ABSTRACT
Aggressive periodontitis is a great challenge to clinicians when providing orthodontic treatment because of the potential for progression of periodontal disease. In this article, we report the successful comprehensive orthodontic treatment of bimaxillary protrusion and severe crowding in an adult with generalized aggressive periodontitis. A woman, aged 22 years 7 months, with a chief complaint of incisal crowding was diagnosed with a skeletal Class I malocclusion associated with severe anterior crowding, possibly worsened by generalized aggressive periodontitis. In addition to a periodontal examination, a blood IgG antibody titer analysis and microbiologic examination for periodontal pathogens were used to diagnose the type of periodontal disease and determine the proper timing to initiate orthodontic treatment. The total active treatment period was 28 months, followed by periodontal prostheses and regeneration therapy. Consequently, satisfactory facial profile, occlusion, and periodontal health were maintained for at least 36 months. These results indicate that efficient screening is important for providing successful orthodontic treatment in patients with advanced periodontal disease. This report also demonstrates the diagnostic importance of blood IgG antibody titer assays and microbiologic examinations to detect periodontal pathogens.
Subject(s)
Aggressive Periodontitis/therapy , Immunoglobulin G/blood , Malocclusion, Angle Class I/therapy , Patient Care Team , Aggregatibacter actinomycetemcomitans/immunology , Aggressive Periodontitis/microbiology , Alveolar Bone Loss/therapy , Antibodies, Bacterial/blood , Cephalometry/methods , Female , Follow-Up Studies , Guided Tissue Regeneration, Periodontal/methods , Humans , Malocclusion, Angle Class I/blood , Oral Hygiene , Patient Care Planning , Periodontal Prosthesis , Porphyromonas gingivalis/immunology , Prevotella intermedia/immunology , Time Factors , Tooth Movement Techniques/methods , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: The study aims to associate serum insulin-like growth factor-1 (IGF-1) levels with cervical maturation stages (CS) 3, 4, and 5 on lateral cephalogram in male subjects and to find out peak serum IGF-1 levels among these three stages. METHODS: The study was conducted on 45 male subjects who were at skeletal maturation stage CS-3, CS-4, and CS-5. Subjects were selected using simple random sampling technique. Serum IGF-1 levels were estimated from blood samples using chemiluminescence immunoassay (CLIA) method. CS was evaluated using a six-stage method of evaluating the cervical vertebrae. Mean IGF-1 levels between the stages were compared by analysis of variance (ANOVA) test. RESULTS: One-way ANOVA showed highly significant differences between all cervical stages with p value<0.01, but post hoc Tukey test showed highly significant differences between CS-4 and CS-5 with p value 0.006. Serum IGF-1 levels showed good association with skeletal age in male subjects; 53.3% of subjects at CS-3, 66.7% subjects at CS-4, and 6.7% subjects at CS-5 showed IGF-1 levels in peak range. CONCLUSIONS: Serum IGF levels can be used as an additional tool to optimize orthodontic treatment timing.
