Orthodontic treatment of adult occlusal traumatic periodontitis using a twin block appliance: a case report.

Malocclusion may lead to the development of occlusal trauma, which can exacerbate periodontal disease. Here, we present a skeletal Class II adult patient with occlusal traumatic periodontitis of upper incisors, who was treated with a two-phased orthodontic treatment. In the first phase, a Twin Block appliance (TBA) was used to increase the vertical dimension of the posterior teeth, to eliminate the anterior occlusal trauma. In addition, TBA also improved mandibular retrusion by forwarding the mandible. In the second phase of fixed orthodontics, occlusion was fine-tuned with infrazygomatic crest (IZC) miniscrews and Class II intermaxillary elastics. At the end of treatment, anterior occlusal trauma was eliminated, periodontal conditions of upper incisors were improved, a stable occlusion and a harmonious profile were obtained. The successful two-phased orthodontic treatment showed that the TBA can effectively eliminate anterior occlusal trauma through restoration of posterior vertical dimension, and can improve mandibular retrusion by forwarding mandible and reconstructing stable occlusion in adult patient.