Orthodontic treatment in stage IV periodontitis – a key topic at Perio Master Clinic 2023

The first session at Perio Master Clinic 2023 in Antwerp next March will focus on the question of orthodontic treatment in patients with stage IV periodontitis and will feature the first of the event’s “duo” presentations in which an orthodontist and a periodontist give two views on the same topic.

The session, moderated by Michèle Reners (Belgium), will open with a presentation by Gil Alcoforado (Portugal) on the long-term results of orthodontic treatments in periodontal patients. Prof. Alcoforado, who received the EFP’s Distinguished Service Award in 2020, will highlight now patient requirements today are taking treatments to limits that would have been unthinkable in the past.

“Patients whose teeth suffered from very advanced periodontal disease, that would normally lead to complete edentulism, are now treated with advanced periodontal-orthodontic-implant-prosthodontic rehabilitations,” he said, adding that success can be achieved only when the various specialities join forces to work “systematically and judiciously from the early stages of the establishment of the global treatment plan.”

His presentation will focus on various aspects of the co-operation between the periodontist and the orthodontist required to achieve functional and aesthetic results. One area of attention is the improvement of gingival aesthetics – very much in demand today – where special care is required in correcting the gingival line in the aesthetic zone.

He will also address whether orthodontic treatment can produce recessions and in which cases, and whether these can be prevented through soft- and/or hard-tissue grafts before the orthodontic treatment is carried out.

His presentation will be followed by the duo lecture Combined periodontal and orthodontic therapy of stage IV periodontitis patients with pathological tooth migration, given by Mariano Sanz and Conchita Martín, respectively professors of periodontology and orthodontics at the Complutense University of Madrid in Spain.

Their joint presentation will address one of the common consequences of the severe periodontal destruction seen in patients with stage IV periodontitis ­– pathological tooth migration with resulting functional and aesthetic consequences.

Treatment of these patients requires first periodontal therapy to arrest inflammation and attain periodontal health, and then orthodontic and restorative treatments to restore function and aesthetics.

The presentation will review the biological bases of orthodontic movements in teeth with a healthy but reduced periodontium and discuss interdisciplinary diagnosis and treatment planning, as well as the treatment sequence and follow-up of both periodontal and orthodontic components.

Professors Sanz and Martín will provide demonstrative cases and clear guidelines from both the periodontal and orthodontic perspectives, based on EFP's clinical practice guideline for the treatment of stage IV periodontitis, which was published in the Journal of Clinical Periodontology earlier this year.

The session will conclude with a clinical case presentation by Andrea Roccuzzo (Switzerland) about a patient with periodontitis, stage IV, grade C, offering a step-by-step explanation of a comprehensive combined ortho-perio treatment including the use of dental implants.

Perio Master Clinic 2023, on “The Perio-Ortho Synergy”, takes place in Antwerp, Belgium, on March 3 and 4 next year. Places are limited to ensure the optimal learning environment, so prompt booking is recommended.

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