvements as a result of realignments and enhancement of papilla height.
Ghezzi
Carlo
C
Department of Periodontology, School of Dentistry, University of Milano, Milan, Italy. carlo-ghezzi@fastwebnet.it
Masiero
Silvia
S
Silvestri
Maurizio
M
Zanotti
Gianfranco
G
Rasperini
Giulio
G
D016301:Alveolar Bone Loss / Q000601:surgery; D016025:Bone Transplantation; D003094:Collagen; D003746:Dental Enamel Proteins / Q000627:therapeutic use; D012534:Dental Scaling; D003970:Diastema / Q000628:therapy; D004955:Esthetics, Dental; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology; D005889:Gingival Recession / Q000601:surgery; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008567:Membranes, Artificial; D016910:Orthodontic Brackets; D017622:Periodontal Attachment Loss / Q000601:surgery; D010510:Periodontal Diseases / Q000601:surgery / Q000628:therapy*; D010514:Periodontal Pocket / Q000601:surgery; D016745:Root Planing; D013524:Surgical Flaps; D014085:Tooth Migration / Q000628:therapy; D014087:Tooth Movement Techniques / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
D003746:Dental Enamel Proteins; D008567:Membranes, Artificial; C109069:enamel matrix proteins; D003094:Collagen