Ortho- Perio: Possibility, limits and sequence of the surgical periodontal therapy in the severely compromised patient
Patients with periodontal disease can present pathological teeth migration, due to occlusal trauma and reduction of the bone support, often with intrabony defects.
Unfortunately this can be associated with esthetic damage of the smile line.
Often is necessary to combine perio-ortho treatment in order to solve both issues.
Animal studies analyzed angular bony defects treated with conventional open flap debridement (OFD) and orthodontic movements, or treated with regenerative procedures and orthodontic movement.
No histological evidence of regeneration in association with OFD has so far been published in humans while several studies have shown the benefits of regenerative surgery through Guided Tissue Regeneration (GTR) or the use of Growth Factors on the histological healing. Besides, all recent reviews showed that regenerative procedure is better than open flap debridement in terms of PD reduction, CAL gain and guarantees the slightest gingival loss after surgery.
The clinical point of view of the orthodontic movement in patients with severe intrabony defects have not been analyzed with randomized clinical controlled trials; so limited reports with different result are present today.
Aim of this presentation is to analyze the possibility, limits and the operative sequence of the periodontal surgery in patients severely compromised