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Open Access
CC BY 4.0 · European Journal of General Dentistry
DOI: 10.1055/s-0045-1812045
Case Report

Interdisciplinary Approach in Management of Secondary Occlusal Trauma: A Case Report with a 2-Year Follow-up

Authors

  • Delfin L. Francis

    1   Department of Public Health Dentistry, Saveetha Dental College and Hospitals, Saveetha University, SIMATS, Tamil Nadu, India

  • Saravanan S.P. Reddy 

    2   Department of Periodontology, Army Dental Centre (Research & Referral), New Delhi, India

  • Shaili Pradhan 

    3   Department of Periodontology and Oral Implantology, Kathmandu Medical College Public Limited, Kathmandu, Nepal
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Abstract

Secondary occlusal trauma in periodontally compromised patients can accelerate attachment loss and complicate management. The combination of substantial periodontal disease and secondary occlusal stress in adults leads to a progressive loss of attachment and bone. If not subjected to appropriate intervention, this condition possesses the capacity to significantly impact the predicted outcome. This case report outlines a comprehensive interdisciplinary strategy employed for localized periodontitis with secondary occlusal trauma. A 40-year-old woman presented with localized periodontitis in mandibular incisors, pathologic migration, thin gingival phenotype, and inadequate keratinized tissue. After initial nonsurgical therapy, orthodontic realignment was performed to correct traumatic occlusion, followed by autologous soft tissue grafting for phenotype modification. After the completion of the initial periodontal therapy, fixed orthodontic treatment was initiated. Soft tissue grafting was employed to enhance the gingival phenotype. Over a 2-year follow-up, clinical attachment improved from 6 to 3 mm, keratinized tissue increased from 1 to 6 mm, and recession height reduced from 5 to 2 mm. Creeping attachment was observed after 1 year. Patient-reported outcomes included improved oral hygiene and reduced anxiety. Furthermore, there was a notable improvement in self-performed plaque control, which was a significant measure reported by the patient. The use of an interdisciplinary strategy was crucial for the efficient management of the potential exacerbation of periodontal disease caused by secondary occlusal trauma. The implementation of post-orthodontic periodontal treatment had the potential to result in significant enhancements in the periodontal phenotype, and hence the achievement of successful self-performed plaque control. An interdisciplinary sequence of orthodontic correction and phenotype modification stabilized traumatized anterior teeth and enhanced gingival phenotype, resulting in durable functional and aesthetic outcomes.

Keywords

case report - interdisciplinary - orthodontic - periodontal

Authors' Contribution

The first author performed all the surgical procedures and follow-up and also contributed to drafting the manuscript. The second author designed the concept, completed the case analysis and evaluation, supervised the study, and contributed to proofreading and final reviewing. The third author performed the necessary orthodontic treatment required in this case. All the authors reviewed and edited the final manuscript. The third author supervised the project administration.


One-Sentence Summary

An interdisciplinary approach, incorporating orthodontic treatment, can mitigate periodontal damage from secondary occlusal trauma, and the periodontal soft tissue phenotypic modification leads to improved long-term prognosis and tooth retention.




Publication History

Article published online:
24 October 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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