Regenerative therapy of osseous defects combined with orthodontic tooth movement.

Combined orthodontic/regenerative therapy can resolve complex clinical problems and enhance bone formation. The purpose of this study was to evaluate the effectiveness of different times of initiating the active orthodontic tooth movement on the regenerative potential of the intrabony defects.Fifteen adult patients with at least three intrabony defects and malocclusion were included. A total of 45 defects were divided into three groups and treated in a split mouth design. The defects were treated with combined orthodontic regenerative therapy with immediate application of orthodontic tooth movement or delayed application of orthodontic tooth movement (test groups) or with regenerative therapy alone (control group). The following hard and soft tissue measurements were recorded prior to initial surgery and after six months and one year: probing depth (DP), clinical attachment level (CAL), bone density (BD) and bone fill (BF).The most significant results were greater for the group treated with combined orthodontic/regenerative therapy with immediate orthodontic tooth movement. The measures for PD reduction and clinical attachment level gain were 4 +/- 0.8 and 5.1 +/- 1.4 mm respectively for immediate application of orthodontic tooth movement, and 3.7 +/- 0.9 and 4.3 +/- 0.6 mm with delayed application of orthodontic movement two months later. Moreover, immediate orthodontic tooth movement showed the most significant increase in bone density and bone fill, which reached 74.2 +/- 14.2 and 3.7 +/- 1.1 mm respectively at the end of the study period.This study evaluated the effect of orthodontic tooth movement on enhancement of periodontal regenerative outcomes. The results demonstrated that a significant improvement in clinical and radiographic parameters was observed. When comparing the different groups, a statistically significant difference was found with immediate application of orthodontic tooth movement.