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    Periodontology

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    Roll Dent

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    of 5

    Q U I N T E S S E N C E I N T E R N AT I O N A L

    PERIODONTOLOGY

    Integrated periodontal, orthodontic, and


    prosthodontic treatment in a case of severe
    generalized aggressive periodontitis
    Lizett Castellanos-Cosano, DDS, MSc, PhD1/Guillermo Machuca-
    Portillo, MD, PhD2/Asunción Mendoza-Mendoza, MD, MSc, PhD2/
    Alejandro Iglesias-Linares, DDS, MSc, PhD1/Lina Soto-Pineda, DDS,
    MSc1/Enrique Solano-Reina, MD, MSc, PhD2

    Objective:5IJTBSUJDMFSFQPSUTBDBTFPGTFWFSFHFOFSBMJ[FEBHHSFTTJWFQFSJPEPOUJUJTBOE
    TVCTFRVFOUDPMMBQTFPGUIFPDDMVTJPOJOBQTZDIJBUSJDQBUJFOU USFBUFECZBOFYUSFNFMZDPO-
    TFSWBUJWFPSUIPEPOUJDQFSJPEPOUBMQSPTUIPEPOUJDUSFBUNFOUSummary: "XPNBOQSFTFOUFE
    XJUITFWFSFBOUFSJPSQSPDMJOBUJPODBVTFECZTFWFSFQFSJPEPOUBMEJTFBTFBOE"OHMFTDMBTT
    **NPMBSNBMPDDMVTJPO5IFQBUJFOUXBOUFEUPQSFTFSWFIFSUFFUIBOESFKFDUFEUIFJEFBPG
    JNQMBOUUSFBUNFOU5IJTDBTFSFQPSUEFNPOTUSBUFTUIBUDPNCJOJOHQFSJPEPOUBMUIFSBQZ PSUI-
    PEPOUJDUSFBUNFOU BOEQSPTUIPEPOUJDT UISPVHIBEFDJTJPONBLJOHTZTUFNXJUIBQSPQFS
    JOUFSEJTDJQMJOBSZDPPSEJOBUJPO
    DBOHSFBUMZJNQSPWFGVODUJPOBOEUIFFTUIFUJDSFTVMU
    $PNQSFIFOTJWFQFSJPEPOUBMUSFBUNFOUUPPLQMBDFCFGPSFPUIFSJOUFSWFOUJPO BOEQFSJPEPOUBM
    NBJOUFOBODFBOEGPMMPXVQUISPVHIPVUUIFUSFBUNFOUBOEBGUFSQMBZFEBDSVDJBMSPMF
    (Quintessence Int 2013;44:481–485; doi: 10.3290/j.qi.a29703)

    Key words:EFOUBMQSPUSVTJPO EFQSFTTJWFEJTPSEFST HFOFSBMJ[FEBHHSFTTJWF


    QFSJPEPOUJUJT JOUSBDPSPOBSZPDDMVTBMSFUFOUJPO PSUIPEPOUJDUSFBUNFOU 
    QFSJPEPOUBMUSFBUNFOU

    " DMJOJDBM DBTF PG TFWFSF HFOFSBMJ[FE BOUJQTZDIPUJD USFBUNFOU  BOE WBSJPVT DBSJ-
    BHHSFTTJWFQFSJPEPOUJUJTXJUIBMUFSFEFTUIFU- PVT UFFUI $MJOJDBM FYBNJOBUJPO TIPXFE UIF
    JDTJTQSFTFOUFE5IFDPNQMFYTJUVBUJPOXBT QSFTFODFPGTFWFSFHFOFSBMJ[FEBHHSFTTJWF
    SFTPMWFE CZ BEPQUJOH B NVMUJEJTDJQMJOBSZ QFSJPEPOUJUJT 'JH
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    " ZFBSPME XPNBO QSFTFOUFE XJUI UIF 5IFPOMZDPOEJUJPONBEFCZUIFQBUJFOUXBT
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    UJPOBOEWFTUJCVMBSFYUSVTJPOPGUIFNBYJMMBSZ
    JODJTPST 5IF QBUJFOU IBE CFFO EJBHOPTFE Control of periodontal disease
    XJUI QTZDIPUJD EFQSFTTJWF EJTPSEFS USFBUFE 5IFmSTUHPBMXBTUPDPOUSPMQFSJPEPOUBMEJT-
    XJUIUIJPSJEB[JOFBOEnVPYFUJOFGPSZFBST  FBTF *U XBT JNQPSUBOU UP QMBDF FNQIBTJT
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    1
    Associate Professor, Department of Stomatology, School of UIFQFSJPEPOUBMTUBUVTXBTQFSGPSNFEFWFSZ
    Dentistry, University of Seville, C/ Avicena s/n, 41009-Sevilla,
    NPOUIT'VMMNPVUIFUJPMPHJDBMBOEDPSSFD-
    Spain.
    UJWF USFBUNFOU XBT QFSGPSNFE 5IF QFSJ-
    2
    Professor, Department of Stomatology, School of Dentistry,
    PEPOUBM SFDPSET CFGPSF JOJUJBMJ[JOH
    University of Seville, C/Avicena s/n, 41009-Sevilla, Spain.
    PSUIPEPOUJDUSFBUNFOUTIPXFEPOMZQPDLFUT
    Correspondence: Prof Enrique Solano-Reina, Facultad de
    Odontología, Univ. de Sevilla, C/ Avicena s/n, 41009-Sevilla, PG NN PS MFTT 3PPU DBOBM USFBUNFOU XBT
    Spain. Email: esolano@us.es QFSGPSNFEJOUIFNBYJMMBSZSJHIUmSTUNPMBS

