"GTR and orthodontics for treating esthetic zone migration"

| Posted in: Science

Journal name: Journal of Indian Society of Periodontology
Original article title: Guided tissue regeneration and orthodontic movement for the treatment of pathological migration in esthetic zone
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:

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Author:

Vaishnavi Ramakant Chodankar, Nikita Ravindra Baheti, Vaibhav Anandrao Karemore, Wasundhara Ashok Bhad, Mangesh Bhalchandra Phadnaik, Santosh Jetu Chavan


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: Guided tissue regeneration and orthodontic movement for the treatment of pathological migration in esthetic zone

Year: 2023 | Doi: 10.4103/jisp.jisp_421

Copyright (license): CC BY-NC-SA


Summary of article contents:

Introduction

Pathological migration of teeth is a significant concern among patients seeking dental treatment, greatly impacting their ability to chew and speak, as well as their self-esteem and aesthetic appearance. The prevalence of this condition is notably high in individuals suffering from moderate-to-severe periodontitis, ranging from 21.73% to 55.8%. This case study highlights the treatment of a 38-year-old systemically healthy, nonsmoking male patient who presented with mobility and forward displacement of his maxillary anterior tooth due to severe periodontal issues. The treatment employed an interdisciplinary approach, combining periodontal therapy with orthodontic intervention, and emphasized the long-term benefits for the patient's aesthetic and psychological well-being.

Regenerative Therapy and Orthodontic Movement

The successful management of pathologically migrated teeth often requires a combination of periodontal rehabilitation and orthodontic treatment. In this case, the patient underwent nonsurgical periodontal therapy followed by regenerative periodontal flap surgery aimed at treating the intrabony defect surrounding the affected tooth. This was crucial as it allowed for significant improvements in the periodontal status before orthodontic alignment took place. Regenerative therapy involved the use of demineralized freeze-dried bone allograft and chorion membrane to enhance bone support and aid in healing. After a thorough recovery, orthodontic treatment was initiated to address the tooth mobility and achieve proper alignment, ultimately reducing the patient's diastema and improving both aesthetic and functional outcomes.

Conclusion

The interdisciplinary approach to treating pathologically migrated teeth significantly enhances patient outcomes, as demonstrated in this case study. By effectively addressing periodontal health prior to orthodontic intervention, practitioners can prevent further deterioration of the affected teeth while simultaneously restoring aesthetic appearance and improving the patient’s quality of life. The follow-up assessments showed lasting stability of results, indicating that by maintaining rigorous oral hygiene and regular professional evaluations, patients can achieve sustained improvements in their dental health and self-esteem. This case underscores the importance of coordinated care in managing complex dental conditions.

FAQ section (important questions/answers):

What is pathological tooth migration and its causes?

Pathological tooth migration refers to the movement of teeth due to severe periodontal disease, resulting in bone loss, gingival inflammation, or occlusal trauma. This condition can lead to significant aesthetic issues and affect a patient’s self-esteem.

How was the 38-year-old male patient's condition treated?

The patient was treated with an interdisciplinary approach. Initially, nonsurgical periodontal therapy was performed to address active inflammation, followed by regenerative periodontal flap surgery, and then orthodontic treatment for aesthetic correction and alignment.

What improvements were seen post-treatment for the patient?

After treatment, the patient experienced significant improvements in aesthetics, periodontal health, and self-confidence. The oral health-related quality of life (OHRQoL) score decreased significantly, indicating enhanced overall well-being.

Why is regular follow-up important after treatment?

Regular follow-up is crucial to monitor oral hygiene, prevent periodontal disease recurrence, and ensure the stability of periodontal and orthodontic improvements. Continued professional evaluations help maintain the achieved health status.

What role does patient consent play in sharing treatment details?

Patient consent is essential in sharing clinical information and images to ensure privacy. Informed consent protects the patient's identity, as their name and personal information are kept confidential while still allowing reporting of their case.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “"GTR and orthodontics for treating esthetic zone migration"”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
In the context of clinical reports, tables are utilized to present data in a structured format. They facilitate easier comparison of parameters and findings related to patient assessments, diagnostic criteria, and treatment outcomes, enhancing the reader's comprehension of the case's details and statistical evidence supporting therapeutic decisions.

