Severe periodontitis and orthodontics: case reports and literature review

Early diagnosis and treatment are essential for successful long-term prognosis in patients with aggressive periodontitis. The role of the orthodontist in diagnosis and referral to periodontal treatment is crucial since most orthodontic patients are adolescents in which aggressive periodontitis mostly affects. Many patients undergoing orthodontic treatment believe that their regular and frequent visits to the orthodontic office are sufficient to monitor their dental and periodontal needs. Orthodontists should be aware of this notion, which makes the fulfillment to the above guidelines of even greater importance. Strict adherence of the guidelines as a routine protocol for periodontal examination prior, during and following orthodontic treatment may dramatically decrease the severity and improve the prognosis of aggressive periodontitis in orthodontic based clinic. Finally, this article describes a combined periodontal-orthodontic therapy in two patients with generalized aggressive periodontitis. A complete periodontal treatment was first conducted. After completely reducing inflammation and stabilizing the periodontium, the clinician started the orthodontic treatment by using moderate forces along with periodontal monitoring, thus reaching the aesthetic and functional objectives set when treatment started.