Multidisciplinary Treatment Of Severe Periodontitis With Posterior Open Bite

This case demonstrates the comprehensive multidisciplinary treatment of generalized severe chronic periodontitis (Stage IV, Grade C), including periodontal therapy to control inflammation, orthodontic treatment to improve occlusal relationships, as well as implant and prosthetic therapy to restore missing teeth. Due to severe loss of periodontal support, the patient exhibited buccal tipping of posterior teeth and labial inclination of anterior teeth, resulting in occlusal trauma in the molar region and open bite in the premolar and anterior regions, along with scattered diastemas in the upper anterior teeth. After initial periodontal therapy, the inflammation was successfully controlled. Subsequently, orthodontic treatment was performed using self-ligating brackets, light archwires, and minimal forces. During treatment, the patient was guided to utilize occlusal forces to assist in cusp intrusion, combined with functional training of the tongue and lip muscles, achieving safer and more efficient tooth movement. This case highlights the synergistic role of periodontal therapy and orthodontics in the multidisciplinary management of severe periodontitis. Orthodontic intervention effectively eliminated occlusal trauma, thereby improving periodontal outcomes. For periodontally compromised patients, orthodontic forces should be minimized, while physiological forces (e.g., occlusal loads, lip/tongue muscle activity) can be harnessed to achieve treatment goals efficiently. Appropriate orthodontic treatment is a critical component of multidisciplinary care for severe periodontitis. This case exemplifies a standardized workflow for such integrated management.