Interdisciplinary approach for treating periodontally compromised teeth.
Journal name: Journal of Indian Society of Periodontology
Original article title: Combined periodontic-orthodonticendodontic interdisciplinary approach in the treatment of periodontally compromised tooth
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:
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D Deepa, D. S. Mehta, Viren K. Puri, Sadashiva Shetty
Journal of Indian Society of Periodontology:
(A bimonthly open-access journal)
Full text available for: Combined periodontic-orthodonticendodontic interdisciplinary approach in the treatment of periodontally compromised tooth
Year: 2010 | Doi: 10.4103/0972-124X.70837
Copyright (license): CC BY-NC-SA
Summary of article contents:
Introduction
Orthodontic treatment in adults often requires a multidisciplinary approach, especially in cases involving chronic periodontitis that leads to pathologic tooth migration. This report presents the case of a 28-year-old male patient with significant periodontal issues affecting his maxillary left lateral incisor (#22), characterized by deep pocket formation, tooth mobility, and malalignment. Sequential treatment included comprehensive periodontal therapy followed by orthodontic intervention using aligners to realign the affected tooth. After three years, the results showed notable improvements in periodontal health and tooth alignment, enhancing both the function and esthetics for the patient.
The Role of Orthodontic Intervention in Periodontal Treatment
Orthodontic therapy, when integrated with periodontal treatment, can effectively address the complications resulting from advanced periodontal disease, such as pathologic migration. Studies have indicated that orthodontic forces may promote new attachment formation and help regenerate lost periodontal support. In this case, following initial periodontal therapy and flap surgery, aligners were used to provide gentle, intermittent forces on the affected tooth, allowing for precise movement without excessive stress on the periodontal tissues. The use of orthodontics contributed not only to realigning the displaced tooth but also to filling the infrabony defect, demonstrating the potential of orthodontic treatment to enhance periodontal healing and restore esthetic alignment in patients with compromised dentition.
Conclusion
The case underscores the efficacy of a combined periodontal and orthodontic approach for treating dentition affected by chronic periodontal disease. By sequentially applying periodontal therapy and controlled orthodontic movement, the patient achieved significant improvements in both periodontal health and tooth alignment. This interdisciplinary treatment strategy not only restored function and esthetics but also improved the patient's quality of life, illustrating the potential for collaboration among dental specialists in complex clinical scenarios. Effective management of periodontal disease through such combined approaches can ultimately result in enhanced patient satisfaction and retention of natural teeth.
FAQ section (important questions/answers):
What did the treatment for the 28-year-old male patient involve?
The treatment included periodontal therapy to resolve chronic periodontitis, orthodontic therapy with aligners to correct the alignment of the maxillary left lateral incisor, and endodontic therapy to treat any infection.
What were the results after three years of post-treatment?
Results showed complete resolution of the infrabony pocket, significant bone fill, reduced tooth mobility, and complete alignment of the affected maxillary left lateral incisor, restoring both aesthetics and function.
How does orthodontic treatment help in cases of advanced periodontal disease?
Orthodontic treatment can realign migrated teeth and improve access for oral hygiene, thus aiding in the management of periodontal disease and promoting regeneration of the periodontal tissue.
What was the timeline for the orthodontic treatment using aligners?
The orthodontic treatment was carried out over a period of six months following the resolution of periodontal inflammation after the initial therapies.
What role did oral hygiene play during the treatment process?
A strict oral hygiene program was crucial, including regular professional cleaning and instructions to maintain clean teeth and reduce inflammation during both periodontal and orthodontic treatment phases.
Glossary definitions and references:
Scientific and Ayurvedic Glossary list for “Interdisciplinary approach for treating periodontally compromised teeth.�. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.
1) Hygiene (Hygienic):
Hygiene refers to practices that promote health and prevent disease, particularly oral hygiene in this context. For the patient, maintaining good oral hygiene is crucial after periodontal therapy to prevent inflammation and support recovery. Instruction and motivation in hygiene play a central role in successful treatment outcomes in periodontal interventions.
2) Surface:
Surface pertains to the outer layer of tissues, specifically the periodontal tissues in this case. The relationship between tooth surfaces and the periodontal attachment is significant, as unhealthy surfaces can harbor plaque and bacteria, exacerbating periodontal disease. Smooth, clean surfaces post-treatment are essential for healing and maintaining periodontal health.
3) Inflammation:
Inflammation is a biological response to harmful stimuli, which in periodontal disease manifests as swollen, tender gums and deep pockets. It indicates infection leading to tissue damage. Reducing inflammation through therapy is critical before orthodontic treatment to prevent further complications and ensure a non-inflamed environment for effective healing and tooth movement.
