(24) Periodontal Phenotype Modification in Surgically Facilitated Orthodontics. A Case Report.

Introduction: Orthodontic treatment has the potential to cause subsequent loss of periodontal support, particularly in patients with a thin periodontal phenotype. Both, soft and hard tissues need to be evaluated prior initiation of movements. In this case report, clinical and radiographic outcomes are assessed in a patient that underwent periodontal surgery to aid orthodontic movement and modify the periodontal phenotype.

Methods: A 40-year-old African American woman was referred for a comprehensive periodontal evaluation prior to orthodontic treatment. Upon clinical evaluation, a Class I malocclusion, and an anterior open bite was noted; root prominences of lower anterior teeth were evident. Orthodontic plan included the lingualization of lower anterior teeth, which lacked buccal plate as evidenced on CBCT. The surgical treatment consisted of corticotomies in the buccal mandible and hard tissue grafting to facilitate orthodontic movement as well as to modify the bone morphotype, thereby preventing displacement of roots beyond the alveolar housing.

Results: At 6 months, teeth were aligned within alveolar housing. Clinical and CBCT evaluations showed no gingival recession, no bone dehiscence/fenestrations or external root resorption.

Conclusions: Surgically facilitated orthodontics and phenotype modification can provide great clinical benefits by accelerating orthodontic movement and improving periodontal phenotype.

Lead Author’s Contributions to the Research Project: The Lead Author was responsible for interpreting clinical findings and the composition of the abstract.