accelerated orthodontic treatment in a patient with reduced periodontal tissue case report

8QN0Q #RTKN,WPGRR 4GXKUVC/GZKECPCFG1TVQFQPEKC %#5'4'2146 YYYOGFKITCRJKEQTIOZ +0641&7%6+10 6JGPGGFVQURGGFWRQTVJQFQPVKEVTGCVOGPVVQHWNſNN VJGRCVKGPVŏUGZRGEVCVKQPUTGUWNVGFKPVJGEQODKPCVKQP QH

8QN0Q #RTKN,WPG

RR

4GXKUVC/GZKECPCFG1TVQFQPEKC

%#5'4'2146

YYYOGFKITCRJKEQTIOZ

+0641&7%6+10

6JGPGGFVQURGGFWRQTVJQFQPVKEVTGCVOGPVVQHWNſNN

VJGRCVKGPVŏUGZRGEVCVKQPUTGUWNVGFKPVJGEQODKPCVKQP

QHQTVJQFQPVKEVTGCVOGPVYKVJCUWTIKECNRTQEGFWTG

%QTVKEQVQO[ YCU KPVTQFWEGF CU C UWRRNGOGPVCT[

VGEJPKSWG HQT QTVJQFQPVKE VJGTCR[ VQ CEJKGXG

CEEGNGTCVGFVQQVJOQXGOGPVUYKVJOKPKOCNUWTIKECN

KPVGTXGPVKQP+VTGFWEGUVTGCVOGPVVKOGD[GNKOKPCVKPI

VJG TGUKUVCPEG QHHGTGF D[ FGPUG EQTVKECN DQPG VQ

VTCFKVKQPCNQTVJQFQPVKEOQXGOGPVCPFFGETGCUGUTQQV

TGUQTRVKQPCPFFCOCIGVQVJGRGTKQFQPVCNNKICOGPV

%QPXGPVKQPCNN[ RGTKQFQPVCN VJGTCR[ KP CFWNV

RCVKGPVUYKVJTGFWEGFRGTKQFQPVKWOCPFQTVJQFQPVKE

KPXQNXGOGPVVTCPUNCVGUKPVQRTQNQPIGFVTGCVOGPVUQT

OC[KPXQNXGCſPCPEKCNEQOOKVOGPVVJCVVJGRCVKGPV

KUPQVCDNGVQCHHQTF#FFKVKQPCNN[VTGCVOGPVTGUWNVU

CTGWPRTGFKEVCDNGDGECWUGVJGDQPGDGJCXKQTOC[ XCT[CPFECWUGCHCKNWTGQTCTGNCVKXGUWEEGUUYJKEJ ECWUGUVJGRCVKGPVUVQDGTGNWEVCPVVQCEEGRVNQPIVGTO VTGCVOGPVU#PCNVGTPCVKXGVQQTVJQFQPVKEVTGCVOGPVKP RCVKGPVUYKVJCTGFWEGFQTCJGCNVJ[RGTKQFQPVKWOKU QTVJQFQPVKEOKETQUWTIGT[QTEQTVKEQVQO[

%QTVKEQVQO[ HQT QTVJQFQPVKE VTGCVOGPV OC[ DG EQPUKFGTGF CU CP KPVGTOGFKCVG VJGTCR[ DGVYGGP QTVJQIPCVJKEUWTIGT[CPFEQPXGPVKQPCNQTVJQFQPVKEU

#EEGNGTCVGFQTVJQFQPVKEVTGCVOGPVKPCRCVKGPVYKVJTGFWEGF

RGTKQFQPVCNVKUUWG%CUGTGRQTV

6TCVCOKGPVQFGQTVQFQPEKCCEGNGTCFCGPRCEKGPVGEQPVGLKFQURGTKQFQPVCNGU

TGFWEKFQU%CUQENÈPKEQ

2CVTKEKC5CPVQ[Q4KXCU5KNXKC6CXKTC(GTP¶PFG\h

 1TVJQFQPVKEU5RGEKCNV[5VWFGPV

h  2TQHGUUQTQHVJG1TVJQFQPVKEU5RGEKCNV[

2QUVITCFWCVG5VWFKGUCPF4GUGCTEJ&KXKUKQPQHVJG1FQPVQNQI[ (CEWNV[70#/

6JKUCTVKENGECPDGTGCFKPKVUHWNNXGTUKQPKPVJGHQNNQYKPIRCIG

JVVRYYYOGFKITCRJKEEQOQTVQFQPEKC

4'57/'0

'NVTCVCOKGPVQFGQTVQFQPEKCGPWPRCEKGPVGEQPRGTKQFQPVKVKU[RG TKQFQPVQTGFWEKFQIGPGTCNOGPVGTGSWKGTGNCEQODKPCEKÎPFGFKUVKP VCUVÃEPKECUSWKTÕTIKECU[VTCVCOKGPVQUKPVGTFKUEKRNKPCTKQUEQPGNſP