2) Relative:
This term underscores the relationship between various clinical findings and their implications for treatment. In dental literature, relative comparisons may indicate how specific symptoms or conditions correlate with treatment efficacy, guiding practitioners in making informed decisions based on analogous cases or scenarios within the same clinical spectrum.

3) Hygiene (Hygienic):
Oral hygiene refers to practices aimed at maintaining mouth cleanliness and preventing diseases. In the context of periodontal treatment, effective oral hygiene is crucial for successful patient outcomes. It reduces plaque buildup, inflammation, and the risk of further periodontal issues, thus significantly impacting long-term patient health and quality of life.

4) Quality:
Quality often pertains to health-related quality of life. In dental treatment contexts, it encompasses various factors such as functional ability, aesthetic outcomes, and overall patient satisfaction after procedures. Evaluating quality ensures treatment approaches not only address symptoms but also enhance the patient's well-being and self-perception.

5) Disease:
Here, disease primarily refers to periodontal disease, which is characterized by the inflammation and infection of the supporting structures of teeth. Its management is critical as it significantly affects oral health and can lead to tooth mobility and loss. Understanding its progression helps in devising effective treatment strategies.

6) Life:
In clinical contexts, the term life often relates to the quality of life and its improvement post-treatment. Dentistry aims to enhance not only oral health but overall life satisfaction, where successful interventions lead to better social interaction, self-esteem, and psychological well-being, marking the importance of holistic care.

7) Inflammation:
Inflammation is a key pathological process in periodontal disease. It signifies the body's response to infection, resulting in swelling, redness, and pain. Addressing inflammation through appropriate therapies is critical for restoring periodontal health and preventing further complications, ultimately guiding the treatment plan's efficacy and success.

8) Rules:
In clinical practice, rules often imply established guidelines or protocols governing treatment procedures. Adhering to rules ensures consistency, safety, and effectiveness in patient care. It aids health practitioners in making evidence-based decisions, optimizing clinical outcomes, and standardizing practices across various cases to ensure best practices.

9) Pur:
In this context, poor is typically used to describe an inadequate state of health associated with periodontal conditions. It signifies unsatisfactory oral hygiene, low self-esteem, and diminished quality of life due to dental issues. Recognizing 'poor' conditions is crucial for prompting timely interventions and improving patient outcomes.

10) Inference:
Inference in clinical settings refers to conclusions drawn from observed data or findings. It plays a vital role in diagnosing conditions and planning treatments based on patient responses and treatment outcomes, enabling practitioners to optimize care strategies and enhance the effectiveness of ongoing treatment processes.

11) Cutting:
Cutting in this context likely refers to a detrimental habit involving the use of anterior teeth for tasks like wire cutting. Such behaviors often contribute to dental issues, including tooth mobility or structural compromise, thus necessitating a comprehensive approach to treatment that addresses both dental care and behavioral modification.

12) Tata:
Tata, referring to the Tata Memorial Hospital and its tissue bank, indicates collaboration with established medical institutions to source materials for regenerative treatments. Successful procedures often rely on quality grafts, emphasizing the importance of partnerships in the healthcare sector to ensure effective therapeutic options for patients.

13) Male:
The term male identifies the gender of the patient involved in the case study. Gender can influence treatment outcomes and health patterns in periodontal disease. Understanding demographic aspects allows healthcare providers to tailor interventions and anticipate complications that may be affected by gender-specific health profiles.

14) Repopulation:
Repopulation refers to the restoration of healthy periodontal tissue following treatment. It highlights the physiological aspect of healing after interventions such as regenerative surgery. Successful repopulation is a goal in periodontal therapy, ensuring re-establishment of functional tissue and supporting structures, ultimately improving overall oral health.

15) Discussion:
Discussion in clinical reports entails the interpretation and analysis of findings. It plays a crucial role in drawing conclusions from research and case studies, emphasizing implications for practice and setting the stage for further inquiries, thereby advancing the understanding of treatment effectiveness and patient care methodologies.

16) Antibiotic (Antibacterial):
Antibiotics are critical in dental treatment for managing bacterial infections, particularly in periodontal disease. They play a supportive role in reducing bacterial load during initial therapies, preventing complications post-surgery, and ensuring successful healing by addressing underlying infections that can compromise recovery and treatment effectiveness.

