Orthodontic treatment of periodontally compromised teeth after periodontal regeneration: A restrospective study

Abstract

Background/purpose: The inconclusive issue of teeth treated with periodontal regeneration and combine with orthodontic tooth movement warrants further investigation and clinical experiences. The objectives of this retrospective clinical study were to analyze periodontal health and stability of teeth with periodontitis under the periodontal regeneration and orthodontic treatment and the timing and direction of orthodontic movement intervention.

Methods: A total of 41 infrabony defect sites (21 patients, from 23 to 66 years-old;) receiving interdisciplinary treatment in the past ten years (from 2008 to 2019) at National Taiwan University Hospital were selected. The defects were grouped into subgroups depending on orthodontic tooth movement timing and directions after periodontal regeneration surgery. The mean baseline probing depth (PD), baseline clinical attachment level (CAL), PD reduction and CAL gain after interdisciplinary treatment were statistically analyzed.

Results: Both early and late orthodontic tooth movement groups showed improvement in PD reduction and CAL gain, and the early orthodontic tooth movement group showed slightly better clinical outcome without statistically significant compared with the late orthodontic tooth movement group. It showed more PD reduction and CAL gain in into-defect group, and it's statistically significant compared to off-defect and alignment groups. No statistically significant in the clinical outcome regarding of protocols (guided tissue regeneration, enamel matrix derivatives or grafting with open flap debridement).

Conclusion: Our study revealed that teeth can be successfully moved following regenerative surgery with good periodontal improvement. Moreover, early orthodontic tooth movement may not jeopardize the regenerative effect, and may have the potential to improve the overall efficiency of the treatment. Besides, moving into the defects can benefit more in probing depth reduction and clinical attachment level gain.

Keywords: Orthodontics; Periodontal regeneration; Periodontitis.