630H
Fig. 11.11 Apical root resorption of 321|123 following orthodontic treatment.
(Reproduced by kind permission of Dr I. L. Chapple, Professor of Periodontology,
Birmingham, UK.)
11.10.4 Gingival recession
The response of the facial periodontal tissues to labial tooth movement in anterior
segments is unpredictable. Labial movement of incisors is sometimes associated with
gingival recession. The risk of recession is greater when the alveolar bone plate is thin
or where dehiscences or fenestrations in the bone exist.
11.10.5 Trauma
Direct local irritation of the soft tissues by components of a fixed appliance can be
minimized if due care and attention is exercised during bonding, banding, and
placement of wires and elastics. If chronic irritation of the gingiva does occur then a
localized, acute inflammatory reaction will quickly follow. This may develop further
into a region of gingival enlargement or a fibrous epulis that is superimposed upon a
burrowing infrabony lesion.
Key Points
Orthodontic problems:
- gingivitis;
- enlargement;
- root resorption;
- gingival trauma.
11.11 AGGRESSIVE PERIODONTAL DISEASES
11.11.0 Introduction
Aggressive periodontal diseases comprise a group of rare, but rapidly progressing
infections that affect the primary and permanent dentitions. The disorders are
associated with a more specific microbial challenge and an inherent defect in the
host's immunological response. The nature of these diseases can lead to premature
tooth loss at an early age. Prompt diagnosis is essential if treatment is to be
successful, and the periodontal status must be monitored regularly to ensure that the
treated disease remains quiescent.