Han Sung-Hoon, Ko Youngkyung, Ham Lyun Kwang, Park Jae Hyun, Kim Yoonji
Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Kore, Seoul, Republic of Korea.
Department of Periodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
J Esthet Restor Dent. 2024 Apr;36(4):595-605. doi: 10.1111/jerd.13166. Epub 2023 Nov 23.
Orthodontic treatment plays a crucial role in achieving optimal dental esthetics and functional occlusion. However, when periodontally compromised patients are involved, additional precautions and considerations are critical. This article aims to provide up-to-date recommendations for the orthodontic treatment of periodontally compromised patients.
Comprehensive diagnosis of the patient's periodontal status, inherent malocclusion, and secondary malocclusion resulting from periodontal disease are essential for achieving optimal esthetics and functional occlusion. This can be facilitated through the use of a simplified checklist. Prior to orthodontic treatment, pre-existing periodontal diseases should be managed. Light and controlled forces should be used to minimize the risk of adverse effects on the periodontium, and any potential traumatic occlusion during tooth movement should be minimized. Furthermore, careful anchorage management is required, and proper application of temporary anchorage devices can significantly expand the scope of orthodontic treatment. Finally, treatment results are maintained by ongoing supportive periodontal therapy even during the retention period.
This article presents clinical cases demonstrating the importance of accurate diagnosis in orthodontics and periodontics and the positive impact of orthodontic treatment on patients with pre-existing periodontal diseases.
An up-to-date orthodontic treatment protocol for periodontally compromised patients is presented.
正畸治疗在实现最佳牙齿美观和功能咬合方面起着至关重要的作用。然而，当涉及牙周受损患者时，额外的预防措施和考虑因素至关重要。本文旨在为牙周受损患者的正畸治疗提供最新建议。
全面诊断患者的牙周状况、固有错颌畸形以及由牙周疾病导致的继发性错颌畸形，对于实现最佳美观和功能咬合至关重要。这可通过使用简化检查表来促进。在正畸治疗前，应处理已存在的牙周疾病。应使用轻柔且可控的力量，以尽量减少对牙周组织产生不良反应的风险，并且在牙齿移动过程中应尽量减少任何潜在的创伤性咬合。此外，需要仔细进行支抗管理，正确应用临时支抗装置可显著扩大正畸治疗的范围。最后，即使在保持期，也需通过持续的支持性牙周治疗来维持治疗效果。
本文通过临床病例展示了正畸和牙周病学中准确诊断的重要性以及正畸治疗对已存在牙周疾病患者的积极影响。
本文提出了针对牙周受损患者的最新正畸治疗方案。
