Mia-Assisted Orthodontics For Protrusion With Missing Teeth And Periodontitis

A 28 - year - old female with a convex face, a missing mandibular incisor, and periodontitis aimed to enhance aesthetics and occlusion. Through non - extraction treatment using mini implant anchors (MIA) and multidisciplinary cooperation, positive results were obtained. The patient was diagnosed with a facial protrusion characterized by maxillary dental protrusion, mandibular skeletal retrognathia, chin retraction, with a tendency of skeletal Class II. MIAs on the entire maxillary alveolar ridge help to distalized the maxillary dentition, and the MIAs in the anterior tooth region were used to assist in the vertical control of anterior teeth and improving the gummy smile. After treatment, she became straight face type with normal occlusion. The periodontal indices improved with the plaque index (58.8% to 23.8%), the bleeding index (28.5% to 9.5%), and the average probing depth (3.1mm to 2.5mm); the tooth mobility was generally reduced. The solution strategies for the absence of the mandibular incisor were between closing the space or implant restoration, and the solution strategies for the maxillary protrusion were between tooth extraction or dentition distalization. The treatment difficulties of this case lied in the periodontal risks, anchorage design, and vertical control. The principles of orthodontic treatment for patients with periodontal disease include minor tooth movement, light forces, short treatment course, and closely monitor the periodontal status. MIA - assisted orthodontics can precisely control tooth movement, balance aesthetics and occlusion with reduced periodontal burden, but long - term maintenance is essential for stable results.