Ortho-Perio Approach: Treatment of Patients with Dentofacial Anomalies and Periodontal Diseases

Ortho-Perio Approach: Treatment of Patients with Dentofacial Anomalies and Periodontal Diseases

Category: Orthodontics

Instructor(s): Giulio Rasperini, Stefano Parma Benfenati, Giuliano Maino, Jean-Marc Dersot

Course structure: Lessons: 9 lessons | Duration: 13 h 44 min

Course overview

In orthodontic rehabilitation cases, the complexity of clinical decisions requires treatment planning options that involve several specialists and effective soft tissue management throughout the entire orthodontic treatment process, from diagnosis to post-brace support.

During the course, which is entirely dedicated to the ortho-perio approach, you will learn:

Course lessons

Lesson 1: 8 signs of periodontitis: diagnosis for orthodontics

• Orthodontics & microbiota
• Periodontal consequences of orthodontic treatments
• Differential diagnosis between gingivitis and periodontitis
• Understand the periodontitis infectious model
• The 8 signs of periodontitis
• The 6 risk-factors of periodontitis
• Clinical implication in orthodontics.

Lesson 2: Borderline cases: diagnosis and ortho-perio therapeutic protocols

• Diagnosis and therapeutic assessments
• Treatment plan option and subjective factors
• Borderline cases:
• localized
• localized/generalized
• generalized.
• Borderline cases: dental ankylosis in the anterior sextant
• Borderline cases: trauma in the anterior segment associated with sagittal and transverse growth deficits
• Muco-gingival reconstructive therapy in an adult borderline case
• Intra-operative Orthodontic-Parodontal Clinical Synergies
• Orthodontic-periodontal assessments before prosthetic finalization.
• The participant can learn:
• The advantages of a combined orthodontic - periodontal diagnosis
• In detail the orthodontic phases and periodontal therapeutic sequences in complete synergy
• Clinical strategies to facilitate orthodontic movement and improve mucogingival problems.

Lesson 3: Periodontal orthodontic synergies for optimal esthetics

• Orthodontic treatment of adult patients: limitations, risks  and patient`s expectation
• Periodontal-orthodontic sinergy:
• to facilitate and accelerate the orthodontic movement
• minimize periodontal risks
• new perspectives capable to enhance the smile aesthetics
• preserve periodontal tissue health.
• Periodontal surgical techniques selected based on different orthodontic and periodontal diagnosis and goals
• Periodontal and Orthodontic indications: advantages and / or disadvantages
• Orthodontics with skeletal anchorage and Periodontal Surgical protocols
• Anchorage selection for optimum case management without patient compliance
• Tutorial videos of some surgical procedures and Guided Mini Screws insertion.
• The participant can learn:
• The advantages of a combined orthodontic - periodontal diagnosis for an optimal aesthetic assessment
• The opportunity to facilitate and accelerate the orthodontic movement
• To minimize the periodontal risk and to enhance the aesthetics  of the smile.

Lesson 4: Optimizing the periodontal conditions around impacted upper and lower canines

• The palatal canines: risks
• The prerequisites before the periodontal exposure surgery of an impacted tooth
• Differences and indications of open and closed surgeries
• Surgeries for the upper and lower canine: the surgical decision tree
• Skeletal anchorage for canine traction
• Moving impacted teeth though and with the periodontium
• Mandibular canines: classification of Mupparapu.

Lesson 5: Optimizing the periodontal conditions around impacted teeth

• Impacted maxillary central incisor and odontoma: diagnosis and treatment planning
• Low and mid maxillary central incisors: tactics
• High maxillary central incisor: clinical case
• Impacted upper and lower premolars: treatment protocols
• Impacted 2nd lower and upper molar
• The prerequisites before the periodontal exposure surgery of an impacted tooth
• Differences and indications of open and closed surgeries
• Surgeries and anchorage for tooth movement of the impacted tooth
• Surgical decision trees applied to the different group of impacted teeth.

Lesson 6: Maxillary lateral incisor agenesis & implant

• Lateral incisor ideal width determination: Bolton index
• 3D implant position
• Osseointegration and aging: clinical cases
• Orthodontics and 3D implantology: diagnosis and treatment planning
• Risks of the single implant in the anterior maxilla
• Bonded bridges: advantages and indications
• The optimal conditions for implant in the anterior maxilla
• Zirconia cantilever bonded bridge: advantages.

Lesson 7: Critical aspects in the solution of complex cases. The point of view of the periodontist

• To know the critical point from the periodontal point of view of complex ortho-perio treatments
• Understand how to manage treat and maintein complex ortho-perio cases
• Critical aspects in the resolution and maintenance of complex clinical cases.

Lesson 8: Periodontal therapy in the interdisciplinary Complex Case. Goals, techniques and therapeutic sequence

• The appropriate diagnostic sequence
• The value and importance of saving the natural tooth
• The potential of the periodontal regenerative procedure
• The periodontal surgical techniques
• The operative sequence in complex cases
• Planning of ortho-perio treatment
• Protocols will be shown with the demonstration of resolution of several clinical cases of patients severely compromised by Periodontal Desease and Malocclusion, saving the natural dentition.

Lesson 9: Gum recession and surgical root coverage. Before, during or after orthodontics?

• Etiologies of gum recession: initiating factors
• Miller's classification
• Root coverage and clinical based decisions
• The decision tree for root coverage techniques:
• Coronally advanced flap (CAF)
• Laterally sliding flap (LSF)
• Free gingival graft (FGG)
• Connective tissue graft (CTG).
• One incision technique: video demonstration
• The conditions for successful root coverage
• Determining the timing of surgery: before, during or after orthodontic treatment.

Who is this course for?

This online course is designed for dentists and dental professionals interested in orthodontics, clinical decision-making and evidence-informed dental practice.