Rehabilitation of compromised periodontium with orthodontic treatment using passive self-ligation system: A case report

Gingival recession is the apical shift of the marginal gingiva beyond the cemento-enamel junction (CEJ), leading to root surface exposure. Misaligned teeth act as a significant predisposing factor in the onset of gingival recession which has aesthetic concerns and can heighten susceptibility to root caries and dentin hypersensitivity. In this case report, an 18-year-old male patient reported with a class II division 1 right subdivision malocclusion complicated by severe upper and lower anterior crowding, collapsed upper arch, retroclined upper and lower incisors and a deepbite. There was a severe isolated gingival recession in relation to lower right central incisor which may be predisposed to his poor oral hygiene as well as its labial position in the jaw with a thin bony biotype. Non-extraction fixed orthodontic treatment was done using Damon Q standard torque brackets (Damon, Ormco Co, CA, USA) with a fixed functional appliance namely Advansync 2 (Ormco Co, CA, USA) for Class II correction. There was gradual improvement in the periodontal status of the lower incisor (tooth number 41), as it was orthodontically moved into a more favourable and stable position without the need of mucogingival surgery which was a very significant and highlighting outcome in this case. Severe crowding was relieved without any extractions and an optimal end treatment result with ideal incisal inclinations, overjet, overbite, and Class 1 occlusion.