title: Orthodontic treatment in the severely compromised periodontal patient.
abstract: We describe the diagnosis and treatment of a class II division 1 malocclusion complicated by severe periodontal disease, tooth loss, dentoalveolar protrusion associated with tipping and extrusion of the maxillary incisors, and a traumatic occlusion. Treatment involved the use of a modified palatal arch to intrude and retract the maxillary incisors and high-pull headgear to enhance anchorage and correct the Class II relationship. After active treatment for 19 months, a good anterior occlusion was achieved, with 17° of lingual retroclination and 3 mm of intrusion at the apex of the maxillary incisors. An acceptable occlusion and periodontal status was maintained over a retention period of 2 years. With the patient's cooperation, a successful outcome was achieved with this approach.
authors.affiliation: Rio de Janeiro State University, Rio de Janeiro, Brazil. danifeutz@yahoo.com.br
authors.forename: Daniela
authors.initials: D
authors.lastname: Feu
authors.forename: Fernanda Catharino
authors.initials: FC
authors.lastname: Menezes
authors.forename: José
authors.initials: J
authors.lastname: Augusto Mendes Miguel
authors.forename: Catia
authors.initials: C
authors.lastname: Cardoso Abdo Quintão
mesh_terms: D000328:Adult; D002508:Cephalometry / Q000379:methods; D003769:Dental Occlusion, Traumatic / Q000150:complications; D005115:Extraoral Traction Appliances; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008312:Malocclusion, Angle Class II / Q000628:therapy*; D052280:Orthodontic Anchorage Procedures / Q000295:instrumentation; D016382:Orthodontic Appliance Design; D010347:Patient Care Planning; D017622:Periodontal Attachment Loss / Q000150:complications; D010510:Periodontal Diseases / Q000150:complications* / Q000628:therapy; D016388:Tooth Loss / Q000150:complications; D014086:Tooth Mobility / Q000150:complications; D014087:Tooth Movement Techniques / Q000295:instrumentation; D016896:Treatment Outcome