| Recent years, interdisciplinary model of therapies is more and more application in the periodontal treatments. The dentists will provide a comprehensive plan of therapies from their respective aspects for the patient. The evaluation of periodontal status is the key to the multidisciplinary treatment plan, including the signs, symptoms, related local and systemic risk factors, etc. Therefore, the periodontal specialist should possess a thorough understanding of the available treatment options and their related indications, contraindications, benefits, and liabilities to effectively formulate a proper treatment plan with other dentists.The rate of prevalence of periodontal-endodontic lesions is high. The proper treatments depend on the accurate diagnosis. Pulpal infection has the potential to initiate inflammatory changes in the alveolus at the apical region of the teeth. If the inflammation failed to control, it will result in the destruction of periodontal tissue. In case 6, the pulp infection of 46 spread out and leaded to severe periodontitis. On the contrary, the severe periodontitis may cause retrograde pulpitis as well. In case 7, the 16 suffer pulp necrosis and root resorption because of the severe periodontitis. In consequence,it is critical to receive root canal therapy and periodontal treatment in time, which therapy is the first depend on the etiology.Malocclusion is a risk factor for periodontitis. Crowded sites harbour increased quantities of supragingival plaque. The non-axial occlusion may result in secondary trauma and displacement of the loosened teeth. We need proper orthodontic treatment to improve the problem above. Periodontal disease must be controlled prior to orthodontic treatment. In case 2, case 3 and case 7, orthodontic treatment is suggested after periodontal status reaching stable, in order to improve poor oral hygiene and improper occlusion influenced by the malocclusion. There is a risk of gingival recession, in particular labial to the incisors when the alveolar bone plate and overlying attached gingiva are thin or where bony dehiscence or fenestrations exist. In case 6 and case 8, the impacted 13 lead to inevitable gingival recession after orthodontic treatment.Prosthodontic is closely related to periodontal health. Proper prosthodontic is helpful for the teeth. Crown prosthesis is suggested after root canal therapy for keeping off fracture. In case 5 and case 7, the root amputation surgery needs to root canal therapy. There are some factors of crown prosthesis influence on periodontal health through increasing the risk of plaque retention. The smooth surface, the contoured form mirrored natural tooth and the good marginal seal of restoration can protect the tooth from plaque accumulation in order to decrease the chance of precipitating periodontal disease. It is generally accepted that restorations whose margins are placed within the biological width will lead to gingival inflammation and connective tissue and bone loss. In case 4, surgical crown lengthening made following prosthodontic of 12,13 compatible with biological width for the sake of keeping gingival health. As a relatively mature prosthodontic technique for dentition defect of patients with periodontitis, implant is widely used in recent years in clinical. However, in case 7, implant surgery of the patient that suffer from aggressive periodontitis still remains a challenge.Therapy of some periodontal diseases is relatively comprehensive. Therapy from only single field is always not achieving satisfactory result. Multidisciplinary treatments can overcome the limitations above by comprehensively devising treatment plans and treating collaboration, and then achieve the good prognosis with which both dentists and patients are content. |
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