Orthodontic and regenerative therapy work together to solve complex clinical problems

Many times dentists and periodontists have patients with complex clinical problems that require the attention of multiple disciplines. A case report published in this month's Journal of Periodontology is the first reported case that demonstrates how orthodontic regenerative combined therapy offered the best option for a complex situation.

Japanese clinicians were presented with a 49-year-old patient whose right maxillary premolar furcation had a bony defect with poor biologic width resulting from extensive subgingival caries. The condition originated about 15 years earlier when his canine was extracted resulting in epithelial cell down growth from the extraction socket to the furcation defect. And the patient was diagnosed with chronic periodontitis.

Knowing that furcation invasion treatment remains one of the most difficult clinical problems, this case resented Dr. Shigeki Ogihara, a private practitioner in Tokyo who is trained in periodontics, orthodontics and restorations, with a greater challenge.

"In this case, we saw comprehensive problems and could not solve them with providing orthodontic or regenerative therapy alone," said Ogihara. "In fact, we could have caused other problems, such as further periodontal tissue break down. We were in a dilemma. Thus, we decided that combination therapy would result in predictable outcomes."

After nine months of combined therapy, periodontal and orthodontic treatment proved to be a success and final restoration was completed.

"This is an example of how periodontal regenerative therapy appropriately sequenced with orthodontic treatment saved a tooth that would have otherwise been lost," said Gordon Douglass, D.D.S., president of the American Academy of Periodontology. "It further demonstrates that regenerative periodontal tissues are strong enough to adapt to orthodontic movement."

For complete treatment details about this case, please call the American Academy of Periodontology's Public Affairs Department at (312) 573-3243.