Treatment progress

Cephalometric values:

Orthodontic management in localizedaggressive periodontitis: a case reportGyawali R1, Shrestha S2, Pokharel PR1, Giri J1, Shrestha G1, Bhattarai B1,1Department of Orthodontics, BPKIHS, Dharan, Nepal2Department of Periodontics and Oral Implantology, BPKIHS, Dharan, Nepal

IntroductionInterdisciplinary approach oforthodontist and periodontist isrequired in orthodontic managementof cases with compromisedperiodontium.1 This is especially truefor adult patients and also youngpatients who suffer from advancedperiodontitis.2,3

Case DescriptionCase History:• 21 year old female • Chief complain of gap between

upper front teeth and extruded left upper front tooth

• No significant medical historyClinical examination:• Midline diastema• Extrusion of 21• Grade I mobility – 21, 36, 46• Gingival swelling• Small sized maxillary laterals

Pretreatment records

Records prior to orthodontic therapy

Before periodontal therapy

1 yr follow up after periodontal therapy

Treatment plan Bonding in upper arch only Closure of midline diastema Intrusion of 21 Build up the maxillary laterals

to close the space

Treatment progress

● 0.022’’ Roth brackets, ● Bondable buccal tubes● 0.014” NiTi

● Space redistribution

Periodontal Therapy Phase I therapy- non surgical

(antibiotic + mechanical debridement)

Flap surgery in all posterior segments

● Radiographs prior to debond

● Post-debond

Conclusion With light force and good oral

hygiene maintenance,orthodontic treatment ispossible in cases withcompromised periodontium.

References1. Vinod K, Reddy YG, Reddy VP, Nandan H,

Sharma M. Orthodontic-periodontics in‐terdisciplinary approach. J Indian SocPeriodontol. 2012;16(1):11-5.

2. Feng at al. An interdisciplinary approach forimproved functional and esthetic results in aperiodontally compromised adult patients.Angle Orthod 2005;75:1061–1070.

3. Gkantidis et al. The orthodontic-periodonticinterrelationship in integrated treatmentchallenges: a systematic review. Journal ofOral Rehabilitation 2010; 37: 377-390