[A preliminary study of combined periodontal-orthodontic approach for treating labial displacement of incisors in patients with periodontal diseases].

Shanghai Kou Qiang Yi Xue

Department of Periodontology, Ninth People's Hospital, College of Stomatology, School of Medicine, Shanghai Jiao Tong University. Shanghai 200011, China.

Published: June 2008

Purpose: The purpose of this study was to evaluate the effect of combined periodontal-orthodontic treatment for patients who had chronic periodontitis with labial displacement of incisors and radiological evidence on migrated incisors.

Methods: Twenty-one adult patients were included in the study. Fifty-two migrated incisors were randomly assigned to treatment with circumferential supracrestal fibrotomy or non-surgery. The mean orthodontic treatment time was 12 months. Before surgery (circumferential supracrestal fibrotomy) and at the end of orthodontic treatment, the following parameters were registered clinically: CAL(clinical attachment loss), TM(tooth mobility), SBI (sulcus bleeding index), PD (probing depth),CEJAC (distance from the CEJ to the alveolar crest) and RL (root length). Standardized intraoral radiographs were taken. SPSS12.0 software package was used for data analysis. Student's t test was performed for coupled data including PD, CAL, CEJAC and RL. Results of SBI and TM were analyzed statistically with Wilcoxon signed rank test.

Results: Comparison of pre- and post-treatment values showed a statistically significant improvement for all parameters without remarkable root apex resorption. TM and CAL reduction were greater in the surgical group compared to the non-surgical group (P<0.05). The reduction of CEJAC between the two groups were significantly different (P<0.01).

Conclusion: The results show the efficacy of combined periodontal-orthodontic approach with circumferential fibrotomy on patients with incisors migration. After proper periodontal surgical therapy, orthodontic movement can positively improve both the alveolar bone and the soft periodontal tissues.

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