Periodontal Assisted Orthodontic-Orthognathic Retreatment Of A Skeletal Malocclusion

The periodontal condition is the first factor should be considered of contemporary orthodontics. The tooth exceed the boundary of the basal bone and over inclination is deleterious to the incisal guide and functional movements. Therefore, this case adopted the lingual periodontium regeneration surgery assisted orthodontic-orthognathic retreatment, which presents a good and stable results. This case report describes an orthodontic-surgical retreatment of an adult patient with severe Class III malocclusion after undergoing excessive camouflaged orthodontics, which results in the damage of the lingual periodontium. A treatment plan comprising lingual periodontium regeneration and combined orthodontic-orthognathic treatment to achieve the optimal functional and aesthetic outcomes. In the perspective of health and function, the tooth should upright in the alveolar housing. In this case, for the purpose of masked the skeletal discrepancy, the camouflaged treatmen ignored the biological limit of dental compensation, the thin symphysis thickness could not afford the extensive incisor retraction, and the neglect of the tooth function cause the second treatment. Therefore, comprehensive analysis is necessary. Camouflaged orthodontics should not be performed blindly .In addition, the lingual periodontium regeneration surgery, though rarely used, also present a stable outcome, long-term stability research is needed. A comprehensive evaluation of the patient's condition should be performed before formulating a treatment plan, the soft tissue and hard tissue limits should be taken into consideration for the good prognosis, and the dentoalveolar compensation should be implemented with caution. Moreover, the interdisciplinary treatment is essential in contemporary orthodontics treatment.