Orthodontic retreatment of an adult patient with periodontal disease using aligners with digital progress monitoring – a case report

Abstract
In recent years the number of older adults willing to begin an orthodontic treatment is increasing. Relapse of malocclusion is a frequent complication, and so far, no retention method has been found that could completely prevent it. Treatment with aligners is a comfortable therapy for patients who have undergone fixed appliances treatment in the past.

Aim
The aim of the present study is to present a case of orthodontic retreatment in a patient with periodontal disease with aligners and the use of digital treatment monitoring.

Material and methods
An analysis of the medical records of the treatment of a patient undergoing periodontal treatment seeking orthodontic retreatment was performed.

Case report
A 59-year-old patient presented due to a relapse of malocclusion and associated esthetic impairment in the anterior region. A complete digital analysis of dentition was performed. Then, a digital set-up was made, which consisted of 15 active aligners in both arches. At the end of the active aligner treatment, a .stl file with the final teeth setting was downloaded from online account and uploaded to the scanner. Then, a scan was made. The comparison with timely made scan showed that the planned positions were achieved. After completion of the active treatment phase, double retention was applied and digital monitoring of stability was undertaken using software of 3Shape package. The teeth positions were perfectly maintained during the entire monitoring. Digital monitoring strengthened patient's cooperation and motivation

Conclusions
The presented treatment protocol for the periodontal patient allowed achieving ideal occlusion, facilitating daily oral hygiene. The tools that allow superimposition of scans enabled accurate analysis of the treatment course and maintaining of its results.