Orthoperio Management for a Patient with Aggressive Periodontitis: A Multidisciplinary Case Report

Abstract

Introduction: The goal of orthodontic treatment is not only to improve facial esthetics and function but also to address the health of supporting structures and how teeth are placed in them. The interrelationship between ortho and perio often resembles symbiosis. Case description: A 21-year-old female patient reported with the chief complaint of forwardly placed upper front teeth and increasing frontal spacing in the maxillary teeth. She had a mild convex profile with a posterior divergence of the face. Results: The occlusal examination revealed Angle's class I molar relationship bilaterally. The upper incisors showed pathologic anterior migration and extrusion of right central incisor, impacted 23 and crossbite in relation to 22 and 24, whereas the lower arch segment demonstrated mild spacing in the incisor region. Discussion: Periodontal findings were 5-7 mm of generalized pocket depth 13 mm in 11 and 12 mm in 26. The periodontal treatment comprised regular reinforcement of oral hygiene instructions, supragingival scaling, and full mouth open flap debridement. Six-month postperiodontal therapy, orthodontic treatment was initiated and space closure was performed using light continuous force. Conclusion: Posttreatment results showed significant improvement in the extraoral features with competent lips and an average over jet and overbite with sufficient space for the replacement of 11.