Clinical effectiveness of regenerative periodontal surgery and orthodontic tooth movement with clear aligners in stage IV periodontitis: a case series

Quintessence Int. 2024 May 30;55(5):348-357. doi: 10.3290/j.qi.b5213521.

Abstract

Objectives: To evaluate the clinical effectiveness of regenerative treatment of intrabony defects in combination with consecutive orthodontic therapy with clear aligners in stage IV (type 2) periodontitis.

Method and materials: Ten patients with a total of 103 intrabony defects were analyzed after regenerative surgery using collagen-deproteinized bovine bone mineral with or without collagen membrane or enamel matrix derivative followed by orthodontic therapy with clear aligners. Changes in radiographic bone level and probing pocket depths were evaluated after 1 year (T1) and at final splinting (T2) after orthodontic tooth movement.

Results: Mean radiographic bone level gain was significant, with 2.13 ± 1.64 mm at T1 and 3.02 ± 2.00 mm at T2. Mean probing pocket depth was significantly reduced from 5.40 ± 1.80 mm at baseline to 3.78 ± 1.73 mm at T1, and remained stable with 3.73 ± 1.70 mm at T2. Pocket closure (≤ 4 mm probing pocket depth) was accomplished in 76% of all defects. Tooth loss amounted to 2.9%.

Conclusion: Within the limitations of the retrospective study design, the findings suggest that the interdisciplinary treatment of periodontitis stage IV by regenerative periodontal surgery and consecutive orthodontic therapy with clear aligners can lead to favorable results.

Keywords: bovine bone mineral; clear aligner; orthodontic tooth movement; pathologic tooth migration; regenerative periodontal therapy; stage IV periodontitis.

MeSH terms

  • Adult
  • Alveolar Bone Loss / diagnostic imaging
  • Alveolar Bone Loss / surgery
  • Animals
  • Bone Substitutes / therapeutic use
  • Cattle
  • Collagen / therapeutic use
  • Female
  • Guided Tissue Regeneration, Periodontal* / methods
  • Humans
  • Male
  • Middle Aged
  • Periodontal Pocket / surgery
  • Periodontitis / surgery
  • Periodontitis / therapy
  • Retrospective Studies
  • Tooth Movement Techniques* / methods
  • Treatment Outcome

Substances

  • Collagen
  • Bone Substitutes