Multidisciplinary Strategy For Severe Periodontitis With Bimaxillary Protrusion

This case highlights the integration of periodontics, prosthodontics, and orthodontics to address severe periodontitis-associated malocclusion, emphasizing functional and aesthetic rehabilitation. A 28-year-old female presented with lip incompetence, dental spacing, and severe chronic periodontitis. Clinical evaluation revealed skeletal Class I, Angle’s Class I malocclusion, and defective restorations. Radiographic analysis confirmed pathological tooth migration and advanced bone loss. Treatment included periodontal therapy (scaling, root planing, flap surgery), replacement of defective crowns, and clear aligner-based orthodontics. Four first premolars were extracted, and micro-implant anchorage (MIA) was utilized for anterior retraction. Anterior teeth were retracted by 6 mm (maxillary) and 5 mm (mandibular) with controlled force. Post-treatment periodontal indices showed reduced probing depth (3.33 mm to 2.50 mm) and bleeding index (3.00 to 1.00). Occlusal scores improved significantly (10.35 to 23.62). Facial convexity and lip seal were normalized. No adverse effects on periodontal stability were observed. Coordinated multidisciplinary care ensured successful outcomes in complex cases of periodontitis-associated malocclusion. Clear aligners, combined with strategic anchorage, effectively managed tooth movement while maintaining periodontal health. This approach highlights the importance of interdisciplinary collaboration in achieving functional and aesthetic rehabilitation.