Interdisciplinary approach for the treatment of pathologic migration in teeth with advanced periodontal disease

Abstract

Pathological migration of anterior teeth is an esthetic and functional problem that may be associated with advanced periodontal disease. It is defined as a change in tooth position resulting from disruption of the forces that maintain teeth in a normal position in relation to their arch. The disruption of the equilibrium in tooth position may be caused by several etiologic factors. These include periodontal attachment loss, pressure from inflamed tissues, occlusal factors, oral habits such as bruxism, tongue thrusting, and the playing of wind instruments, loss of teeth without replacement, a labial frenum, gingival enlargement and iatrogenic factors. However according to the literature, the destruction of tooth-supporting structures is the most relevant factor associated with pathologic migration. Unfortunately, pathologic tooth migration can be associated with esthetic damage of smile line, reducing patient′s self-esteem. To solve both issues, therefore, a combination of orthodontic and periodontal treatment is often needed.

Keywords

• orthodontic treatment
• pathological migration
• periodontitis