Abstract
Background
Light forces and an appropriate force system should be used to treat adult patients with periodontal disease.
Aims
To describe the orthodontic treatment of an adult patient with a Class I deep bite malocclusion, horizontal and vertical bone loss and root resorption.
Methods
After periodontal surgery and initial alignment of the maxillary incisors with a fixed orthodontic appliance the maxillary incisors were splinted together as a single unit. A double palatal arch and sectional buccal archwires were used for anchorage. The palatal arch and splint were joined by a NiTi coil spring (100 g). The incisor segment was then intruded and retracted with a force acting just below the centre of resistance of the splinted incisor teeth. The force system avoided extruding the maxillary molars. The maxillary teeth were then rebonded to close the spaces between maxillary lateral incisors and canines. A Hawley appliance was used for retention. Treatment was completed in 22 months.
Conclusions
Surgical treatment and intrusion with light forces encouraged the development of periodontal attachment to the teeth affected by severe horizontal and vertical bone loss. Retraction of the proclined incisors improved the facial aesthetics.