Clinical effectiveness of regenerative periodontal surgery and orthodontic tooth movement with clear aligners in stage IV periodontitis: A case series.

This article evaluates the clinical effectiveness of combining regenerative periodontal surgery with subsequent orthodontic tooth movement (OT) using clear aligners in patients diagnosed with stage IV periodontitis exhibiting pathological tooth migration (PTM). In a retrospective analysis of ten patients with 103 intrabony defects treated in a private periodontal practice, significant radiographic bone level (rBL) gains and reductions in probing pocket depths (PPD) were observed one year after surgery and at final splinting following orthodontic treatment. Although improvements in periodontal parameters were less pronounced compared to previous studies using fixed orthodontic appliances, the combined approach with clear aligners resulted in favorable outcomes, including 76% pocket closure and low tooth loss (2.9%). The study suggests that interdisciplinary treatment with regenerative surgery followed by clear aligner therapy is a viable option for managing stage IV periodontitis with mild to moderate malocclusion, provided inflammation is controlled and tooth mobility is adequately stabilized before orthodontic intervention.