4) Disease:
Disease in this context refers to periodontal disease that affects the supporting structures of the teeth, leading to tissue destruction and tooth mobility. Understanding and managing disease progression are vital, as periodontal conditions directly impact the effectiveness of subsequent orthodontic treatments. Comprehensive periodontal therapy is necessary to improve overall dental health.
5) Male (MÄlÄ“):
Male describes the gender of the patient, influencing various factors in treatment such as biological response to therapy and psychological aspects of dental aesthetics. Gender-specific considerations can play a role in treatment planning, including the assessment of periodontal health and responses to both periodontal and orthodontic interventions in adults.
6) Post:
Post refers to the period following treatment interventions, which is crucial for evaluating outcomes. In dentistry, post-treatment evaluations help assess the success of the combined periodontal and orthodontic approaches. Monitoring healing, assessing periodontal attachment restoration, and ensuring satisfactory esthetics are key factors considered in the post-treatment phase.
7) Observation:
Observation is a critical aspect of clinical practice involving careful monitoring of the patient's conditions and treatment effects. Throughout the case, regular observation allowed for timely adjustments and evaluation of the periodontal health, the movement of teeth, and the effectiveness of both periodontal and orthodontic treatments to ensure optimal outcomes.
8) Karnataka (KarṇÄá¹aka):
Karnataka is the state's context in which the treatment took place, providing geographic and demographic relevance to the case. Understanding regional healthcare practices, access to multidisciplinary treatment, and cultural attitudes toward dental health informs the overall assessment of patient care strategies within the healthcare system in India.
9) Education:
Education refers to the essential aspect of informing patients about their dental health and the significance of oral hygiene practices. In this case, educating the patient ensures awareness about the importance of maintaining proper hygiene post-treatment. Effective patient education can enhance compliance and the overall success of dental therapies.
10) Arranging:
Arranging involves the strategic planning and alignment of the patient's teeth during orthodontic treatment. The success of realignment depends on effectively arranging the teeth to achieve not only functional occlusion but also esthetic satisfaction. Proper arrangement allows for better oral hygiene access and helps restore the natural aesthetics of the smile.
11) Activity:
Activity in this context refers to the biological processes involved in periodontal healing and tooth movement. Enhanced activity of periodontal cells is necessary for effective tissue regeneration and maintenance of periodontal health. Understanding the relationship between orthodontic activity and periodontal biology is crucial for successful treatment integration.
12) Bleeding:
Bleeding is a clinical sign indicating the severity of periodontal disease and inflammation. Its presence during probing suggests a compromised periodontal status. Monitoring bleeding during examinations is crucial for assessing treatment effectiveness and guiding the need for additional therapeutic measures to improve periodontal health.
13) Grafting:
Grafting in periodontal therapy refers to using materials to restore lost periodontal tissues or enhance healing. Although this case did not utilize grafting techniques, understanding grafting principles is important. It may be considered in severe cases to augment bone levels and aid in the periodontal healing process.
14) Quality:
Quality pertains to the standard of care provided to the patient throughout treatment. In dentistry, the quality of both surgical and orthodontic outcomes influences patient satisfaction significantly. Ensuring high-quality treatment involves the integration of effective periodontal methods with orthodontic precision, leading to improved long-term results and enhanced aesthetic outcomes.
15) Cutting:
Cutting refers to the surgical intervention during periodontal therapy, including flap procedures to access and clean deep periodontal pockets. Skilled cutting techniques are essential to minimize tissue trauma, facilitate effective cleaning, and enhance healing chances. Precision in cutting can influence periodontal regeneration and tooth repositioning validity.
16) Repair:
Repair involves the processes involved in healing and restoring periodontal tissues post-treatment. Successful repair is critical in reversing the effects of periodontal disease. The combination of periodontal therapy and light orthodontic forces facilitates the repair and regeneration of periodontal structures, promoting healthy tooth support and aesthetics in the patient's dentition.
17) India:
India serves as the geographical context for the presented case, highlighting local dental healthcare practices, resources, and patient demographics. The healthcare environment in India influences treatment modalities available for periodontal and orthodontic interventions, contributing to understanding how regional factors may play a role in patient outcomes.
18) Life:
Life represents the overall quality of life improvements sought by patients through dental treatment. The combination of periodontal therapy and orthodontics aims to enhance both functional and aesthetic conditions, significantly impacting the patient's confidence and daily activities. Restoring function and aesthetics transforms the patient's overall quality of life.
Other Science Concepts:
Discover the significance of concepts within the article: �Interdisciplinary approach for treating periodontally compromised teeth.�. Further sources in the context of Science might help you critically compare this page with similair documents:
Plaque control, Functional improvement, Multidisciplinary approach, Chronic periodontitis, Oral prophylaxis, Periodontal therapy, Oral hygiene instruction, Orthodontic therapy, Periodontal pocket, Occlusal plane, Intrabony defect, Psychological results, Hand hygiene program.