A 60s Patient’s Orthodontic Treatment Review | A Case Combining Partial Orthodontics for the Front Teeth After Periodontitis Treatment with No-Prep Veneers

Hello. This is Yonsei Baro Dental Clinic, a Gangnam and Apgujeong orthodontic clinic.

“Is orthodontic treatment possible even in my 60s?” “Can I receive orthodontic treatment even though I have periodontitis?” These are the questions most frequently asked by middle-aged and older patients.

To give you the conclusion first, **it is often possible.

** However, when periodontitis is present, the principle is not to begin orthodontic treatment immediately, but to first complete gum treatment and start orthodontic treatment once the condition has stabilized.

Today, we will introduce the actual treatment case of a patient in their 60s whose periodontitis-spaced front teeth were arranged with partial orthodontics and naturally completed with no-prep veneers.

This is Yonsei Baro Dental Clinic in Apgujeong, a Gangnam orthodontic clinic.

Today, I would like to share the story of orthodontic treatment for a patient in their 60s.

23.10~24.05

Let’s begin the story of orthodontic treatment in a patient in their 60s with periodontitis.

This patient visited us for no-prep veneer treatment.

The gums around the front teeth were quite swollen, and because of longstanding periodontitis, the space between the front teeth had gradually widened, while the teeth had also moved downward.

23.10

If no-prep veneers were placed in this condition, the two central incisors would look extremely large, almost like oversized front teeth.

The ends of the teeth that had moved downward could be ground down to make them shorter.

However, the space between the front teeth was about 3 mm. If each front tooth were enlarged by 1.5 mm toward the center, the teeth would look like pieces of xylitol gum.

23.10

In addition, the lateral incisors next to the central incisors were undersized, so they were small.

If the central incisors became larger, the lateral incisors would appear relatively smaller.

After explaining the situation, we decided to first improve the alignment and redistribute the space with partial orthodontics for the front teeth so that no-prep veneers would be possible.

24.03

Controlling periodontitis before orthodontic treatment is more important than anything else.

We reduced the gum swelling through scaling and gum treatment, then performed partial orthodontic treatment on the front teeth using MTA mini-tube appliances.

After five months of treatment, the two central incisors that had moved downward had moved upward, and their heights had become aligned.

During this process, the space between the central incisors naturally narrowed.

Although this was partial orthodontic treatment, the right canine had also moved downward, so we placed a miniscrew and performed treatment to level the occlusal plane.

24.04

After seven months of orthodontic treatment, the orthodontic phase was completed, and we began preparing for the no-prep veneers.

24.04~24.05

These are the images before and after the no-prep veneer treatment.

We intentionally did not completely eliminate the black triangle, the space that appears when the gum between the front teeth has receded.

Completely closing this area can create an environment where bacteria accumulate easily, increasing the risk of gum disease.

By leaving it open to this extent, it is not visible from the outside, while the patient can manage it independently with an interdental brush as part of their regular care.

24.04~24.05

The color was matched to a natural tone.

Now, here are the before-and-after comparison photographs.

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This is how the patient looked after the wire retainer was placed.

Initial visit – front teeth – after no-prep veneer treatment

These photographs show the patient at the initial visit, after orthodontic treatment, and after no-prep veneer treatment, in that order.

Because the treatment has been completed successfully, retention and maintenance are important.

In particular, since the periodontitis had been severe, thorough care will be necessary to prevent recurrence.

There is no need to give up on orthodontic treatment simply because you are in your 60s.

Rather, when the aesthetics and function of the teeth have declined because periodontitis has caused the front teeth to separate or because the teeth have shifted, **a natural and healthy result may be expected when periodontal treatment and partial orthodontics are appropriately combined.

** As in this case, **

when the space is redistributed with orthodontic treatment before proceeding with no-prep veneers, it is possible to create a natural smile without making the teeth excessively large, while also taking long-term maintenance into consideration.**