Orthodontic treatment in patients with periodontitis is both feasible and potentially beneficial. Pathologic tooth migration is a common consequence of periodontal breakdown, and orthodontic therapy can help reestablish proper tooth positions, improve occlusion, and enhance esthetics. Successful outcomes require close collaboration between orthodontists and periodontists and lifelong retention to prevent relapse. When executed during periods of periodontal stability, orthodontic treatment does not worsen periodontal status and can contribute to long-term functional and esthetic improvements. The clinical cases presented as examples have been managed in accordance with current literature, addressing potential complications and their solutions. Effective communication among all specialties is essential to achieving the best outcomes as orthodontics contributes significantly to interdisciplinary rehabilitation by optimizing space distribution for implant planning, ensuring proper mesio-distal and vertical positioning, and facilitating long-term prosthetic success. In complex cases, prosthetic implants may also serve as reliable anchorage to enable controlled tooth movement. Together, these strategies provide a biologically sound pathway for integrated periodontal, orthodontic, and implant-based treatment.

Learning objectives:

1. To understand the etiology, clinical manifestations, and interdisciplinary management of pathologic tooth migration, enabling clinicians to diagnose it early, identify underlying periodontal risk factors, and implement orthodontic and periodontal strategies that restore stable tooth position and long-term function.
2. To understand the biomechanical principles and clinical guidelines governing ideal intrusive forces, enabling clinicians to apply light, controlled forces that minimize root resorption risk, preserve periodontal health, and achieve predictable vertical tooth movement.
3. To recognize the indications, advantages, and limitations of using prosthetic implants as orthodontic anchorage, and to integrate them effectively into interdisciplinary treatment plans to facilitate controlled tooth movement in complex cases with reduced periodontal support.