Treatment of compromised teeth: a multidisciplinary approach.

Treatment for uprighted abutment teeth that may have infrabony pockets can be considered complete when the following criteria are met: 1. The uprighted tooth is in its proper vertical axis. 2. There is a significant decrease in soft-tissue pocket depth. 3. Crestal leveling is evident radiographically. 4. Adequate space has been created to accommodate a pontic (minimally 6.5mm). The advantages of employing this orthodontic-periodontal technique are as follows: 1. Leveling of the osseous crest fosters pocket elimination obviating the necessity for removal of a great deal of supporting bone. Concomitantly, a significant decrease in pocket depth usually eliminated the need for periodontal surgery. 2. The resulting occlusal forces are placed in favorable axial inclinations. 3. There is an improved crown-to-root ratio, since the uprighted and extruded tooth is reduced to the level of the occlusal plane. This reduction is sufficient to improve considerably the prognosis of a questionable abutment tooth. 4. A pontic space is created for an esthetic and properly contoured pontic. 5. Parallelism is attained, so that the marginal integrity is more easily accomplished. 6. The orthodontic procedures are relatively uncomplicated, efficient, and esthetic, provided there is little or no lower anterior crowding. 7. The restorative dentist has a proper abutment tooth with a good prognosis for prosthesis.