Realignment of periodontally-affected maxillary teeth--a periodontist's perspective. Part II: Case reports

Orthodontic therapy as part of a patient's overall periodontal rehabilitation may have many benefits. For the three patients described in this report, these benefits included: an improvement in appearance, which indirectly also increases the patient's motivation; improved access for cleaning teeth; restitution of edge-to-edge incisal occlusion; an improvement in lip-seal, thereby reducing anterior gingival dryness; reduction in the non-axial loading which can act as a cofactor with plaque to accelerate periodontal destruction; and possible regeneration of lost attachment apparatus through the combination of surgery and orthodontic tooth-intrusion. Successful orthodontic treatment in these patients depended upon adequate control of periodontal inflammation by thorough scaling and the maintenance of good oral hygiene. Treatment may be carried out in patients suffering from refractory periodontitis, provided inflammation is controlled during the period of orthodontic tooth movement; however, close monitoring is needed, especially if the patient continues to smoke.