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

Patients who have a moderate periodontitis with pathologic tooth migration of maxillary incisors, it is necessary not only periodontal treatment for reduce periodontal inflammation, but also orthodontic treatment to teeth repositioning. For orthodontic treatment, it is necessary to apply less force and careful considerations of the center of resistance of the tooth and optimal force of tooth movement. At this time, the segmental arch applied only to the target teeth, is more effective and predictable, because applied force and direction can be controlled. In addition, to design the orthodontic appliance that can prevent the unwanted tooth movement that used as an anchorage is important. In recent years, various types of skeletal anchorage system have been used for preventing loss of the anchorage. We reported the patient who had extruded maxillary central incisor due to pathologic tooth migration, treated by a successful periodontal-orthodontic multidisciplinary treatment using an orthodontic appliance designed to apply less traumatic force and reduce an anchorage loss.
Humans ; Incisor ; Inflammation ; Orthodontic Appliance Design ; Orthodontic Appliances ; Orthodontic Wires ; Periodontitis ; Tooth ; Tooth Migration ; Tooth Movement

OBJECTIVETo evaluate the role of the combined periodontic-orthodontic treatment in the esthetic reconstruc- tion of the anterior teeth area following periodontitis.

METHODSThirteen 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.

RESULTSThree 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 sig- nificant 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 ortho- dontic treatment. This result indicated significant difference compared with that of pre-orthodontic treatment (1.69 mm ± 0.57 mm) (P < 0.05).

CONCLUSIONAfter 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.

Adult ; Dental Scaling ; Esthetics ; Humans ; Periodontal Pocket ; Periodontics ; Periodontitis ; Tooth Migration ; Tooth Movement Techniques

Transmigration of an impacted tooth through the symphyseal suture is a rare and special developmental anomaly of unknown etiology that is unique to the mandibular canine. Maxillary canine transmigration is even rarer. Transmigrated canines are particularly significant due to the aesthetic and functional importance. A maxillary lateral incisor crossing the mid-palatal suture has never been reported in the literature. The aim of this report is to present the first case of simultaneous transmigration of a lateral incisor and canine in the maxilla. The paper also reports four unusual cases of unilateral canine transmigration in the maxilla and mandible and successful eruption of one of the transmigrated mandibular canines following orthodontic traction. Etiology of transmigration and its clinical considerations are also discussed.
Cuspid ; Incisor ; Mandible ; Maxilla ; Sutures ; Tooth Migration ; Tooth, Impacted ; Traction

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

PURPOSE: Pathologic tooth migration (PTM) is a tooth displacement which is derived from imbalance of tooth retention force and is dominantly found out in maxillary anterior area. PTM in maxillary anterior area was tried to corrected with periodontal treatment and a clear aligner in this study and the result was evaluated clinically and radiographically. METHODS: For the treatment of a patient with chronic periodontal disease accompanied by maxillary anterior pathologic tooth migration, clear aligner was applied to move teeth after a series of case-related periodontal therapy. Clinically, probing depth, gingival recession, clinical attachment level and mobility were measured pre- and post-treatment, and radiographic examination was performed as well. RESULTS: Clinically, we found the decrease of the probing depth, gingival recession, clinical attachment level and mobility. And we could also acknowledge the reduction of vertical and horizontal dimension on infrabony defect radiographically. However, it is still controversial if there was an actual bone filling. CONCLUSIONS: Clear aligner is an effective appliance to move teeth since it costs little in terms of expense and time. In addition, it wraps whole crowns, providing advantages to deal with crowding, spacing, and size of arch. In short, clear aligner could be a useful treatment option for PTM patient, since it provides decreased probing depth, gingival recession, clinical attachment level, mobility and esthetical restoration.
Chronic Periodontitis ; Crowding ; Crowns ; Displacement (Psychology) ; Esthetics, Dental ; Gingival Recession ; Humans ; Periodontal Diseases ; Periodontitis ; Retention (Psychology) ; Tooth ; Tooth Migration

PURPOSE: Pathologic tooth migration (PTM) commonly occurs in the anterior region and is associated with periodontal disease. The treatment of PTM of anterior teeth can be complex and time consuming, and a multidisciplinary approach is often required. MATERIALS AND METHODS: The patient was a 38-year-old woman with a chief complaint of saving and realigning her elongated maxillary left central incisor. This paper describes the successful combined periodontal regenerative (guided tissue regeneration) and prosthetic treatment and a 2-year follow-up of maxillary central incisor with pathologic tooth migration, deep intrabony defect, and poor prognosis. RESULTS: The right maxillary central incisor was restored by laminate veneer and the left by all-ceramic crown. The patient had no pain and discomfort and was satisfied with the outcomes of her treatment for 2 years. She has maintained her recall program at the Department of Periodontology at 3 months interval. CONCLUSION: The key step in the successful treatment of PTM in anterior region is to obtain a high level of cooperation from the patient. Maintenance of the treatment result of PTM is dependent on the continuous preservation of periodontal health.
Adult ; Crowns ; Female ; Follow-Up Studies ; Humans ; Incisor ; Periodontal Diseases ; Tooth ; Tooth Migration

migration of the mandibular third molar without cystic lesion is unknown. So periodical X-ray taking is essential.]]>
Mandible ; Molar ; Molar, Third ; Tooth Migration

OBJECTIVETo investigate the changes of available spaces of posterior arch segments in mandibular dentition from 13 to 18 years of age, which would provide information for space analysis of whole dental arch in adolescents.

METHODSTwenty-six adolescents (12 males, 14 females) with normal occlusion were selected. All of the subjects had lateral cephalograms taken at the same time each year for 6 years. Longitudinal cephalometry and statistic analysis were conducted for all subjects.

RESULTSSignificant differences of available space were found between males and females. The growth of available space from 13 to 18 years of age was 5.12 mm in females and 5.79 mm in males. The completion of mandibular remodeling in males lagged behind females for about 1 year. No significant increase was found in girls beyond 16 years and in boys beyond 17 years. There was a 1.22 mm increase on each side per year in females until 16 years and a 1.45 mm increase in males until 17 years. The increase of available space was made partly by resorption of bone from the anterior border of the ramus and partly by mesial movement of the first molar. The mesial movement of dental arch was probably stimulated by the eruption of the third molars.

CONCLUSIONSThe prediction of available space should be based on age and sex.

Adolescent ; Age Factors ; Cephalometry ; Dental Arch ; growth & development ; Female ; Humans ; Longitudinal Studies ; Male ; Mandible ; growth & development ; Molar, Third ; growth & development ; Orthodontics, Corrective ; Sex Factors ; Tooth Eruption ; Tooth Migration

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