17) Swelling:
Swelling is a common symptom associated with inflammation in periodontal disease. It indicates underlying issues such as infection or tissue irritation. Monitoring and reducing swelling through treatment is vital for patient comfort and aids in the recovery process, driving the effectiveness of periodontal interventions.

18) Dressing:
Dressing in the medical context refers to a protective covering applied to surgical sites. In periodontal procedures, it protects the surgical area, promotes healing, and minimizes postoperative discomfort. Appropriate dressing materials contribute to successful recovery and can improve patient compliance with postoperative care instructions.

19) Bleeding:
Bleeding is often a symptom of periodontal disease and can occur during procedures. It is an indicator of tissue health and is monitored closely during treatment. Minimizing bleeding is essential for patient safety and comfort, and effective management of bleeding issues is a key aspect of surgical protocols.

20) Surface:
Surface refers to the outer layer of periodontal tissues that can be indicative of health or disease. In clinical settings, assessing the surface condition can reveal signs of inflammation or infection, guiding treatment decisions and helping practitioners understand the extent of periodontal involvement and necessary interventions.

21) Repair:
Repair involves the process of restoring periodontal tissues after damage due to disease or trauma. In periodontal therapy, promoting repair is essential for regaining functional integrity and health. Successful repair strategies often include surgical interventions and tailored treatment plans that focus on tissue healing and restoration.

22) Reason:
Reason refers to the justification for treatment decisions made in clinical settings. Understanding the underlying reasons for a patient's condition is crucial for accurate diagnosis and effective treatment planning. It enhances practitioner awareness and ensures that interventions are tailored to the patient's specific needs.

23) India:
India serves as the geographical context for this case study, indicating the healthcare practices and cultural perspectives relevant to the population being treated. Recognizing regional influences can inform clinical practices, access to treatment modalities, and patient compliance, thus impacting overall treatment outcomes in the area.

24) Glass:
In the context of dental treatments, glass may refer to materials used in dental cements or restorative procedures, such as glass ionomer cement. These materials play critical roles in bonding and ensuring the stability of dental restorations, ultimately affecting treatment success and longevity of results.

25) Edema (Oedema):
Edema is characterized by localized swelling due to excess fluid accumulation, typically arising from inflammation or injury. In periodontal therapy, managing edema is essential as it correlates with patient comfort and healing. Appropriate interventions aim to reduce edema to optimize recovery and enhance overall treatment efficacy.

26) Pune:
Pune indicates a specific location in India where healthcare services are provided. The mention of Pune in relation to the study highlights the importance of regional medical practices and availability of healthcare resources, which can influence patient treatment options and clinical outcomes in periodontal care.

27) Silk:
Silk is often used in dental procedures as suture material due to its strength and biocompatibility. It supports wound closure after surgical interventions in periodontal therapy. The choice of silk for suturing relates to patient comfort and the effectiveness of healing processes in the oral tissues.

28) Line:
In clinical contexts, the term line may refer to guidelines or pathologies observed in the tissues, such as the gingival margin or the line of tissue demarcation in surgical sites. It aids clinicians in treatment planning and assessment of surgical outcomes, influencing procedural approaches.

29) Pain:
Pain serves as a subjective symptom often experienced after surgical interventions such as periodontal treatment. Managing pain effectively is crucial for patient comfort and recovery. Pain control strategies are integral to post-surgical care, enhancing patient experience and compliance with follow-up treatments to ensure optimal healing.

30) Drug:
In the context of periodontal therapy, the term drug often refers to medications, such as antibiotics or analgesics, used to manage infections and control pain. The appropriate prescription of drugs significantly impacts treatment efficacy, patient comfort, and overall healing processes in managing periodontal diseases.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘"GTR and orthodontics for treating esthetic zone migration"’. Further sources in the context of Science might help you critically compare this page with similair documents:

Interdisciplinary approach, Psychological impact, Periodontal disease, Endodontic treatment, Oral hygiene maintenance, Suture Removal, Bone loss, Periodontal therapy, Orthodontic treatment, Pocket probing depth, Fixed retainer, Severe periodontitis, Nonsurgical periodontal therapy, Oral health-related quality of life, Guided tissue regeneration, Clinical attachment.

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