PATHOLOGICAL MIGRATION OF ANTERIOR TEETH IN PATIENTS WITH MODERATE TOSEVERE PERIODONTITIS

THE PURPOSE OF THIS STUDY was to determine the prevalence of pathologi c migration of anterior teeth in patients with moderate to severe peri odontitis. The correlation between pathologic migration of anterior te eth and attachment loss (AL) was investigated, and an attempt was made to identify the most common early form of pathologic migration. Preva lence of tooth migration was studied in a group of 343 patients with m oderate to severe periodontitis before treatment. The presence of path ologic migration was determined from the chief complaint and patient a wareness of tooth movement in the last 5 years. Forty-four patients (a ge range 18 to 69; mean = 48.75) with 75 pairs of migrated and non-mig rated teeth were studied further to determine if there is a correlatio n between severity of periodontal AL and pathologic migration. Migrate d teeth were compared to control contralateral teeth that did not have migration. In addition, tooth mobility of the anterior teeth on 36 of the 44 patients was measured using the mobility meter. It was anticip ated that tooth mobility would follow the same pattern as AL in relati on to pathologic migration. The type and severity of displacement was recorded for each tooth affected by migration. The types of pathologic migration recorded were diastema, extrusion, rotation, facial flaring , and drifting into edentulous spaces. Pathologic migration prevalence was 30.03% +/- 2.5 (103/343 subjects). The mean AL of migrated teeth (4.79 +/- 0.28 mm) was significantly greater (P < 0.0001) than control teeth (3.21 +/- 0.18 mm). The numeric values (called PTV) of migrated teeth (17.6 +/- 1.5) were significantly greater (P < 0.0001) than con trol teeth (9.4 +/- 1.1). It was difficult to identify a primary form of displacement, as most patients demonstrated a combination of moveme nts. The percentage of the 44 patients who presented with a specific t ype of movement was: facial flaring (90.9 +/- 4.4%), diastema (88.6 +/ - 4.8%), rotation (72.7 +/- 6.8%), extrusion (68.2 +/- 7.1%), and tipp ing (13.6 +/- 5.2%). The results of this study confirms clinical impre ssions that periodontal disease destruction of the attachment apparatu s plays a major role in the etiology of pathologic migration.