Perio & ortho

• perio pt need to be stable before being considered for ortho
• correction of malocclusion & malalignment

  • make oh easier?
  • no strong evidence for prevention of perio
  • might compensate in minor cases
  • class 2 causing gingival trauma considered
• how do ortho appliances cause gingival inflammation?

  • direct trauma
  • plaque retention
• deep traumatic overbite?

  • study models
  • OHI, PMPR, gingivectomy?
  • appliance to guard, reduce incisors?
• tooth drift?

  • management - why? perio? can we realign?
  • loss of perio support, occlusal interference, soft tissues, combo
• management of drifting?

  • if perio stable - occ guard, selective grinding
  • ortho?
  • long term monitoring
  • tx of perio before ortho