Today many adult patients with periodontal disease demonstrate positioning of teeth that comprise their ability for proper mechanical tooth cleaning of approximal tooth surfaces. With adequate combined periodontal-orthodontic treatment it is possible to re-establish a healthy and well-functioning dentition. However, while orthodontic treatment can realign periodontally affected teeth, esthetic appearance may be compromised by gingival recession due to alveolar bone dehiscences or fenestrations in combination with a thin gingival biotype. This article reports an interdisciplinary (periodontic, orthodontic, restorative) approach for the treatment of a periodontally compromised patient with anterior dental malalignment. Periodontal therapy, including periodontal plastic surgery to obtain root coverage as well as orthodontic treatment by means of a miniscrew implant anchorage were used to achieve stable periodontal conditions and successful esthetic and functional final results.
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