Combined Perio-Ortho Treatment of Infrabony Defects in Stage IV, Type 2 Periodontitis Patients: A Case Series

Periodontitis stage IV may be characterized by pathologic tooth migration (PTM), which, when orthodontic correction is needed, represents the conditions that define the type 2 phenotype, according to the European Federation of Periodontology Clinical Practice Guidelines. Here, four clinical cases of patients with stage IV, type 2 periodontitis and deep intrabony defects adjacent to the migrated teeth are presented. After successfully completing steps 1 and 2 of periodontal treatment, the intrabony defects were subjected to regenerative periodontal surgery, and active orthodontic movement began soon (2 to 4 weeks) after surgery. Follow-ups of up to 24 months demonstrate the effectiveness of interdisciplinary periodontal-orthodontic treatment in controlling inflammation, regenerating intrabony defects, and realigning pathologically migrated teeth, thereby restoring esthetics and function for the patient.