Ortho Tip for December 3 2015

Here is an interesting article from the AJODO that talks about intrusion of maxillary incisors in a periodontally compromised case.

It has application to middle age and senior patients where extruded teeth are causing esthetic and functional issues.

If a maxillary incisor is orthodontically intruded back to its original position, the base of the gingival sulcus will migrate up and deepen the gingival sulcus. This may also resorb the buccal and lingual plates of bone. So generally in these cases orthodontic intrusion is contraindicated.

However, in this article the researchers did a supracrestal fiberotomy at each orthodontic appointment to free the gingival attachment during the intrusion to prevent buccal and lingual bone loss from the intrusion. At the end of the intrusion they performed guided tissue generation with bone grafting to repair the angular bone defect that intruding the tooth caused.

The result was that the angular vertical bone defect was repaired and the intruded incisors had a normal gingival attachment at the appropriate level for function and esthetics. No buccal or lingual bone loss occurred.

Very interesting!

Stan

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