2018 Volume 60 Issue 2 Pages 95-104
Careless incorporation of orthodontic treatment into periodontal therapy may accelerate the progression of periodontal tissue destruction; however, it has been reported that orthodontic therapy is not a contraindication if inflammation is sufficiently controlled. Herein, we report the 17-year treatment course of a patient with generalized severe chronic periodontitis who has received initial periodontal therapy, periodontal-orthodontic treatment, and supportive periodontal therapy (SPT). Nonsurgical therapy was performed in addition to conventional periodontal tissue examination, bacterial testing with polymerase chain reaction (PCR) and serum antibody titer testing, in order to assist in the diagnosis and maintain motivation, since the patient had dental treatment phobia and refused to undergo periodontal surgical treatment. Dramatic improvement of the gingival inflammation was observed as a result of appropriate self-care, as well as scaling and root planing by the dental practitioner. Amelioration of the interdental separation and malalignment noted prior to the treatment was observed following the periodontal-orthodontic treatment, and treatment was provided for stabilization of the periodontal tissue and proper occlusion. At present, 17 years have elapsed since the initial visit, and the patient has received SPT for 13 years without any problems. Based on our experience with this patient, we believe that by performing periodontal-orthodontic treatment in addition to controlling inflammation in patients with pathologic tooth position abnormality, it is possible to preserve the teeth with progressive destruction of periodontal tissue, so that they function optimally and are also aesthetically pleasing.
