Abstract

Update on Periodontal Limits to Orthodontic Tooth Movement - How to Overcome Them

by Chung Chun-Hsi

It is well known that there are anatomic and periodontal boundaries that limit the amount of acceptable tooth movement. Patient’s gingival phenotype and morphology of alveolar bone should be considered in orthodontic treatment planning. Nowadays non-extraction modality has become popular in the treatment of crowded dentition. However, significant dental arch expansion and incisal proclination often take place, which may result in gingival recession and/or bone dehiscence. Extraction therapy sometimes is necessary to reposition the teeth in the center of the alveolar bone so the periodontal condition can be improved. For certain patients, soft tissue grafting and/or corticotomy in conjunction with bone grafting would be needed. To avoid excessive dental expansion, miniscrew-assisted RPE can be attempted on young adults to treat narrow maxilla. However, for older adults surgical expansion would be needed. In this presentation, the periodontics-orthodontics interdisciplinary treatment approach to maintain the periodontal integrity, minimize future periodontal concerns, and allow efficient orthodontic treatment will be updated.

Learning Objectives

After this lecture, you will be able to understand the anatomic and periodontal boundaries for orthodontic tooth movement.
After this lecture, you will be able to learn the indication of periodontal soft and hard tissue augmentation for orthodontic treatment.
After this lecture, you will be able to learn the miniscrew-assisted RPE for orthodontic treatment.