Immediate orthodontic treatment after regeneration of periodontal intrabony defects: A long-term retrospective study

Orthodontic movement is often necessary for periodontally compromised patients to enhance esthetics, function, and long-term occlusal stability. However, the impact of orthodontic treatment immediately following the regeneration of intrabony defects on periodontal healing remains a topic of debate. The objective of this long-term case series study was to test the hypothesis that orthodontic treatment performed immediately after regenerative procedures for periodontal intrabony defects did not adversely affect periodontal healing.

This case series study involved nine periodontally compromised subjects with a total of 17 intra-bony defects. Orthodontic brackets were applied immediately before surgery. Flaps were raised, and diseased roots were debrided. All intra-bony defects were filled with alloplastic bone grafts and covered with resorbable membranes, except for one defect treated with Emdogain. All patients initiated orthodontic treatment immediately after periodontal regenerative surgery. Clinical parameters, including probing depth, attachment level, and bone fill, were assessed at baseline and during final maintenance therapy.

The mean follow-up duration was 12.8 years. None of the 17 surgically regenerated teeth were lost. The mean reduction in probing depth was 3.94 mm (95% confidence level, 3.19-4.68; P < 0.001), with a mean clinical attachment gain of 3.47 mm (95% confidence level, 2.90-4.03; P < 0.001). The mean radiographic bone fill was 4.89 mm (P < 0.001).

Based on the findings of this long-term case study, it can be concluded that immediate orthodontic treatment does not adversely affect the maturation process of periodontal regeneration outcomes and can be maintained for more than ten years.