Sequential soft- and hard-tissue augmentation after clear aligner-mediated adjustment of traumatic occlusion: A case...

Oral health and esthetic concerns have increasingly motivated adults with periodontitis to seek orthodontic care. Patients with periodontitis often have other dental complications that can make treatment more challenging or less likely to be successful. The predictability of multidisciplinary regenerative and orthodontic treatment approaches in a patient with periodontitis, thin periodontal phenotype, and anterior crossbite is described.

A 35-year-old man was designated as having a high risk of experiencing soft-tissue recession owing to his thin periodontal phenotype. After the initial periodontal therapy, clear aligners were used to eliminate the anterior crossbite that was causing traumatic occlusion. In addition, a subepithelial connective tissue graft was used to alter the thin periodontal phenotype. Three months later, guided bone regeneration with corticotomy was performed to increase bone mass, and orthodontic traction was used at 2 weeks after surgery. Orthodontic treatment was continued until all the spaces had been closed. Clinical and radiographic evaluations conducted at the 6-month follow-up revealed substantial improvements in both the soft- and hard-tissue phenotypes.

Outcomes in this case indicate that sequential soft- and hard-tissue augmentation, after eliminating traumatic occlusion via using a clear aligner, may be a valuable approach for improving soft- and hard-tissue support in patients with periodontitis.