Dental esthetics, orthodontic treatment, and oral-health attitudes in young adults.

INTRODUCTION: The aim of this study was to investigate whether young adults with varying dental esthetics and histories of orthodontic treatment also differ in oral-health attitudes, preventive behaviors, and self-perceived oral health. METHODS: The sample comprised 298 young adults, 18 to 30 years old, with at least 13 years of primary and secondary school education. The subjects were asked to complete questionnaires dealing with various measures related to oral-health attitudes, preventive behaviors, and perceptions of oral health. Dental esthetics were assessed by means of the aesthetic component of the index of orthodontic treatment need. Dental plaque accumulation was assessed in a subsample of respondents. RESULTS: Subjects with high dental-esthetics scores reported more favorable oral-health attitudes, such as internal control, dental awareness, value of occlusion, and preventive behavior expectations than subjects with lower scores. Subjects with previous orthodontic treatment showed greater internal control and dental awareness than those who had not previously been treated. Subjects ranking high in dental esthetics and those with previous orthodontic treatment reported stricter oral-hygiene adherence than others. Self-perceived oral health was better in high scorers on dental esthetics. Less plaque accumulation was found in subjects with higher dental esthetic scores and in those with previous orthodontic treatment. CONCLUSIONS: These findings suggest that favorable dental esthetics and previous orthodontic treatment might be important variables in explaining individual differences in oral-health attitudes and behaviors.     

Perception of orthodontic treatment need among Swedish children,adolescents and young adults

Objective: Perceptions of orthodontic treatment need and perceptions of dental aesthetics was investigated among subjects ages 10, 15 and 19.

Materials and methods: A total of 489 subjects completed a questionnaire after inspecting 10 photographs in the Aesthetic Component scale of the Index of Orthodontic Treatment Need to (i) reveal the lower limit for orthodontic treatment need and (ii) rate their dental aesthetics by selecting the most similar photo.

Results: The mean lower limit for orthodontic treatment need was significantly higher (and closer to literature-based standards) among subjects, age 10 (4.2?±?1.5), than among subjects, age 15 (3.6?±?1.2) (p?=?.0009), and subjects, age 19 (3.5?±?1.2) (p?=?.00002). Among subjects ages 15 and 19, the lower limit for orthodontic treatment need was lower in groups with (i) self-perceived orthodontic treatment need (p?=?.002 and .001, respectively) and (ii) previous orthodontic treatment (p?=?.005 and .035, respectively). Self-perceived orthodontic treatment need was present in more than one-third of subjects, age 19, who had previously received orthodontic treatment. Subjects of foreign origin reported that their dental aesthetics were worse (p?=?.002) and those same subjects, age 19, set the lower limit for orthodontic treatment lower (p?=?.047) than Swedes, age 19.

Conclusions: The lower limit for orthodontic treatment need among subjects, age 10, was higher – compared to subjects, ages 15 and 19 – and closer to literature-based standards. Subjects with self-perceived orthodontic treatment need, subjects with previous orthodontic treatment, and subjects age 19 of foreign origin, have higher aesthetic demands.     

Influence of anterior occlusal characteristics on self-perceived dental appearance in young adults

OBJECTIVE: To determine the individual and combined influence of some anterior occlusal characteristics on self-perceived dental appearance in a sample of young adults. MATERIALS AND METHODS: This cross-sectional study was conducted at a dental clinic of a private university in Lima, Peru. A total of 267 first-year students (16 to 25 years old) were randomly selected. A visual analog scale (VAS) was used to determine the self-perceived dental appearance. Clinical examinations were conducted to determine incisal irregularity, anterior dentoalveolar spacing, midline diastema, anterior missing teeth, overjet, and overbite. Simple and multiple linear regression analyses were performed to determine the individual and combined influence of each anterior occlusal characteristic on self-perceived dental appearance. RESULTS: From the eight occlusal characteristics and two covariables evaluated, only maxillary and mandible incisal irregularity (P=.001 and .002 respectively), presence of anterosuperior spacing (P<.001), and number of missing anterior teeth (P=.003) were inversely associated with self-perceived dental appearance, whereas gender (male) was directly associated to the dependent variable (P=.021). Specifically, anterior maxillary spacing, maxillary incisal irregularity, mandible incisal irregularity, and the number of missing teeth were, in that order, the anterior occlusal characteristics with the most negative influence on self-perceived dental appearance. CONCLUSIONS: This study confirmed that occlusal characteristics in the anterior portion of the mouth play a role on dental esthetics. However, it should be emphasized that their grouped influence is minimal (less than 20%).     

