The aim of this article is to present a precise periodontal terminology that orthodontists can use to clarify communication between orthodontists treatment and their patients. What’s mean periodontal issues that arise in adult orthodontic treatment, what the purpose of the discussion? In general terms we refer, of course, to mechano-therapy for adults and to the periodontal diseases that arise with this class of patients and to the treatment that is available for these maladies. Orthodontists who treat adult patients and record procedures in careful way need to rely upon a precise periodontal vocabulary so that, as group leaders, they can communicate effectively with other members of the inter-disciplinary treatment team as well as with patients. In the management of this effort, orthodontists are responsible for referring patients to periodontists when it’s necessary and for keeping the lines of communication open between patients, and periodontists.

In this article we describe a method for maintaining periodontal health that we have used in a quasi-systematic fashion in our orthodontie treatment of patients with chronic Periodontitis. Taking charge of their periodontal care and stabilizing their teeth are obligatory first steps in their orthodontic therapy. Then we ask them to initiate careful brushing by mechanical or sonic techniques.

During the course of orthodontic treatment these adult patients have routine monthly visits for essential periodontal therapy that consists of plaque removal and smoothing of the root surfaces of all teeth and implants with Vector Pro® and its carbon and composite inserts associated with hydroxylapatite and hydrogen peroxide. These monthly visits for periodontal care together with mechanical or sonic tooth brushing at home have effectively contributed to the long term stability of our results, from both orthodontic and periodontal perspectives.

The use of implants to replace congenitally missing teeth is a-predictable esthetic Solution that is, paradoxically less invasive than the traditional reliance on bridges to supply the missing elements because it demands little or no sacrifice of dental tissue. But this noble goal cannot be achieved unless we can assure prospective patients that the results will be stable and esthetically satisfying over the long term. This is an issue of primordial importance in view of the tender age of the patients that are the usual candidates for this treatment modality for agenesis. And no such assurance can be proffered unless we deal with the problem in a multi-disciplinary fashion from the very outset of treatment planning. We must evaluate the space needed for a replacement not just from the standpoint of the prosthetic requirements alone but also with an assessment of the associated osseous and gingival tissues in the framework of a tri-dimensional implant placement.

This article shows how to apply orthodontie force to impacted cuspids and bring them into proper arch position using a unique innovative anchorage system consisting of two short mini-screws placed buccally in cortical bone. Attached to this fixed anchorage is an .018 TMA round wire that emerges from the gingiva to exert direct 3D control on the canine without any additional dental support. The general procedure for moving impacted teeth into position and the mechanics utilized are described in detail with illustrations from clinical cases we have treated.