Rotated Upper Central Incisor Complicated by Pathological Migration with Crowding in Upper and Lower Anterior Teeth Treated by Clear Aligners

Abstract

Pathological tooth migration increased between 2.95 to 7.97 times as bone loss increased [1], it is difficult to treat, and the multidisciplinary approach is usually needed [2-4]. The combination of periodontal and orthodontic treatment is being used to improve the periodontal conditions and esthetics [2-6]. Most of the case reports were related to tipping or intrusion of the central incisors [2-6]. Fixed appliances make brushing and flossing more difficult. Oral hygiene practices during clear aligner treatment can be easily maintained. A Meta-analysis concluded that clear aligners were better for periodontal health than fixed appliances [7]. Another systematic review showed a significant improvement of the periodontal health indexes was revealed, in particular when clear aligner treatment was compared to fixed appliances [8], no periodontal adverse effects were observed in the studies using clear aligner treatment [8].