![]() Masticatory forces start to occur in inclined planes, which causes dental hypermobility and thickening of the periodontal ligament. When there are pathological changes in tooth positioning, ![]() This occurs because it is extremely important that masticatory forces are transmitted in the axial direction of teeth, allowing the application of intense forces with less tension on the periodontal ligament. This spacing is the most evident sign of pathological change in tooth positioning, occurs in a progressive manner and the most affected teeth are the maxillary incisors.Ĭoncomitantly, periodontal patients have traumatic occlusion, which can contribute to the development of destructive periodontal disease, since secondary occlusal trauma may further deteriorate the supporting tissues. Patients with periodontitis often have several sequelae, such as: 1) inadequate angulation 2) excessive buccal projection 3) extrusion of one or more incisors and 4) development of single or multiple diastemas in anterior teeth, with progressive spacing of incisors, often fan-shaped. However, even after complete removal of the disease, the patient with pathological migration should not be considered completely treated. The first step in treating these patients is always the elimination of active periodontal disease. Thus, recovery of the integrity and continuity of the dental arch, as well as balanced tooth positioning, is an essential step for the successful treatment of a patient with periodontitis and pathological migration of teeth. Since one of the most important factors for periodontal balance is the physiological stimulation received by the tissues during function. In these cases, orthodontic tooth movement is an important step when planning the global treatment of the patient, In fact, periodontal treatment as a single therapy is not always able to correct and control the damage produced by periodontal disease and a consequent pathological occlusion, depending on the degree of tissue impairment. With an increasing number of adult patients seeking orthodontic treatment, it is now common to treat patients who need correction of functional and esthetic sequelae of periodontal disease.
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