Combined Periodontal-orthodontic Treatment in Generalized Stage III Grade C Periodontitis: A Case Report

doi:10.12337/zgkqjxjyzz.2025.04.006

Chinese Journal of Stomatological Continuing Education ›› 2025, Vol. 28 ›› Issue (4): 220-236.DOI: 10.12337/zgkqjxjyzz.2025.04.006

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Combined Periodontal-orthodontic Treatment in Generalized Stage III Grade C Periodontitis: A Case Report

Ganggang Qi¹, Yixiang Wang¹, Qian Liu¹, Xiaoyan Chen², Xiaojun Li^1,*

¹Department of Periodontics, Stomatology Hospital,School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, Zhejiang Province, P.R. China;
²Department of Orthodontics, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou , Zhejiang Province, P.R. China

Online:2025-07-31 Published:2025-07-31
Contact: Xiaojun Li. Tel: 0571-87215797. Email: ddslee312@zju.edu.cn. Address: No. 166 Qiutao North Road, Shangcheng District, Hangzhou 310016, Zhejiang Province, P.R. China.
Supported by:
Exploration and Development Project of ZJUSS (No.RD2022DXKB03)

Abstract

Abstract: Objective: Report the efficacy of systematic treatment combined with orthodontic treatment in a case of extensive Stage III Grade C periodontitis. Diagnosis and treatment: In this case, periodontal basic treatment was conducted to control periodontal inflammation, bone grafts were implemented to improve the supporting periodontal tissues, orthodontic treatment was used to manage the periodontal tissues and occlusal balance, ultimately achieving control of periodontal inflammation with long-term stability. Results: This case achieved good clinical results, the patient's periodontal inflammation was effectively controlled, and there was significant improvement in the structure, function, and aesthetics of the periodontal tissues. Conclusions: The diagnosis and treatment process and results of this case can provide one of the personalized treatment plans for periodontal orthodontic combined treatment.

Key words: periodontitis, sequential treatment, bone grafts, orthodontic therapy, combination therapy

Ganggang Qi, Yixiang Wang, Qian Liu, Xiaoyan Chen, Xiaojun Li. Combined Periodontal-orthodontic Treatment in Generalized Stage III Grade C Periodontitis: A Case Report[J]. Chinese Journal of Stomatological Continuing Education, 2025, 28(4): 220-236.

References

[1] Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition[J]. J Clin Periodontol, 2018, 45 Suppl 20:S149-S161.
[2] Mohammed H, Rizk MZ, Wafaie K, et al.Reminders improve oral hygiene and adherence to appointments in orthodontic patients: a systematic review and meta-analysis[J]. Eur J Orthod, 2019, 41(2):204-213.
[3] Papageorgiou SN, Antonoglou GN, Michelogiannakis D, et al. Effect of periodontal-orthodontic treatment of teeth with pathological tooth flaring, drifting,elongation in patients with severe periodontitis: A systematic review with meta-analysis[J]. J Clin Periodontol, 2022, 49 Suppl 24(Suppl 24):102-120.
[4] Martin C, Celis B, Ambrosio N, et al. Effect of orthodontic therapy in periodontitis and non-periodontitis patients: a systematic review with meta-analysis[J]. J Clin Periodontol, 2021, 49 Suppl 24:72-101.
[5] Nyman S, Gottlow J, Karring T, et al.The regenerative potential of the periodontal ligament[J]. J Clin Periodontol, 1982, 9(3):257-265.
[6] Jepsen S, Gennai S, Hirschfeld J, et al. Regenerative surgical treatment of furcation defects: a systematic review and bayesian network meta-analysis of randomized clinical trials[J]. J Clin Periodontol, 2020, 47 Suppl 22:352-374.
[7] Tu CC, Lo CY, Chang PC, et al.Orthodontic treatment of periodontally compromised teeth after periodontal regeneration: a restrospective study[J]. J Formos MedAssoc. 2022, 121(10):2065-2073.
[8] Herrera D, Sanz M, Kebschull M, et al. Treatment of stage IV periodontitis: the EFP S3 level clinical practice guideline[J]. J Clin Periodontol, 2022, 49 Suppl 24:4-71.
[9] Sanz M, Herrera D, Kebschull M, et al. Treatment of stage I-III periodontitis-the EFP S3 level clinical practice guideline[J]. J Clin Periodontol, 2020, 47 Suppl 22(Suppl 22): 4-60.
[10] Kloukos D, Roccuzzo A, Stähli A, et al. Effect of combined periodontal and orthodontic treatment of tilted molars and of teeth with intra-bony and furcation defects in stage-IV periodontitis patients: a systematic review[J]. J Clin Periodontol, 2021, 49 Suppl 24:121-148.
[11] Han J, Dong J, Zhao H, et al.Efficacy of periodontal tissue regeneration combined with orthodontic therapy on periodontitis and its influences on inflammatory factors in patients[J]. J Biomater Tissue Eng, 2020, 10(5):737-742.
[12] Cortellini P, Tonetti MS.Clinical concepts for regenerative therapy in intrabony defects[J]. Periodontol 2000, 2015, 68(1): 282-307.
[13] Nibali L, Sultan D, Arena C, et al.Periodontal infrabony defects: systematic review of healing by defect morphology following regenerative surgery[J]. J Clin Periodontol, 2021;48(1):100-113.
[14] Dung SZ, Tzeng IS, Li CS.Immediate orthodontic treatment after regeneration of periodontal intrabony defects: a long-term retrospective study[J]. J Dent Sci, 2025, 20(1):417-427.
[15] Tietmann C, Bröseler F, Axelrad T, et al.Regenerative periodontal surgery and orthodontic tooth movement in stage IV periodontitis: a retrospective practice-based cohort study[J]. J Clin Periodontol, 2021, 48(5):668-678.
[16] Pini Prato GP, Chambrone L.Orthodontic treatment in periodontal patients: the use of periodontal gold standards to overcome the “grey zone”[J]. J Periodontol, 2020, 91(4):437-441.
[17] Zhong W, Zhou C, Yin Y, et al.Expert consensus on orthodontic treatment of patients with periodontal disease[J]. Int J Oral Sci, 2025, 17(1):27.
[18] Erbe C, Heger S, Kasaj A, et al.Orthodontic treatment in periodontally compromised patients: a systematic review[J]. Clin Oral Investig, 2023, 27(1):79-89.
[19] Sharma AA, Park JH.Esthetic considerations in interdental papilla: remediation and regeneration[J]. J Esthet Restor Dent, 2010, 22(1):18-28.
[20] Jepsen S, Caton JG, Albandar JM, et al. Periodontal manifestations of systemic diseases and developmental and acquired conditions: consensus report of workgroup 3 of the2017 world workshop on the classification of periodontal and peri-implant diseases and conditions[J]. J Periodontol, 2018, 89 Suppl 1:S237-S248.
[21] Newman MG, Takei H, Klokkevold PR, et al.Carranza’s clinical periodontology[M]. 12th ed. St. Louis: Elsevier, 2014.

Combined Periodontal-orthodontic Treatment in Generalized Stage III Grade C Periodontitis: A Case Report

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