Abstract
A 23-year-old woman with a noncontributory medical history was referred to our hospital in December 1992 with a chief complaint of anterior crowding. A complete oral examination revealed the pronounced loss of periodontal attachment in most parts of the dentition, anterior spacing, and crowding with collapse of the posterior occlusion. Initial periodontal therapy was started after a diagnosis of generalized aggressive periodontitis with pathologic migration of the anterior teeth arising from secondary occlusal trauma, leading to midline diastema and posterior bite collapse. Following the completion of the initial periodontal therapy by both the periodontist and the dental hygienist,periodontal surgeries-including a guided tissue regeneration technique for the progressive deep pockets-were performed for teeth 13, 14, 15,16, 17, 24, 25, 26, and 27. Tooth 14 was extracted during supportive periodontal therapy (SPT). After the healing of the periodontal tissue, orthodontic treatment based on an edgewise technique-including bite opening, the correction of crowding and space closure-was applied to reestablish esthetic and physiologic occlusion. After 1 year of orthodontic treatment, prosthetic treatment was performed for teeth 13∼15 and 44∼46. The patient returned for SPT about 15 years after the initial visit. The mean attachment level, probing depth (PD) and the number of sites with a PD of more than 4 mm were decreased from 5.2 mm, 4.5 mm and 107 sites (61.5%) and maintained at 4.9 mm, 2.9 mm and 18 sites (12.0%) in February 2006, respectively. The outcome of this case demonstrates the resolution of periodontal tissue destruction and malocclusion, with gains in the clinical attachment levels and a successful esthetic and functional final result.
Nihon Shishubyo Gakkai Kaishi (J Jpn Periodontol) 49 : 316-322, 2007.
