Surgical orthodontic treatment for severe maxillary protrusion with aggressive periodontitis

We report a 24-year-old Japanese female case with aggressive periodontitis showing severe maxillary protrusion. The patient had severe labial inclination of maxillary incisors and mild skeletal class II. Before orthodontic treatment, the gingival inflammation was eliminated by continuous professional debridements including scaling and root planing. Based on the loss of supporting periodontal tissue, we applied the orthodontic treatment combined with maxillary anterior alveolar osteotomy (Wassmund method) in order to minimize tooth movement. Continuous supportive periodontal treatment was successful to maintain healthy periodontal tissue throughout the surgical orthodontic treatment and another 2-year follow-up period. The overall treatment dramatically improved an esthetics of the patient which was obtained by the decreased overjet and jaw discrepancy with no obvious loss of periodontal attachments.