FGQDVGPGTTGUWNVCFQUÎRVKOQU1DLGVKXQ2TGUGPVCTGNVTCVCOKGP

VQFGQTVQFQPEKCCEGNGTCFCGPRCEKGPVGEQPOCNQENWUKÎPUGXGTC RGTKQFQPVKVKU[RGTKQFQPVQTGFWEKFQRCTCGNÃZKVQGPGNVTCVCOKGPVQ QTVQFÎPEKEQGPWPOGPQTVKGORQ[EQPOÈPKOCCNVGTCEKÎPGPNQU

VGLKFQURGTKQFQPVCNGU/GVQFQNQIÈC2CEKGPVGHGOGPKPCFGCÌQU

FGGFCFFQNKEQHCEKCNSWGRTGUGPVCOCNQENWUKÎPENCUG++GUSWGNÃVKEC ENCUG++OQNCT[ENCUG++ECPKPCFKCUVGOCURGTſNEQPXGZQKPEQORG VGPEKCNCDKCNUQPTKUCIKPIKXCN[VGLKFQURGTKQFQPVCNGUFKUOKPWKFQU 'NVTCVCOKGPVQKPKEKCNVWGQTVQFÎPVKEQRGTKQFQPVCNUGIWKFQRQTEQTVK EQVQOÈCU'NVTCVCOKGPVQRGTKQFQPVCNEQPUKUVKÎGPTCURCFQ[CNKUCFQ TCFKEWNCTGKPUVTWEEKQPGUFGJKIKGPG%QNQECEKÎPFGCRCTCVQNQIÈC ſLCRTGUETKREKÎP4QVJUNQVGPCODCUCTEQUUKPGZVTCEEKQPGU

4GUWNVCFQU#NVÃTOKPQFGNVTCVCOKGPVQUGNQITCTQPTGUWNVCFQUGUVÃ

VKEQUQENWUCNGU[HWPEKQPCNGU%QPENWUKQPGU.QURCEKGPVGUEQO

RTQOGVKFQURGTKQFQPVCNOGPVGRWGFGPVTCVCTUGUCVKUHCEVQTKCOGPVG EQTTKIKGPFQNCOCNQENWUKÎPEWCPFQUGWVKNK\CWPGPHQSWGKPVGTFKUEK RNKPCTKQ

