The adult patient with Stage 3 and 4 periodontitis frequently develops, due to pathologic tooth migration, a secondary malocclusion that requires interdisciplinary intervention for occlusal, functional and aesthetic finalization. Treatment very often involves the orthodontist, who is called upon to improve occlusion, aesthetics, facilitate the alignment of teeth to optimize prosthetic restorations or the redistribution of spaces for the placement of implants. It is essential for the orthodontist to know the periodontal health conditions necessary to perform the orthodontic treatment without worsening the periodontal support already compromised by periodontitis. Moreover an accurate planning should include to adapt the biomechanics to the new anatomic conditions, to properly assess any anchorage and tooth movement needs, choose the most suitable appliance and monitor the health of the periodontium throughout treatment. Retention is another aspect that must be adequately planned considering the following steps of interdisciplinary treatment which often requires additional restorative procedures, and must be monitored over time. This workflow enables long term success and maintenance of the patient's natural dentition, as evidenced by 25 years of clinical experience and studies of more than 50 patients.


Learning Objectives
After this lecture, you will be able to recognize the periodontal indexes necessary for safe orthodontic treatment in patients with periodontitis
After this lecture, you will be able to define the keypoints for successful treatment plan in periodontally compromised patients
After this lecture, you will be able to know key elements for retention and long-term maintenance of the dentition