Combined Ortho-Perio treatment with severe crowding of anterior teeth - A Case Report

There is an ever increasing concern for dentofacial esthetics in adult population. The primary motivating factor for seeking orthodontic treatment is dental appearance 1 . The disruption of equilibrium in tooth position may be caused by several etiologic factors. These include pressure from inflamed tissues, periodontal attachment loss, occlusal factors, loss of teeth without replacement oral habits such as tongue thrusting and bruxism, gingival enlargement and crowding . Periodontal disease in the upper anterior region can be in isolation or may affect more teeth. The periodontal disease and its sequale such as pathological migration, diastema, labial and lingual tipping or missing teeth often lead to functional and esthetic problems either alone or with restorative problems. Advanced periodontal disease is characterized by severe attachment loss, reduced alveolar bone support, tooth mobility and gingival recession. Orthodontic treatment is initiated only after periodontal disease is brought under control 3 . This communication highlights good treatment outcome achieved in a patient with impaired dentofacial aesthetics and advanced periodontal disease with severe crowding.