Orthodontic, periodontal and prosthodontic treatment for a periodontally compromised patient with a deep overbite

Background: Periodontitis may result in displacement, overeruption and the tilting of teeth, which can lead to occlusal prematurities and accelerate the loss of periodontal structures. Orthodontic treatment is needed to correct displaced tooth positions, but inappropriate force and tooth movement can lead to further loss of supporting tissues. Aim: To describe the treatment of a deep overbite in a 32-year-old male with a history of periodontitis, gingival recession and missing premolars. Methods: After evaluation, fixed appliances applying light forces were chosen as the appropriate treatment approach. A segmental arch and a utility arch technique were applied. Periodontal therapy was conducted before and throughout orthodontic care. Results: After 28 months of treatment, a normal overbite and overjet were restored. A displaced premolar was repositioned. Space needed for the prosthetic replacement of the missing teeth was obtained and dental implants were planned after orthodontic treatment. The height of the alveolar bone increased in some areas. After 18 months of retention, the attachment level of the upper left incisor increased approximately 1 mm. Conclusion: For patients with a compromised periodontium, adequate management of the tissues is the basis of orthodontic care. Appropriate orthodontic treatment may be beneficial to periodontal health in the long term.