Abstract
•The patient presented with severe periodontal supporting tissue loss pretreatment.•Large scale retraction and intrusion of maxillary central incisors were achieved by applying light orthodontic force.•Esthetic result was achieved through multidisciplinary cooperation between orthodontic and periodontal treatments.
Using elastic bands without fixation to close maxillary central incisor diastema is one of the most common mistakes in dentistry that will cause iatrogenic defects to periodontal tissues. The elastic bands can easily slide apically on the incisors and get retained in gingival tissue. The inflammatory response resulting from the foreign bodies usually leads to periodontal tissue breakdown, marked tooth mobility, pathologic migration, and even exfoliation of affected teeth. On the one hand, the consequences will cause negative functional, esthetical, and psychological implications on the patients; in contrast, the compromised periodontal supporting tissue makes it challenging for dentists to preserve the affected incisors and restore the dental arches. In this case report, we present the treatment of a patient whose maxillary central incisors were severely protruded, extruded, and had limited periodontal supporting tissue resulting from iatrogenic damages of incorrect use of elastic bands. The maxillary central incisors’ retraction and intrusion were achieved by applying light orthodontic forces. Gingival recessions were treated with periodontal plastic surgery. Functional occlusion and esthetic profile were obtained after 34 months’ treatment. The stable outcome was presented with a 2-year follow-up.