Crown Truncation In Orthodontics For An Adult With Periodontitis

Orthodontic treatment in adults with severe periodontitis often risks alveolar bone resorption. This case demonstrates how incisor crown truncation after root canal therapy (RCT) improves crown-root ratio, levels the curve of Spee, and minimizes bone loss during the orthodontic treatment. A 40-year-old female patient presented with complaints of anterior diastema and protrusion, requesting orthodontic treatment. Initial findings included 4mm overbite, Class I molar relationship, scattered spaces, and alveolar bone resorption up to 1/3–1/2 root height. By comprehensive consideration systemic periodontal treatment was first performed, and orthodontic treatment was initiated 3-6 months after ensuring stable periodontal health. RCT was performed on maxillary teeth 12-22 and mandibular teeth 32-42, followed by crown truncature of 2-3mm reduction to coordinate the crown-root ratio and assist in leveling. The concept of light force was applied throughout the treatment, and periodontal re-examinations were conducted regularly. The patient’s alveolar bone had already undergone significant resorption. On closing spaces, intrusion of the anterior teeth could lead to further alveolar bone resorption.The use of crown truncature not only balanced the crown-root ratio but also avoid further alveolar bone resorption. This approach demonstrates the importance of integrating periodontal considerations into orthodontic treatment planning, particularly in cases with compromised periodontal support. Combining crown truncation with orthodontics offers a strategic solution for adults with advanced alveolar bone loss, balancing treatment efficacy and periodontal safety. Further studies are needed to confirm long-term outcomes across diverse clinical settings.