Isolated vertical infrabony defects treated by orthodontic tooth extrusion

It has been reported that periodontal disease and traumatic occlusion may cause an isolated vertical infrabony defect. In such cases, the improvement of both inflammation and the occlusion are necessary to ameliorate the defect. We discuss the successful orthodontic treatment of an adult patient with isolated vertical infrabony defects of the maxillary right lateral incisor, left canine, and mandibular left incisor regions. The patient showed an anterior crossbite and one- and two-wall wide isolated vertical infrabony defects. The inflammation was improved by a periodontist; however, the vertical infrabony defects remained. In order to improve the defects, the pulps of the maxillary right lateral incisor, left canine, and mandibular left incisor were extirpated, and temporary crowns were put on those teeth. Next, an edgewise appliance was applied to the maxillary and mandibular teeth. After the anterior crossbite was improved, the incisor edge regions of the temporary crowns were ground, and the maxillary right lateral incisor, left canine, and mandibular left incisor were extruded until they touched antagonistic teeth. The patient's anterior crossbite, traumatic occlusion and gingival esthetics were improved by this treatment. Panoramic and dental radiographs after treatment also showed improvement of the vertical infrabony defects. Thus, tooth extrusion might be effective to improve one- and two-wall wide isolated vertical infrabony defects.