Interdisciplinary Management of Advanced Periodontitis With Severe Anterior Alveolar Ridge Deficiency Using Periodontally Accelerated Osteogenic Orthodontics and Titanium Mesh-Guided Bone Regeneration: A Case Report

Advanced periodontitis with severe anterior alveolar ridge deficiency can complicate orthodontic tooth movement and subsequent rehabilitation.This report describes the interdisciplinary management of a 46year-old woman diagnosed with generalized Stage III Grade B periodontitis, severe anterior maxillary alveolar ridge deficiency, pathological migration of the maxillary anterior teeth, and multiple missing teeth.Initial nonsurgical periodontal therapy was performed before surgical intervention.After clinical periodontal stability was achieved, the patient underwent periodontally accelerated osteogenic orthodontics (PAOO) consisting of selective alveolar corticotomies combined with guided bone regeneration (GBR) using a particulate bone graft and titanium mesh for space maintenance.Controlled orthodontic treatment was subsequently initiated, and supportive periodontal therapy was provided at three-month intervals.Serial clinical photographs and conventional radiographs documented maintenance of the augmented anterior ridge contour, progressive orthodontic alignment, and periodontal stability during the available follow-up.Strategically maintainable teeth were preserved, and implant-supported rehabilitation remained planned as a future restorative phase.Because standardized three-dimensional measurements were unavailable, the magnitude and composition of regenerated bone could not be quantified.This case documents a carefully sequenced approach integrating periodontal stabilization, regenerative surgery, orthodontic treatment, and supportive periodontal maintenance.The observations are limited to a single patient and should not be interpreted as proof of predictable treatment effectiveness.