Clinical evaluation of correction of pathologic migration with periodontal therapy

Objective: There is a paucity of clinical evidence regarding the amount and frequency of repositioning of pathologically migrated teeth after conventional periodontal treatment. The present study was carried out to find and relate these two parameters of periodontal success with severity of migration. Method and Materials: A total of 45 subjects with a history of recently formed diastema or noticeable increase in already existing diastema were selected. Twenty-nine patients with 76 diastema sites participated in the study (16 patients were lost to follow-up). Repositioning was assessed by measuring the sites on study models obtained at baseline, reevaluation at 6 weeks after nonsurgical periodontal therapy, and 4 months after surgery. Results: After nonsurgical therapy, 65.78% of sites demonstrated some degree of repositioning, while 7.89% closed completely. Four months after surgical treatment, 32.30% of sites showed complete repositioning and 47.69% of sites showed an additional partial repositioning. This corresponds to a 79.99% rate of positive responses to therapy. When sites measuring = 1 mm were considered, 65.38% showed complete closure and 96.15% demonstrated positive response to therapy. Conclusion: The findings suggest that there is an inverse relationship between the severity of migration and amount (as well as frequency) of repositioning. The results emphasize the importance of early diagnosis in the successful treatment of pathologic migration to prevent more complex and time-consuming orthodontic and prosthodontic procedures. Keywords: complete closure, pathologic tooth migration, periodontal disease, periodontal therapy, repositioning, severity of migration