Clinical effectiveness of regenerative periodontal surgery and orthodontic tooth movement with clear aligners in stage IV periodontitis: a case series

Objectives: To evaluate the clinical effectiveness of regenerative treatment of intrabony defects in combination with consecutive orthodontic therapy with clear aligners in stage IV (type 2) periodontitis. Method and materials: Ten patients with a total of 103 intrabony defects were analyzed after regenerative surgery using collagen-deproteinized bovine bone mineral with or without collagen membrane orenamel matrix derivative followed by orthodontic therapy with clear aligners. Changes in radiographic bone level and probing pocket depths were evaluated after lyear (T-1) and at final splinting (T-2) after orthodontic tooth movement. Results: Mean radiographic bone level gain was significant, with 2.13 +/- 1.64 mm at T-1 and 3.02 +/- 2.00 mm at T-2. Mean probing pocket depth was significantly reduced from 5.40 +/- 1.80 mm at baseline to 3.78 +/- 1.73 mm at T-1, and remained stable with 3.73 +/- 1.70 mm at T-2. Pocket closure (<= 4mm probing pocket depth) was accomplished in 76% of all defects. Tooth loss amounted to 2.9%. Conclusion: Within the limitations of the retrospective study design, the findings suggest that the interdisciplinary treatment of periodontitis stage IV by regenerative periodontal surgery and consecutive orthodontic therapy with clear aligners can lead to favorable results.