Combined Periodontal-Orthodontic Treatment of Pathologic Tooth Migration: A Case Study with 10-Year Follow-Up

Pathologic tooth migration is a change in tooth position resulting from disruption of the forces that maintain teeth in a normal position in relation to their arch. The disruption of the equilibrium in tooth position may be caused by various etiologic factors. Loss of attachment apparatus along with a non periodontal related condition such as excess occlusal force, a progressive migration of tooth may take place. Mostly this migration can be associated with aesthetic damage of the smile line. To solve these issues, a combination of periodontal and orthodontic treatment is often needed. In this presentation a 23-year-old, systemically healthy, non-smoking female presented with the complaint of bleeding gums, mobility and increased space between upper and lower front teeth causing un-aesthetic appearance and low self esteem. She was treated with interdisciplinary approach of orthodontic and periodontal intervention. Improvement of facial esthetics contributed to the self-confidence of an adult periodontal patient with pathologic tooth migration. Follow up at 10 years post treatment confirmed the good choice of treatment planning and the tendency to improve the results over time. Periodontally compromised orthodontic patients can be satisfactorily treated, achieving correction of the malocclusion and a marked improvement in esthetics when an interdisciplinary approach is used.