基于牙美学指数对青年人群正畸需要的评估

目的：使用牙美学指数评估青年人群的正畸需要,并分析牙外观自我评估值同牙美学指数分值之间的关系。方法：358名大学生参加了牙美学指数检查,同时每位被调查者使用视觉模拟量表对牙外观进行自我评估。对牙美学指数分值和牙外观自我评估进行简单线性相关分析,并基于牙美学指数分组对牙外观自我评估进行秩合检验。结果：37.7%的被调查对象牙美学指数分值≥31,属于需要正畸治疗人群。牙美学指数与牙外观自我评估间呈中度负相关（P〈0.001）,基于牙美学指数分组对牙外观自我评估进行秩合检验表明4组间得分差异有统计学意义（P〈0.001）。结论：本样本中,37.7%的被调查对象需要正畸治疗;牙美学指数与牙外观自我评估呈反向关系。表明牙美学指数可用于青年人群口腔健康相关生活质量的相关研究。     

Oral health status of low-income, middle-aged to elderly Hong Kong Chinese with type 2 diabetes mellitus

PURPOSE: To study oral health conditions, diabetic medical complications and their association in type 2 diabetes mellitus (DM). MATERIALS AND METHODS: Cross-sectional survey of 364 type 2 DM patients (63.6 +/- 10.1 years, 54% female) and 161 controls (64.1 +/- 10.6 years, 53% female) with or without essential hypertension, predominantly low-income, attending a hospital were recruited. Periodontal disease (Community Periodontal Index [CPI]) and dental status (decayed, missing and filled teeth [DMFT]) were recorded. Fasting plasma glucose and, for DM patients, HbA1C and DM complications were recorded on enrolment and follow up, respectively. RESULTS: Many DM subjects had fair diabetic control. Both groups (control/DM) had poor oral health: DMFT = 14.5/16.8, CPI 4 = 36%/50%, (P < 0.02) while DM subjects had less DT(adjusted) = 2.1/1.4 (P < 0.01). Of the follow-up DM individuals, 294 (81%) had medical complication(s). Regression analyses showed association between advanced periodontal attachment loss (ALoss) and age, male gender, smoking and DM; MT and DMFT were associated with age, female gender, smoking, DM and hypertension. ALoss and DMFT were not associated with DM complications. CONCLUSIONS: The oral health of the surveyed Chinese subjects was poor. Type 2 DM subjects were affected more by ALoss and MT but less DT. Subjects with hypertension had higher odds for MT.     

Relative esthetic importance of orthodontic and color abnormalities

OBJECTIVE: To assess the relative importance of an orthodontic esthetic index, dental fluorosis and nonfluoride opacities, with respect to parents' satisfaction with their children's dental esthetics. MATERIALS AND METHODS: Dental examinations of Iowa Fluoride Study participants assessed fluorosis and nonfluoride opacities in the mixed dentition. Dental casts of 200 randomly selected subjects were scored using the Dental Aesthetic Index (DAI) criteria. Parent satisfaction was assessed via multiple items on a questionnaire. Associations were evaluated using logistic regression. RESULTS: Nineteen percent of parents were somewhat or very dissatisfied with their children's dental esthetics. Overall DAI score was positively associated with dissatisfaction (P < .001), as was fluorosis (P = .003). CONCLUSIONS: In addition to changes related to DAI scores, parent esthetic satisfaction decreased with the presence of fluorosis. Dental professionals should address both the issues of tooth positioning and color aberration with respect to dental esthetics.     

