Periodontal Regeneration and Orthodontic Treatment of Severely Periodontally Compromised Teeth: 10-Year Results of a Prospective Study

The aim of this study was to investigate the long-term clinical conditions of periodontally compromised teeth treated by means of orthodontics after periodontal regeneration (GTR). Forty-eight patients affected by severe periodontitis who presented at least one nonmolar, malpositioned tooth with a pocket depth (PD) ≥ 7 mm, were consecutively enrolled in a private specialist practice. The treatment consisted of the following steps: infection control, provisional splinting, GTR, orthodontic treatment, final splinting, and supportive periodontal therapy (SPT). Thirty-six patients completed the 10-year study, as 12 were lost to follow-up. The total number of sites with PD ≥ 7 mm decreased from 25.4 ± 16.7 to 1.8 ± 2.1. PD of the teeth involved in the orthoperio treatment significantly decreased from 6.3 ± 1.5 mm to 3.1 ± 0.6 mm. One test tooth had to be extracted before the final examination due to root fracture, while two teeth lost vitality and received a root canal treatment. Eight episodes of recurrence, which required additional treatment, occurred during the 10 years of follow-up. The results of this study suggest that if a periodontal infection is under control, the orthodontic treatment does not reduce the long-term benefits of periodontal regeneration, even where the disease has caused massive tissue destruction.