Summary of webinar: Power2Reason – Orthodontics in periodontally compromised patients: Morten Laursen
Conclusion
orthodontic treatment can achieve:
- Greater cleansability through alignment
- Potential reduced periodontal pocketing through long junctional epithelium formation
- Rehabilitation through idealising tooth position for their eventual loss and prosthetic replacement in ideal position
Risk of not factoring in periodontal disease
- Increased force = root resorption
- Increased force = loss of anchorage
- Active disease = increase loss of periodontal tissue
1/ Treatment protocol: Anterior intrusion with mini implants with TADs
- TAD Where: Distal to canine
- TAD How :Indirect ligation to canine bracket
- TAD Effects: Absolute intrusion of 2-2 = 3mm
2/ Treatment protocol: Lingual root torque of incisor with Auxiliary torqueing archwire
- Attachments x 3
- 1st molars R and L
- Affected lower incisor
BASE ARCHWIRE – prevent AP and vertical changes to lower incisor
- 020 ss
AUXILIARY ARCHWIRE
- 19x25TMA
- Down bend or RCOS = lingual root torque
Biomechanics
- Lingual root torque to lower incisor