Sequencing of Periodontal Procedures and Orthodontic Treatment
Severe cases of periodontal disease often require periodontal surgery and realignment of teeth. Surgical techniques have been developed that attempt to minimize post-surgical gingival recession and compromise the interdental papillae. A case report is presented in which reversal and correction of a deteriorating maxillary frontal dentition were effectively achieved through combined use of periodontal and orthodontic principles. The treatment plan included the control of periodontal inflammation, restoration of lost attachment apparatus, realignment of anterior dentition, stabilization of occlusion, and minor periodontal plastic surgery. The anticipated loss of a maxillary lateral incisor was avoided. Restoration of a pleasant smile with nicely aligned teeth and esthetic gingival contours was achieved. The correct sequencing of the procedures involved was considered a key factor for the long-term esthetic outcome.