Relationship between orthodontic treatment and dental caries: results from a national survey

Objectives: Orthodontic treatment has been suggested to increase the risk of dental caries. The aim of this study was to evaluate the association between orthodontic treatment and the likelihood of dental caries. Methods: The study included data for adults aged ≥ 19 years who participated in the Korea National Health and Nutrition Examination Survey in 2013–2015. The participants’ demographic, socio-economic, and general and oral health-care data were collected by trained interviewers using a structured questionnaire. The number of decayed teeth (DT) and the decayed, missing and filled teeth (DMFT) index score on oral examinations performed by dentists were compared between subjects who underwent orthodontic treatment and those who did not, using the chi-squared test and logistic regression analysis. Results: All logistic regression analysis models showed a significant association between orthodontic treatment and untreated dental caries. The likelihood of having untreated dental caries was lower in subjects who had received orthodontic treatment than in those who had not, regardless of confounding factors (P < 0.001). After adjustment for confounding factors, the mean number of DT was lower in subjects who had received orthodontic treatment than in those who had not (0.66 vs. 0.94; P < 0.001). There was no statistically significant difference in the DMFT index score between the two groups. Conclusions: Orthodontic treatment was associated with a decreased likelihood of untreated dental caries. Moreover, there was no evidence indicating a link between the DMFT index score and orthodontic treatment.Key words: Dental caries, DMFT index, DT index, epidemiology, orthodontic treatment     

Dental health of 12-year-olds in Israel-2002

OBJECTIVE: To gather epidemiological information on caries prevalence and treatment needs of Israeli 12-year-olds. RESEARCH DESIGN: Prevalence survey of a representative sample of 12-year- olds examined according to WHO Oral Health Survey methods. RESULTS: The mean DMFT was 1.66 (DT = 0.91, MT = 0.03 FT = 0.72), a 40% decline since the previous national survey in 1989. DT and DMFT were lower amongst males (p < 0.01). There were no differences between urban and rural communities. Arab subjects had a higher prevalence, higher DT, MT and DMFT (p < 0.01), but lower FT than the Jewish subjects. In fluoridated areas, the mean DMFT was 1.39 compared to 1.83 in the non-fluoridated areas (p < 0.01). SiC (Significant Caries Index which shows the average DMFT of the third of the population with the highest DMFT) was found to be 4.31. CONCLUSIONS: Caries prevalence has declined among 12-year-olds in Israel. However, 53.9% of the children still suffer from caries at this age. There are wide dental health disparities.     

上海地区青少年正畸治疗需要的调查研究

目的:调查上海地区青少年人群的正畸治疗需要及自身美学评价。方法:随机抽取上海地区11～13岁青少年686例(男355例,女331例),由正畸专科医师采用正畸治疗需要指数(index of orthodontic treatment need,IOTN)评定受试者正畸治疗需要。IOTN包括学(dental health component,DHC)及美学(aesthetic component,AC)2部分。同时采用IOTN的美学部分让受试者对自身美观程度进行评价(self-perceived aesthetic component,SAC)。采用描述性统计及卡方检验对调查结果进行统计分析。结果:DHC评分显示26.0%的受试者明确需要正畸治疗,19.8%的受试者为临界病例;AC评分显示5.5%的受试者明确需要正畸治疗,31.7%为临界病例;SAC评分显示1.7%的受试者明确需要正畸治疗,6.4%为临界病例。在明确需要正畸治疗的受试者中,最常见的特征是严重接触点异常(>4 mm)。DHC与AC在评价治疗需要时77.8%结果一致,AC与SAC在评价治疗需要时65.0%结果一致。结论:将近一半的青少年人群明确需要正畸治疗或为临界病例,受试者在进行自身美观程度评价有从轻的倾向。     

Patients' satisfaction with dental esthetics

BACKGROUND: Esthetics has become an important issue in modern society, as it seems to define one's character. In the past, functional demands were the main consideration in dental treatment. Today, with the decrease in caries prevalence, the focus has shifted toward dental esthetics. The authors conducted a study to evaluate the factors influencing patients' satisfaction with their dental appearance and with the results of esthetic treatment. METHODS: The authors surveyed a population of 407 adults (mean age, 21 years). They distributed a questionnaire regarding satisfaction with current dental esthetics and previous esthetic treatments. RESULTS: Of the 407 subjects, 152 (37.3 percent) were dissatisfied with their dental appearance. Tooth color was the primary reason for dissatisfaction (133 [89.3 percent] of 149 subjects), followed by poor tooth alignment (36 [23.7 percent] of 152 subjects), although 110 (27 percent) of the 407 subjects had received orthodontic treatment. The authors found no correlation between patients' satisfaction with their dental appearance and having undergone any procedure to whiten their teeth. Nevertheless, 134 (88.2 percent) of the dissatisfied subjects reported that they would like to undergo this procedure. CONCLUSIONS: Tooth color was a major factor with regard to dental esthetics. Most subjects were interested in improving their appearance and whitening their teeth. CLINICAL IMPLICATIONS: When planning treatment, dentists should take into consideration esthetic objectives in addition to function, structure and biology. This requires the clinician to rely on several disciplines in dentistry to deliver the highest level of dental care, which should lead to a higher level of patient satisfaction.     

