Periodontal Approach of A Patient With Periodontitis Before Orthodontic Treatment: Long Term Follow-Up

Abstract

The aim of this case report was to present the comprehensive periodontal treatment and two-years follow-up results of an adult patient with Stage III, Grade C periodontitis who had pathological tooth migration (PTM) with gingival recession before orthodontic treatment. Full mouth plaque and gingival indices, bleeding on probing, probing depth and clinical attachment loss of patient were measured. Vertical bone losses in the central, lateral incisors and molar regions were found. Clinical attachment loss was 5.17 mm. Gingival recessions of #31 and #34 teeth were 4 mm and 5 mm, respectively. #31 tooth had Class II mobility. A combination of amoxicillin and metronidazole (AMOX/MET) was recommended for seven days during full mouth scaling and root planing. Flap operations and free gingival grafts (FGGs) were performed. After the six-week recovery period, non-extraction fixed orthodontic treatment was started. At the end of two years follow-up, gaining of keratinized tissue was detected as 3 mm in both teeth and 3.09 mm of clinical attachment level gain was ensured while orthodontic treatment continued. This case report presents that periodontal treatment provides long-term periodontal stability during fixed
orthodontic treatment.

Keywords

• Gingival recession
• Orthodontics
• Pathological tooth migration

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