Interdisciplinary treatment approach in a class III patient with severe periodontitis: challenges and solutions in an University Dental Clinic

Introduction: The orthodontic treatment of adult patients with interdisciplinary treatment needs often presents a challenge and it requires good cooperation between dental specialists in order to achieve an optimal result. The case report describes the joint interdisciplinary treatment of a 40-year-old patient with Angle class III occlusion, progenic forced bite, severely malpositioned teeth and periodontitis. Conservative dental treatment was also neces-sary due to insufficient restorations and carious lesions. Treatment method: The therapy encompassed orthognatic surgery as well as orthodontic, periodontal and conservative treatments together with tooth re-contouring at the end. Following thorough treatment planning, the first step involved systematic periodontal treatment. Once stable periodontal conditions were achieved and maintained, the position of the maxillary front teeth was corrected by means of a multibracket appliance, followed by bimaxillary ortho-gnathic surgery. Finally, direct tooth recontouring using composite resins was performed in order to improve the esthetic appearance of the maxillary front teeth. Result: Thanks to good interdisciplinary cooperation between specialists in various dental disciplines including maxillofacial surgery, periodontology, orthodontics and conservative dentistry, the healthy and painless functioning of the jaws could be restored under healthy periodontal conditions and an esthetically appealing appearance of the teeth could be achieved. Conclusion: Shared objectives and treatment planning between dental specialists should be aimed for in patients requiring interdisciplinary treatment. In order to achieve optimal treatment outcomes, the individual treatment steps should always be planned and, if necessary, adjusted in terms of time and interim results. Keywords: dysgnathia, orthognatic surgery, periodontal treatment, preoperative and postoperative orthodontic treatment, tooth recontouring