Periodontal disease in patients with cleft palate and patients with unilateral and bilateral clefts of lip, palate, and alveolus

BACKGROUND: Long-term health of the stomatognathic system, as well as esthetics, is the therapeutic goal in patients with facial clefts. The aim of this study was to analyze the periodontal situation of patients with cleft palate (CP) and cleft lip, palate, and alveolus (CLPA) to elicit the differing degrees and localization of periodontal disease. METHODS: In 30 patients with unilateral cleft lip, palate, and alveolus (UCLPA), 30 patients with cleft palate (CP), and 20 patients with bilateral cleft lip, palate, and alveolus (BCLPA), the gingival situation was identified and classified according to the sulcus bleeding index (SBI). Periodontal attachment loss and pathological loosening of teeth were noted for identification of periodontal lesions. The state of oral hygiene was recorded by the approximal plaque index (API). RESULTS: In general, poor oral hygiene was found in all patients. The SBI showed a high incidence of gingivitis in patients with cleft lip, palate, and alveolus. Patients with cleft palate had a minor extent of sulcus bleeding. Periodontal disease was found to a similar extent to that in the general population in patients with cleft palate, whereas patients with cleft lip, palate, and alveolus had a predisposition to deep periodontal destruction of teeth adjacent to the cleft. The registration of pathological loosening of teeth, a result of attachment loss, corresponded to the degree of periodontal disease shown by the attachment loss. CONCLUSIONS: A critical periodontal situation was found in patients with unilateral and bilateral cleft lip, palate, and alveolus, ultimately leading to tooth loss in the front tooth region. In contrast, patients with cleft palate exhibited periodontal situations similar to that found in the general population with additional damage, which may be attributed to orthodontic treatment.     

Why is there heterogeneity in the effect of dental checkups? Assessing cohort effect

Celeste RK, Nadanovsky P. Why is there heterogeneity in the effect of dental checkups? Assessing cohort effect. Community Dent Oral Epidemiol 2010; 38: 191–196. © 2010 John Wiley & Sons A/S Abstract – Objectives: To evaluate age as a potential effect modifier of the relation between frequency of dental check‐up and oral health. Methods: Data from a Brazilian oral health survey carried out in 2002–2003 was obtained for three age groups: 15–19‐year‐old (n = 16411); 35–44‐year‐old (n = 13 269); and 65–74‐year‐old (n = 5 300). Individuals were examined by dentists and followed to an interview. Self‐reported time since last dental visit was measured as ‘less than 1 year’; ‘from 1 to 2 years’; ‘3 or more years’ or ‘never’. Outcomes modelled with negative binomial regression were DMFT index and DT, MT and FT. Results: Visiting the dentist more recently was associated with fewer teeth with untreated dental caries (DT) and more teeth with fillings (FT) across all age groups. Among the 15–19‐year‐old, the longer the time since last visit the lower the DMFT and MT. On the other hand, among the 35–44 and the 65–74‐year‐old the longer the time since last dental visit the higher the DMFT and MT, though this trend reverted in the ‘never visited’ group. Conclusions: Age modified the effect of dental visits on DMFT and MT. In younger cohorts, the low frequency of dental check‐up among those with good oral health may reflect the fact that these young people do not feel they need to go to the dentist very often, while in older cohorts, the current low frequency of dental check‐up associated with bad oral health may be a reflection of a lifetime of high disease incidence coupled with access barriers. Questions regarding the time and frequency of dental visits may capture different dimensions of utilization of dental services, and so pooled estimates are not appropriate. Our results may help explaining contrasting results in previously published studies.     

Multidisciplinary treatment of mandibular prognathism with multiple congenitally missing teeth

Surgical orthodontic treatment and dental implant therapy were performed on a man (aged 18 years 8 months) with mandibular prognathism and seven congenitally missing teeth: upper canines, first and second premolars and lower right second premolar. After 17 months of preoperative orthodontic treatment at age 20 years 1 month, sagittal split ramus osteotomy was performed using the remaining upper deciduous teeth as an anchor for intermaxillary fixation. In postoperative orthodontic treatment, the remaining deciduous teeth were extracted, and fixture installation was performed. The entire therapy required 4 years to complete (age 22 years 8 months). After completion of orthodontic treatment, superstructures were put in place. This patient had many dental problems, so multidisciplinary care was performed in conjunction with other departments to improve oral function and facial esthetics.     

