Recognizing the importance of basic periodontal therapy through a complex case on the verge of occlusal collapse

Abstract

A 48-year-old male patient presented a with a chief complaint of gingival swelling around 7 . He had lost bilateral mandibular canine teeth due to periodontal disease at around age 30, and had continued to lose teeth thereafter, but had low oral health consciousness, poor plaque control, and was a smoker until around age 40. The aforementioned tooth loss triggered a pronounced dental irregularity, and inflammation and a tendency toward deviated mastication began to appear. The patient's continuity of teeth and proper occlusal relationship were lost due to pathological tooth displacement in addition to poor plaque control, and occlusal trauma mainly to the molars was considered to have seemingly induced the occlusal collapse. The patient was diagnosed with generalized severe chronic periodontitis based on bone resorption throughout the jaws. Periodontal surgery was performed after improving the oral environment, starting with lifestyle modification and oral hygiene instruction. The patient was treated with autologous tooth transplantation, regenerative therapy, and localized orthodontic treatment to stabilize the mandibular position, to disperse occlusal forces, and to achieve a good occlusal relationship and together with continued SPT, the good progress has been observed.