Periodontal and Orthodontic Synergy in the Management of Stage IV Periodontitis: Challenges, Indications and Limits
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Population
2.2. Active Periodontal Treatment
2.3. Orthodontic Therapy
2.4. Supportive Periodontal Care
2.5. Smile Aesthetic Evaluation
2.6. Clinical Periodontal Parameters
2.7. Radiographic Periodontal Parameters
2.8. Data Analysis
3. Results
3.1. Patients
3.2. Orthodontic and Aesthetic Treatment Outcomes
3.3. Periodontal Clinical and Radiographic Outcomes
4. Discussion
5. Conclusions
- PD and CAL obtained with the active periodontal treatment remained stable after OT and during the 8.9 years of follow-up;
- all anterior teeth with PTM were successfully retained during OT and SPC;
- intruded teeth experienced stability in MBL with some degree of root resorption;
- patients were highly satisfied with their own final smile aesthetics;
- the perception of aesthetics differed between patients and clinicians.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | T0 Baseline | T1 Active Periodontal Treatment | ΔT0–T1 | T2 Orthodontic Treatment | ΔT0–T2 | T3 Last Follow-Up | ΔT0–T3 |
---|---|---|---|---|---|---|---|
FMPS (%) | 53.1 ± 17.9 * | 15.9 ± 2.9 | 37.1 ± 17.7 † | 16.9 ± 2.7 | 36.2 ± 17.9 † | 18.2 ± 4.3 | 34.9 ± 18.4 † |
FMBS (%) | 34.2 ± 16.7 * | 8.7 ± 3.6 | 25.5 ± 14.8 † | 8.4 ± 3.1 | 25.8 ± 15.1 † | 7.5 ± 3.2 | 26.7 ± 15.5 † |
PD (mm) | 4.2 ± 0.9 * | 3.1 ± 0.3 | 1.1 ± 0.8 † | 2.9 ± 0.4 | 1.3 ± 0.9 † | 3.0 ± 0.3 | 1.2 ± 0.8 † |
CAL (mm) | 5.0 ± 1.1 * | 4.4 ± 0.7 | 0.6 ± 0.9 ‡ | 4.1 ± 0.8 | 0.8 ± 1.1 † | 4.4 ± 0.9 | 0.6 ± 1.0 ‡ |
REC (mm) | 0.8 ± 0.6 * | 1.3 ± 0.6 | −0.5 ± 0.5 † | 1.2 ± 0.6 | −0.4 ± 0.6 † | 1.4 ± 0.7 | −0.6 ± 0.7 † |
N° teeth | 21.9 ± 4.6 * | 19.5 ± 5.0 | 2.4 ± 2.2 † | 19.3 ± 4.9 | 2.6 ± 2.2 † | 19.1 ± 4.8 | 2.8 ± 2.1 † |
Variables | T0 Baseline | T1 Active Periodontal Treatment | ΔT0–T1 | T2 Orthodontic Treatment | ΔT0–T2 | T3 Last Follow-Up | ΔT0–T3 |
---|---|---|---|---|---|---|---|
PD (mm) | 4.3 ± 1.0 * | 2.9 ± 0.5 | 1.4 ± 0.9 ‡ | 2.9 ± 0.6 | 1.4 ± 1.0 ‡ | 2.8 ± 0.5 | 1.5 ± 0.8 ‡ |
CAL (mm) | 5.1 ± 1.4 * | 4.3 ± 1.0 | 0.8 ± 0.9 ‡ | 4.3 ± 1.1 | 0.8 ± 1.0 ‡ | 4.4 ± 1.1 | 0.7 ± 1.0 |
REC (mm) | 0.8 ± 0.7 * | 1.4 ± 0.8 | −0.6 ± 0.5 ‡ | 1.4 ± 0.8 | −0.6 ± 0.7 ‡ | 1.6 ± 0.9 | −0.8 ± 0.7 ‡ |
CEJ-RA (mm) | 16.3 ± 1.6 * | — | — | 15.2 ± 1.9 | 1.1 ± 0.8 ‡ | 14.7 ± 1.8 | 1.6 ± 1.2 ‡ |
Residual bone (%) | 65.2 ± 10.9 † | — | — | 64.6 ± 9.4 | −0.6 ± 6.9 | 65.1 ± 10.3 | −0.1 ± 7.7 |
Reason for Extraction | T0 to T1 | T1 to T2 | T2 to T3 | Total |
---|---|---|---|---|
Periodontal lesion | 51 (71%) | 4 (100) | 0 | 55 (67%) |
Root fracture | 2 (3%) | 0 | 6 (100) | 8 (10%) |
Endodontic failure | 13 (18%) | 0 | 0 | 13 (16%) |
Non-restorable carious lesion | 6 (8%) | 0 | 0 | 6 (7%) |
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Garbo, D.; Aimetti, M.; Bongiovanni, L.; Vidotto, C.; Mariani, G.M.; Baima, G.; Romano, F. Periodontal and Orthodontic Synergy in the Management of Stage IV Periodontitis: Challenges, Indications and Limits. Life 2022, 12, 2131. https://doi.org/10.3390/life12122131
Garbo D, Aimetti M, Bongiovanni L, Vidotto C, Mariani GM, Baima G, Romano F. Periodontal and Orthodontic Synergy in the Management of Stage IV Periodontitis: Challenges, Indications and Limits. Life. 2022; 12(12):2131. https://doi.org/10.3390/life12122131
Chicago/Turabian StyleGarbo, Daniela, Mario Aimetti, Loretta Bongiovanni, Cristina Vidotto, Giulia Maria Mariani, Giacomo Baima, and Federica Romano. 2022. "Periodontal and Orthodontic Synergy in the Management of Stage IV Periodontitis: Challenges, Indications and Limits" Life 12, no. 12: 2131. https://doi.org/10.3390/life12122131