外科矫正骨型下颌下后缩畸形的术前术后正畸治疗

以近期连续收治的１７例骨型严重下颌后缩的患者为例，重点介绍对该类畸形患者的术前准备，特别是术瓣术后正畸治疗及Ｈｅ导板的应用。正畸治疗内容包括；去代偿扩大上牙弓，排齐牙齿，平整Ｈｅ曲线，使上下牙弓形态协调，恢复Ｈｅ平衡重建良好的咬合关系。     

外科矫正骨型下颌后缩畸形的术前术后正畸治疗

以近期连续收治的 17例骨型严重下颌后缩 (已作正颌手术 )的患者为例 ,重点介绍对该类畸形患者的术前准备 ,特别是术前术后正畸治疗及导板的应用。正畸治疗内容包括 :去代偿扩大上牙弓 ,排齐牙齿 ,平整曲线 ,使上下牙弓形态协调 ,恢复平衡重建良好的咬合关系。作者的经验表明 ,对严重骨型下颌后缩患者 ,要获得形态和功能完美结合的理想治疗目标 ,外科和正畸联合治疗 ,特别是术前、术后的正畸准备 ,是保证手术成功的必须和必要的条件。     

Dental fear and adult oral health in Australia

Abstract– Objective: This study aimed to investigate the association between dental fear and both dental caries and periodontal indicators. Methods: A three‐stage stratified clustered sample of the Australian adult population completed a computer‐assisted telephone interview followed by a clinical examination. Oral health measures were the DMFT index and its components, periodontitis and gingivitis. A total of 5364 adults aged 18–91 years were dentally examined. Results: Higher dental fear was significantly associated with more decayed teeth (DT), missing teeth (MT) and DMFT. There was an inverted ‘U’ association between dental fear and the number of filled teeth (FT). Periodontitis and gingivitis were not associated with dental fear. The association between dental fear and DMFT was significant for adults aged 18–29 and 30–44 years, but not in older ages. Dental fear was significantly associated with more DT, MT, and DMFT but with fewer FT after controlling for age, sex, income, employment status, tertiary education, dental insurance status and oral hygiene. Conclusion: This study helps reconcile some of the conflicting results of previous studies and establishes that dental fear is associated with more decayed and missing teeth but fewer FT. That people with higher dental fear have significantly more caries experience underlines the importance of identifying and then reducing dental fear as important steps in improving adult oral health.     

Comparison of caries prevalence in two populations of cleft patients.

OBJECTIVE: To assess and compare the oral and dental status and the level of oral health care among Polish and German patients with cleft lip and palate treated in ?ód? and Erlangen, followed by an assessment of the level of realization of oral care procedures. DESIGN: Oral and dental status were assessed by the presence of dental plaque and caries lesions. Parents of each patient completed a questionnaire related to frequency of tooth brushing, frequency of dental visits, and the use of means with increased fluoride content. SETTING: Department of Dentistry for Developmental Ages, Medical University of ?ód?, ?ód?, Poland, and Department of Orthodontics, University of Erlangen-Nuremburg, Erlangen, Germany. PATIENTS AND INTERVENTION: Thirty-seven Polish patients were examined between February and April 2004. Sixty-three German patients were examined between October 2004 and August 2005. RESULTS: In Erlangen, decayed teeth = 1.625, missing teeth = 0.014, and filled teeth = 2.39. In ?ód?, decayed teeth = 2.5, missing teeth = 0.09, and filled teeth = 0.75. Among the subjects with Approximal Plaque Index scores <40%, the Decayed-Missing-Filled-Teeth Index was significantly higher in Polish than in German patients. In the total population of patients, a positive correlation between the value of the API Index and caries intensity was recorded. Declared parents' answers did not copy the actual oral cavity status. Conclusions: Caries prevalence in each group was much higher than in the general population and significantly higher among Polish than German cleft patients. Programs for cleft children promoting oral health, especially aimed at plaque control, are recommended in the early stages of the children's lives.     