    VOLUME 44t/6.#&37t+6-:"6(6452013 481


    Q U I N T E S S E N C E I N T E R N AT I O N A L
    Castellanos-Cosano et al

    Fig 1 Clinical extraoral (a and b) and


    intraoral (c to e) diagnostic records taken
    before the start of any periodontal or orth-
    a b odontic treatment.

    c d e

    Fig 2 Periapical radiographic series before the start of periodontal treatment.

    Orthodontic treatment PDDMVTBM QMBOF  BOE UP FTUBCMJTI BO BEF-


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     VOLUME 44t/6.#&37t+6-:"6(6452013


    Q U I N T E S S E N C E I N T E R N AT I O N A L
    Castellanos-Cosano et al

    b
    Fig 3 (a and b) Radiographic record at the beginning of the orth-
    odontic treatment. Note the marked maxillary and mandibular tooth
    proclination accompanied by general horizontal bone loss in all
    a quadrants.

    a b c

    d e f

    g h i

    Fig 4 (a to j) Orthodontic treatment evolution after perform-


    ing periodontal treatment, with both maxillary canines and
    mandibular left second incisor extraction. Note that mandibu-
    lar tooth proclination was controlled from the beginning to
    avoid occlusal trauma and increasing overjet. Retraction and
    torque correction was performed using a step-by-step activa-
    j tion process with soft archwire sequences.

    VOLUME 44t/6.#&37t+6-:"6(6452013 


    Q U I N T E S S E N C E I N T E R N AT I O N A L
    Castellanos-Cosano et al

    b
    Fig 5 (a and b) Radiographic records taken after completion of the
    periodontal and orthodontic treatment with temporary wire reten-
    a tion in the maxillary and mandibular incisors.

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    NBYJMMB  EFTQJUF HPPE NBOBHFNFOU PG REFERENCES
    UPSRVF ESJWFO CZ UIF SFUSVTJPOJOUSVTJPO 1. Gary C. Armitage development of a classification
    UPSRVFVUJMJUZBSDIXJSF TLFMFUBM$MBTT**NBM- system for periodontal diseases and conditions.
    PDDMVTJPOJTDMJOJDBMMZNBOJGFTUBOEOFFETUP Ann Periodontol 1999;4:1–6.

    484 VOLUME 44t/6.#&37t+6-:"6(6452013


    Q U I N T E S S E N C E I N T E R N AT I O N A L
    Castellanos-Cosano et al

    a b c

    Fig 6 Extraoral (a and b) and intraoral (c


    to e) records obtained after completion of
    periodontal and orthodontic treatment. d e

    a b

    c d
    Fig 7 (a to d) Detailed photographs of maxilla retention constructed from maxillary right first premolar to
    left first premolar in a canine substitution position.

    2. Levin L, Einy S, Zigdon H, Aizenbud D, Machtei EE. 4. Janson M, Janson G, Murillo-Goizueta OEF. A modi-
    Guidelines for periodontal care and follow-up dur- fied orthodontic protocol for advanced periodontal
    ing orthodontic treatment in adolescents and disease in Class II division 1 malocclusion. Am J
    young adults. J Appl Oral Sci 2012;20:399–403. Orthod Dentofacial Orthop 2011;139:S133–144.
    3. Monteiro da Silva AM, Oakley DA, Newman HN, 5. Re S, Corrente G, Abundo R, Cardaropoli D. Orth-
    Nohl FS, Lloyd HM. Psychosocial factors and adult odontic treatment in periodontally compromised
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    odontol 1996;23:789–794. ative Dent 2000;20:31–39.

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