Case Study: The Path To Healthy Teeth and Gums

Patient. Travis is a previous patient of Baltimore Orthodontic Group. At an earlier age, he had undergone Phase I treatment, helping to ensure that all of his permanent teeth had room to erupt. Now, at 14 years old, Travis was excited to begin the second stage of orthodontic treatment! 

Problem. Because of his genetically thin tissues, Travis had a history of gum recession. The recession was severe enough on the lower front teeth to necessitate gum grafting. Gum grafting is a periodontal procedure where donor gingival tissue is taken from a host site and adapted to a recipient site. The grafting process has multiple functions: 1) It helps to "regrow" the gum tissue; 2) Protect the tooth roots; 3) Decrease sensitivity; and 4) Lower the risk of additional recession.

Process. Now, at this second phase of treatment to correct an overbite and crowding, it was important to carefully monitor Travis's lower gum tissues. Our goal was to make sure the recession did not re-emerge, especially as his teeth began to shift during the course of orthodontic treatment. 

Solution. As noted above,Travis presented with excess overjet, sometimes called an "overbite," and lots of crowding on the lower arch (his bottom left canine was almost completely blocked out from alignment). Both conditions necessitate bringing the bottom teeth forward with the aid of rubber bands to help straighten their appearance and at the same time, reduce the "overbite distance" between the top and bottom teeth. This is illustrated in the lateral photo below.

Due to Travis's thin gum tissues and history of gum grafting, extra caution was needed during his dental treatment. As a result, the decision was made to perform interproximal reduction between his lower incisors. Interproximal reduction is a minimally invasive and safe procedure where a thin strip of sandpaper is gently passed between each tooth in a contouring process. This procedure creates additional space – designed to help keep the teeth centered in the soft tissue. It also helps to establish ideal tooth alignment and symmetry.

Results. Travis was a rockstar with his Invisalign trays and rubber bands and finished treatment in less than two years! The result of his treatment was a perfect smile, where his teeth and gums are in optimal condition. His photo at the beginning of this case study shows him smiling from ear-to-ear on the day of his retainer delivery! We are so excited for you Travis and proud of your commitment to a better smile!