Long-term stability of regenerative periodontal surgery and orthodontic tooth movement in stage IV periodontitis: 10-year data of a retrospective study.

BACKGROUND: This study aimed to evaluate the long-term effectiveness of regenerative treatment of intra-bony defects in combination with consecutive orthodontic therapy (OT) in stage IV periodontitis. METHODS: Twenty-two patients with a total of 256 intra-bony defects were analyzed after regenerative surgery followed by OT initiated 3 months later. Changes in radiographic bone level (rBL) and probing pocket depths (PPD) were evaluated after 1 year (T1), final splinting (T2), and 10 years (T10). RESULTS: Mean rBL gain was significant with 4.63 mm (±2.43 mm) after 1 year (T1), 4.19 mm (±2.61 mm) at final splinting (T2), and 4.48 mm (±2.62 mm) after 10 years (T10). Mean PPD was significantly reduced from 5.84 mm (±2.05 mm) at baseline to 3.19 mm (±1.23 mm) at T1, to 3.07 mm (±1.23 mm) at T2, and to 2.93 mm (±1.24 mm) at T10. Pocket closure (PPD ≤ 4 mm) was achieved in 90% of all defects. Tooth loss amounted to 4.5%. CONCLUSIONS: Within the limitations of this retrospective study design, these 10-year findings suggest that in motivated and compliant patients with stage IV periodontitis and in need of OT an inter-disciplinary treatment can lead to favorable and stable long-term results.

[Tooth preservation by forced extrusion using magnets. A case report]. / Zahnerhalt durch forcierte Magnetextrusion. Ein Fallbericht.

Teeth with extensive loss of coronal tooth structure due to caries or trauma require restorative or prosthetic rehabilitation. However, deep subgingival preparation jeopardizing the biological width or the loss of ferrule effect compromise a succesful longterm restoration. Therefore, crown lengthening is indicated instead. This can be achieved by resective osseous surgery or by forced extrusion of the tooth. An advantage of crown lengthening by extrusion is the preservation of the adjacent periodontium and alveolar bone. Particularly in the esthetically challenging maxillary front region the level of the marginal gingiva can be positively corrected by forced extrusion using orthodontic appliances or magnets. Magnets for forced extrusion due to their small size can be invisibly integrated into temporary devices providing further advantages in the esthetic zone. However, forced extrusion requires a longer treatment time. This case report presents a forced extrusion procedure using magnets on a severely destroyed canine with optimization of the marginal gingiva.