Periodontal Surgery for the Orthodontic Patient

O.SANDID, SQODF2007

Periodontal Surgery for the Orthodontic Patient

• 1. Pericision-Circumferential Supracrestal Fiberotomy• 2. Frenectomy• 3. Gingival Grafting• 4-Surgical Exposure of Impacted Tooth For Orthodontics• 5-Extraction supernumerary teeth mesiodens• 6- Impacted Wisdom teeth• 7-Repositioning - impaction lower second molar• 8-Gummy smile• 9- Mini-implant• 10- Corticotomy • 11-Orthodontics extractions – Space gaining• 12- Black triangle

1- Pericision-Circumferential Supracrestal Fiberotomywww.orthofree.com

Fiberotomy (CSF) Preventing Orthodontic RelapseRelapse of severely rotated teeth due to rebound of elastic fibres in the supracrestal tissues

can be reduced by pericision.

http://www.aso.org.au/members/NSW%20Brighter%20Futures/Brighter_Futures_002.pdf

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2- Frenectomywww.orthofree.com

http://www.omahaperio.com/services/frenectomy.aspx

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e.com

Closure of the maxillary midline diastema , with frenectomy and

orthodontic treatment

Ankyloglossia: large frenulum can limit tongue movement thereby cause eating problems and

interfering with speech.

3- Gingival Graftingwww.orthofree.com

http://www.mrzperio.com

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Gingival Grafting: Orthodontic tooth movement may lead to gingival recession. The treatment of gingival recession is to cover the exposed root surfaces to improve esthetics and to reduce hypersensitivity, This treatment involves the utilization of a small piece of tissue

removed from the roof of the mouth and placed in an area of extremely weak, thin tissue to prevent further recession.

4-Surgical Exposure of Impacted Tooth For Orthodonticswww.orthofree.com

O.SANDID- O.Migault

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Canine Exposure: This procedure involves opening a flap and removing small amounts of bone in order to bond an orthodontic “button” to a tooth that is not properly positioned in the arch. Once the button is bonded to the tooth, the orthodontist can move this tooth into

the appropriate place.

5-Extraction supernumerary teeth- mesiodenswww.orthofree.com

O.SANDID

6- Impacted Wisdom teethwww.orthofree.com

Impacted Wisdom teeth- Pericoronitis

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7-Repositioning - impaction lower second molarwww.orthofree.com

8-Interdisciplinary approach to improve smile estheticswww.orthofree.com

http://www.gummysmile.com/

Gummy smileThe combination of the overgrown gum tissue and the high lip line are working together to

reduce the beauty of this smile.Following minimally-invasive surgery, where the patient had no post-surgical pain, we can now see the fullness of her smile. Her high lip line is not a severe problem and is less of a concern.

9-Mini-implantwww.orthofree.com

Mini-implant (Could eliminate need for Headgear):Temporary anchorage devices are utilized in conjunction with orthodontics to assist in moving teeth. This procedure involves placement of the TAD (titanium bone anchor) directly through

the gums into the bone, eliminating unwanted movement of anchorage teeth, decreasing treatment time and making headgear a thing of the past for patients

L. Massif, L. Frapier, EMC

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10- Corticotomy facilitated orthodonticswww.orthofree.com

http://parkell.cdeworld.com/

Corticotomy, Periodontally Accelerated Osteogenic Orthodontics (PAOO): is ideal for patients who want braces, but do not want the traditionally long treatment time. For this procedure,

the gum tissue is gently separated from the bone, making a “flap”. The bone is then activated by creating small cuts into the bone to facilitate the orthodontic movement, and the sites are

then augmented with graft material. After this, orthodontic treatment begins. PAOO significantly decreases the treatment time (1 year to 6 months, 2 years to 6-8 months), enhances the range of movement, requires fewer permanent extractions, and less root

resorption has been reported

11-Orthodontics extractions – Space gaining

12- Black trianglewww.orthofree.com

http://www.oralhealthgroup.com/news/treating-the-dreaded-black-triangle/1002990029/?&er=NA

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Bibliography• 1. Andlin-Sobocki A. Changes of facial gingival dimensions in children. • A 2-year longitudinal study. J Clin Periodontol. 1993 Mar;20(3):212-8.• 2. Boyd RL, Leggott PJ, Quinn RS, Eakle WS, Chambers D. Periodontal implications of • orthodontic treatment in adults with reduced or normal periodontal tissues versus • those of adolescents. Am J Orthod Dentofacial Orthop. 1989 Sep;96(3):191-8.• 3. Edwards JG. A surgical procedure to eliminate rotational relapse.• Am J Orthod. 1970 Jan;57(1):35-46.• 4. Edwards JG. The diastema, the frenum, the frenectomy: a clinical study.• Am J Orthod. 1977 May;71(5):489-508.• 5. Lindhe J. 1992, Clinical Periodontology, 2nd Ed, Munksgaard, Copenhagen • 6. Monefeldt I, Zachrisson B. Adjustment of clinical crown height by gingivectomy • following orthodontic space closure.• Angle Orthod. 1977 Oct;47(4):256-64.