A case of pathological tooth movement improved only by basic periodontal treatment

Abstract

【Case Summary】 A 54-year-old female patient presented with a chief complaint of widening interdental spaces. The patient had generalized moderate periodontitis in the maxilla and mandible, and there was significant bone loss around the upper left incisor, and pathologic tooth migration (PTM) caused the interdental space and esthetic disturbance.【 Treatment plan and course of treatment】The patient requested orthodontic treatment, but we decided to perform basic periodontal treatment first and then reevaluate the overall condition of the dentitions and scrutinize the validity of the orthodontic treatment option. As a result, the patient's PTM was successfully corrected without orthodontic treatment, surgery, or prosthodontic treatment by thorough control of inflammation. 【Discussion】The proportion of PTM in patients with periodontitis is estimated to be about 33% to 55%, and many of them complain of esthetic problems. The cause of PTM is considered to be multifactorial, but inflammation and occlusal force are considered to be the major problems. In the present case, we did not resort to orthodontic or prosthodontic treatment, but provided SRP along with thorough OHI and eventually shifted to SPT. PTM is not localized to a single tooth, but occurs in relation to and as a result of conditions of the entire dentition. The improvement of PTM through periodontal treatment resulted not only in the closure of the void, but also in the restoration of continuity of the dentition and changes in occlusion.