Universidade Vila Velha, Departamento de Odontologia, Disciplina de Ortodontia (Vila Velha/ES, Brazil).
Dental Press J Orthod. 2020 Nov-Dec;25(6):79-116. doi: 10.1590/2177-6709.25.6.079-116.sar.
There is an increasing number of adult patients with sequelae of periodontal diseases seeking orthodontic treatment to improve their occlusion and quality of life. However, it is important to highlight that the patient who has vertical bone loss has unique needs, arising from the frequent related pathological migrations. Therefore, it requires an individualized orthodontic treatment in terms of anchorage, biomechanics, and multidisciplinary planning, which raises doubts in the hierarchy of priorities and organization of the treatment plan.
It was proposed a stratified hierarchy of the needs of orthodontic-periodontal treatment in six levels, which were illustrated with examples of clinical cases in which biomechanical planning and a multidisciplinary approach made it possible to obtain a balanced occlusion, aesthetic improvement and stabilization of the results.
Orthodontic treatment of periodontal patients with a multidisciplinary approach is increasingly frequent and should be planned individually, considering bone losses suffered by each patient. Respecting some limitations, it is possible to improve the level of bone insertion, smile aesthetics and masticatory function, to facilitate oral hygiene through the orthodontic treatment of adult patients with little bone support. It is also important to highlight that there are unique aspects in the orthodontic retention in these cases.
越来越多的牙周病后遗症成年患者寻求正畸治疗，以改善其咬合和生活质量。然而，重要的是要强调，有垂直骨丧失的患者有独特的需求，这源于频繁相关的病理性迁移。因此，在锚固、生物力学和多学科规划方面需要进行个体化的正畸治疗，这在治疗计划的优先级和组织方面引起了疑问。
提出了正畸-牙周治疗需求的分层层次，共六个层次，并通过生物力学规划和多学科方法的临床病例示例进行了说明，这些方法使获得平衡的咬合、美学改善和结果稳定成为可能。
越来越多的牙周病患者需要多学科的正畸治疗，应根据每位患者所遭受的骨损失情况进行个体化计划。在尊重某些限制的情况下，可以通过对牙槽骨支持较少的成年患者进行正畸治疗来改善牙槽骨植入水平、微笑美学和咀嚼功能，通过正畸治疗来促进口腔卫生。在这些情况下，正畸保持也有独特的方面，这一点也很重要。