Dental esthetic self-perception in young adults with and without previous orthodontic treatment

The aim of this study was to determine which dental esthetic self-perception evaluation tool discriminated better between orthodontically treated or untreated Peruvian young adults. A total of 630 students were randomly chosen from the 2000 admitted in 2002 to a private university in Peru. Students undergoing active orthodontic treatment at the time of examination were excluded. Self-perceived dental esthetic appearance was evaluated through Standardized Continuum of Aesthetic Need, Oral Aesthetic Subjective Index Scale, and Visual Analogue Scale (VAS). A stepwise multivariate discriminant analysis was developed to classify orthodontic treatment according to the three evaluation tools. A total of 199 students (31.6%) reported a history of orthodontic treatment. Differences between orthodontically treated and untreated groups were found only for the mean VAS score (P < .001). Although three different approaches were used to evaluate dental esthetic self-perception, only VAS allowed the discrimination of the self-perceived dental appearance between orthodontically treated and untreated Peruvian university young adults. Similarities in the self-perceived dental appearance of treated and untreated groups reported in previous epidemiological studies could be explained because different evaluation instruments were used. Further studies are required to support current findings.     

Is the Child Perceptions Questionnaire for 11–14 year olds sensitive to clinical and self‐perceived variations in orthodontic status?

OBJECTIVES: To assess the association between scores on the Child Perceptions Questionnaire for 11-14 year olds (CPQ11-14) and clinical and self-perceived measures of malocclusion. METHODS: Children were recruited from an orthodontic clinic just prior to starting orthodontic treatment. They completed a copy of the CPQ11-14 and a short questionnaire concerning their feelings about the condition of their teeth. Study models were taken and rated according to the Dental Aesthetic Index (DAI) and the Peer Assessment Rating (PAR) index by two sets of three examiners. Intra and inter-rater reliabilities for the two sets of examiners ranged from 0.80 to 0.99. CPQ11-14 scores were calculated for the full 35-item version and for 16 and 8-item short forms by summing the item response codes. The association between these scores, the DAI and PAR ratings and self-perceived measures of malocclusion were examined using appropriate parametric and nonparametric tests. RESULTS: Complete data were collected for 141 children, 63 boys and 78 girls. The mean age was 12.5 (SD = 1.0). DAI scores ranged from 17.0 to 58.0 with a mean of 35.0 (SD = 8.0). The distribution of subjects across the four severity categories was minor/none - 6.6%, definite - 35.2%, severe - 15.6% and handicapping 42.6%. PAR scores ranged from 8.0 to 66.0 with a mean of 31.4 (SD = 11.1). Eight percent had scores of 50 or above indicating marked deviation from an ideal occlusion. Both the long and the short forms of the CPQ11-14 identified substantial variability in the impacts of malocclusion. Correlations between CPQ11-14 scores and the orthodontic indices ranged from 0.26 to 0.31 (P < 0.01). There was a clear gradient in CPQ11-14 scores across four categories of the PAR based on quartiles. The gradient across the DAI categories was less clear. There were significant associations between all CPQ11-14 scores and the children's self-ratings of oral health, ratings of the extent to which the condition of the teeth affected life overall and expressions of happiness with the appearance and arrangement of the teeth. CONCLUSION: The results provide some evidence of the validity of the CPQ11-14 when used with children needing orthodontic treatment. However, because clinical samples are biased the study needs to be repeated in different treatment settings in order to confirm the utility of the measure.     

Orthodontic approach for patients with severe periodontal disease

Although comprehensive orthodontic treatment cannot preclude the possibility of periodontal disease developing later, it can be a useful part of the overall treatment plan for a patient who already has periodontal involvement. A careful clinical examination must determine the patient's dental health status, including any existing destruction or deficiencies of the teeth and their support, as well as the patient's ability to achieve and maintain good overall oral hygiene. Two major criteria should be considered in the treatment of these patients: (1) the patient should be seen frequently for periodontal maintenance and (2) minimal orthodontic forces should be applied. Segmented archwires could be used for the treatment mechanics. After treatment, splinting of the teeth is necessary both short- and long-term. With this orthodontic approach, both dental esthetics and function improve and can be maintained. A male patient, 50 years of age, with severe periodontal involvement was referred to the authors' clinic, from the periodontal department, for treatment. The mandibular incisors were intruded by using segmental archwires. At the end of treatment, permanent retention was required due to the severe bone loss.