West China Journal of Stomatology

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Esthetic reconstruction of the anterior teeth area following a combined periodontic-orthodontic treatment in adult periodontal patients

Zhu Lihong1, Li Sa1, He Fei1, Wu Yong1, Zhou Yan1, Qin Nianhong1, Ding Yi2.   

  1. 1. Center of Stomatology, The Second Clinical Hospital of Jinan University, Shenzhen People’s Hospital, Shenzhen 518020, China; 2. State Key Laboratory of Oral Diseases, Dept. of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2014-02-11 Revised:2014-06-21 Online:2014-10-01 Published:2014-10-01

Abstract:

Objective To evaluate the role of the combined periodontic-orthodontic treatment in the esthetic reconstruction of the anterior teeth area following periodontitis. Methods Thirteen adult patients with anterior teeth displacements were treated. The probing pocket depth (PD; 102 teeth, 612 sites), bleeding on probing (102 teeth, 204 sites), papilla index (PI; 128 papillae), and papillary height (PH; 128 papillae) of each patient were assessed at baseline, 3 months after the initial therapy, and the end of the orthodontic treatment. Non-parametric and paired-sample t tests were carried out for the statistical analysis of the data. Results Three months after initial therapy, the sites with PD≤3 mm accounted for 79.58% (487/612) of the observed teeth, and 88.73% (181/204) of the buccal and lingual sites of the teeth showed negative bleeding on probing. These findings were better than those at baseline [26.31% (161/612) and 22.06% (45/204), respectively] (P<0.05), but no significant difference was observed compared with pro-orthodontic treatment (P>0.05). Prior to orthodontic treatment, the levels of the PI of 8 and 21 papillae were Ⅲ and Ⅱ, respectively, among the 128 observed papillae. After the orthodontic treatment, 51 papillae were at level Ⅲ and 68 papillae were at level Ⅱ. The PH of the 102 papillae was 2.84 mm±0.62 mm after orthodontic treatment. This result indicated significant difference compared with that of pre-orthodontic treatment (1.69 mm±0.57 mm) (P<0.05). Conclusion After initial therapy, moderate orthodontic teeth movements may reconstruct the interproximal soft tissue, with esthetic improvement of the papillary level and resolution of the periodontal defects.

Key words: periodontal initial therapy, orthodontic treatment, gingival papilla, black triangle, esthetic