Multidisciplinary management of an adult skeletal Class III patient with generalized aggressive periodontitis and canine-premolar transposition

This case report presents orthodontic camouflage treatment and the correction of transposed canine-first premolar teeth in a patient who presented with a skeletal Class III and familial periodontal problem. A 28-year-old female patient who was diagnosed with generalised aggressive periodontitis was treated by scaling and root planing plus the adjunctive use of systemic antibiotics and surgical therapy prior to referral to the orthodontic department. After the progression of the disease was controlled, orthodontic treatment was commenced to correct the dental transposition by using a modified Nance-TPA appliance and sectional arch mechanics. A non-extraction orthodontic camouflage treatment was planned to eliminate the anterior crossbite and to establish a proper occlusion by closing the multiple diastemata. Treatment outcomes remained stable in the 2-year follow-up period. Severe orthodontic-periodontal problems can be successfully treated by oral hygiene motivation, an interdisciplinary approach, and the selection of appropriate biomechanics.