OBJECTIVE: To evaluate the clinical efficacy of clear aligner therapy in patients with severe periodontitis accompanied by pathological tooth displacement in the anterior region. METHODS: This retrospective study analyzed patients diagnosed with severe periodontitis and pathological displacement in the anterior region, who visited both the Periodontics and Orthodontics Departments at Peking University School and Hospital of Stomatology between 2019 and 2022. A total of 26 eligible cases were included in this study. All the patients underwent regular periodontal maintenance throughout the treatment process, and clear aligners were used for orthodontic treatment. Intraoral scans were analyzed by dedicated software to measure and compare occlusal distribution and proximal contact scores before and after orthodontic treatment. Periodontal clinical indicators were assessed at three key time points: before periodontal treatment (T0), before orthodontic treatment (T1), and after orthodontic treatment (T2). All the cases were treated with clear aligner. RESULTS: A total of 217 pathologically displaced anterior teeth from 26 patients were analyzed. Among these, 105 teeth exhibited periodontal pockets [probing depth (PD) ≥5 mm] before periodontal treatment. After clear aligner therapy, the occlusal score improved significantly from 10.35±8.61 to 23.62±9.73 (P < 0.001), and the proximal contact score increased from 13.62±4.73 to 31.62±10.37 (P < 0.001). The median PD decreased significantly from 3.33 mm [interquartile range (IQR)=0.92] at T0 to 2.50 mm (IQR=0.67, P < 0.001) at T1 and remained stable at 2.50 mm (IQR=0.50) after treatment (T2). A significant reduction in PD was observed between T0 and T2 (P < 0.001), but no significant difference was found between T1 and T2 (P=0.948). CONCLUSION Clear aligner therapy demonstrates favorable clinical efficacy in patients with severe periodontitis and pathological anterior tooth displacement. It effectively improves occlusal distribution and proximal contact while maintaining periodontal health in these patients. However, further large-scale prospective controlled studies are needed to verify its long-term clinical outcomes.
Humans ; Retrospective Studies ; Periodontitis/therapy* ; Female ; Male ; Adult ; Tooth Migration/therapy* ; Tooth Movement Techniques/methods* ; Treatment Outcome ; Middle Aged ; Young Adult ; Orthodontic Appliances, Removable

Child ; Child, Preschool ; Dentition, Mixed ; Humans ; Radiography, Panoramic ; Tooth Extraction ; Tooth Migration ; therapy ; Tooth, Impacted ; therapy ; Tooth, Supernumerary ; diagnostic imaging ; pathology ; surgery

OBJECTIVECombined orthodontic-periodontal treatment with supracrestal fiberotomy was undergone on the periodontal patients with anterior displacement of incisors. Evaluate of the changes before and after treatment.

METHODSPeriodontal indices, periapical x-ray analysis, and model analysis were used for investigating the changes of alveolar bone height and periodontal health by orthodontic treatment following supracrestal fiberotomy of anterior displaced incisors on periodontal patients.

RESULTSAlveolar bone height was increase by 1.2 mm in fiberotomy patients. The overjet was reduced from 7.0 mm to 2.0 mm, while the overbite was decreased from 4.0 mm to 2.0 mm, and the periodontal health maintained as well.

CONCLUSIONCombined orthodontic periodontal treatment with supracrestal fiberotomy could correct the malpositioned teeth, and improve the periodontium conditions and gain the crest bone.

Adolescent ; Adult ; Child ; Combined Modality Therapy ; Female ; Humans ; Incisor ; Male ; Middle Aged ; Orthodontics, Corrective ; Periodontitis ; complications ; therapy ; Tooth Migration ; etiology ; therapy