Document Type : Original Article
Authors
1
Oral Medicine, Periodontology, Oral Diagnosis and Radiology Department, Faculty of Dental Medicine (girls section), Al Azhar University, Cairo, Egypt
2
Orthodontic Department, Faculty of Dental Medicine (girls section), Al Azhar University, Cairo, Egypt
3
Oral Medicine, Periodontology, Oral Diagnosis and Radiology Department, Faculty of Dental Medicine, Al Azhar University, Cairo, Egypt
Abstract
Pathologic migration is defined as a change in tooth position resulting from disruption of forces which maintain tooth in a normal position. Pathologic migration of tooth due to periodontal disease is considered as one aspect of esthetic problems. The purpose of the present study's, to evaluate a combined periodontal regenerative procedure with orthodontic therapy in order to solve functional and esthetic problems in migrated periodontally affected teeth. Fourteen patients suffering from extruded maxillary incisors with 15 intra-bony defects have probing depth (PD)7.7mm due to advanced periodontal disease were included in the present study .At base line PD, clinical attachment level (CAL) and radiographic examination were performed. All patients received periodontal therapy, which include elevation of periodontal flap (papilla preservation technique) with Demineralized freeze dried bone allograft (DFDB). Active orthodontic treatment was started after one week from the surgery using the segmented arch technique, in order to intrude the moved teeth into the defects. Maintenance therapy was performed every month until orthodontic treatment was completed. At the end of the study period (one year) all the clinical parameters were reevaluated At the end of treatment, the value of mean PD reduction was 4.1+ 1.39mm. Mean gain of CAL was 5.32 + 1.6mm .All differences were highly significant. Radiological examination revealed a favorable bone fill of all defects. Moreover, after the completion of orthodontic treatment a satisfactory realignment of the pathologically extruded teeth were achieved. The present study for the combined regenerative periodontal technique and orthodontic therapy performed to treat extruded teeth with intra-bony defects, showed a highly significant probing depth reduction, gain in clinical attachment and favorable radiological bone fill.
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