-G[YQTFU#EEGNGTCVGFQTVJQFQPVKEUTGFWEGFRGTKQFQPVCNVKUUWG

2CNCDTCUENCXG1TVQFQPEKCCEGNGTCFCRGTKQFQPVQTGFWEKFQ

#$564#%6

1TVJQFQPVKEVTGCVOGPVKPCRCVKGPVVJCVUWHHGTGFRGTKQFQPVKVKUCPFCU

CTGUWNVJCUCTGFWEGFRGTKQFQPVKWOQHVGPTGSWKTGUCEQODKPCVKQPQH

UGXGTCNUWTIKECNVGEJPKSWGUCUYGNNCUKPVGTFKUEKRNKPCT[VTGCVOGPVU

CKOGFCVCEJKGXKPIQRVKOWOTGUWNVU 1DLGEVKXG6QRTGUGPVC

VTGCVOGPVYKVJCEEGNGTCVGFQTVJQFQPVKEUKPCRCVKGPVYKVJUGXGTG

OCNQEENWUKQPRGTKQFQPVKVKUCPFTGFWEGFRGTKQFQPVKWOVQCEJKGXG

QTVJQFQPVKEVTGCVOGPVUWEEGUUKPNGUUGTVKOGCPFYKVJOKPKOWO

CNVGTCVKQPQHRGTKQFQPVCNVKUUWGU/GVJQFQNQI[[GCTQNFHGOCNG

RCVKGPVFQNKEJQHCEKCNYKVJCUMGNGVCNENCUU++OCNQEENWUKQPOQNCT

ENCUU++ECPKPGENCUU++URCEKPIEQPXGZRTQſNGKPEQORGVGPVNKRU

IWOO[UOKNGCPFCFXCPEGFRGTKQFQPVCNNQUU+PKVKCNQTVJQFQPVKE

RGTKQFQPVCNVTGCVOGPVYCUHQNNQYGFD[EQTVKEQVQO[2GTKQFQPVCN

VTGCVOGPVEQPUKUVGFKPTQQVRNCPPKPICPFUECNKPICUYGNNCUQTCN

J[IKGPGKPUVTWEVKQPUUNQV4QVJRTGUETKRVKQPſZGFCRRNKCPEGU

YGTGRNCEGFKPDQVJCTEJGUYKVJQWVGZVTCEVKQPU4GUWNVU#VVJG

GPFQHVTGCVOGPVGUVJGVKEQEENWUCNCPFHWPEVKQPCNTGUWNVUYGTG

CEJKGXGF %QPENWUKQPU 2GTKQFQPVCNN[ EQORTQOKUGF RCVKGPVU

ECPDGUWEEGUUHWNN[VTGCVGFD[EQTTGEVKPIOCNQEENWUKQPYJGPCP

KPVGTFKUEKRNKPCT[CRRTQCEJKUWUGF

e120-e127

© 2015 Universidad Nacional Autónoma de México, Facultad de Odontología This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/) See related content at doi: http://dx.doi.org/10.1016/j.rmo.2016.03.035

YJKEJKUEJCTCEVGTK\GFD[CDKQNQIKECNOGEJCPKUO

DCUGF QP VJG TGIKQPCN CEEGNGTCVKQP RJGPQOGPQP

QT4#2D[KVUCETQP[O+PHTQUVUJQYGFVJCV

JCTOHWN TGIKQPCN UVKOWNK QH UWHHKEKGPV OCIPKVWFG

OC[IKXGTKUGVQCUJCTRN[CEEGNGTCVGFCEVKXKV[CPF

TGQTICPK\CVKQPKPVJGDQP[CPFUQHVVKUUWG*GECNNGF

VJKUECUECFGQHRJ[UKQNQIKECNJGCNKPIRTQEGUUGU4#2

6JKURJGPQOGPQPKUEJCTCEVGTK\GFD[CPCEVKXCVKQPQH

VJGNQECNK\GFTGOQFGNKPIRTQEGUUYJKEJCEEGNGTCVGU

JGCNKPIGURGEKCNN[CHVGTUWTIGT[YKVJFCOCIGVQEQTVKECN

DQPG6JKUUWTIKECNKPLWT[KUCHCEVQTQHTGKPHQTEGOGPV

HQTVJGKPFWEVKQPQH4#2

6JGUWTIKECNVGEJPKSWGUHQTCEEGNGTCVGFQTVJQFQPVKEU

CTG FKXKFGF KPVQ EQTVKEQVQO[ QT FGEQTVKECVKQP CPF

QUVGQVQO[ %QTVKEQVQO[ KU C UWTIKECN VGEJPKSWG

KP YJKEJ QPN[ VJG EQTVKECN DQPG KU EWV FTKNNGF QT

OGEJCPKECNN[CNVGTGFWPVKNDQPGOCTTQYKUTGCEJGFCPF

TGOCKPUKPVCEV1PVJGEQPVTCT[CPQUVGQVQO[EQPUKUVU

KPRGTHQTOKPIUWTIKECNKPEKUKQPUVJTQWIJVJGEQTVKECN

WRWPVKNDQPGOCTTQYCPFKUWUWCNN[VJGHQTOCVKQPQT

UGRCTCVKQPQHCPGYDQPGUGIOGPV

6JGDGPGHKVUQHEQTVKEQVQO[KPEQORCTKUQPYKVJ

EQPXGPVKQPCNQTVJQFQPVKEUCTG

9KFGTCRRNKECVKQPKPVJGVTGCVOGPVQHOCNQEENWUKQPU PGGFHQTGZVTCEVKQPU

&GETGCUGKPVTGCVOGPVVKOG

+PETGCUGKPCNXGQNCTXQNWOGCPFOQTGOCKPVGPCPEG RTGGZKUVKPIDQPGHGPGUVTCVKQPUCPFFGJKUEGPEGU YKVJVJGWUGQHDQPGITCHVU

#NXGQNCTTGOQFGNKPIHQTVJGKORTQXGOGPVQHVJG RCVKGPVyURTQſNGYJGPTGSWKTGF

VGGVJ

/#6'4+#.5#0&/'6*1&5

%CUGTGRQTV

(GOCNGRCVKGPVQH[GCTUQHCIGU[UVGOKECNN[ UCPGTGHGTTGFQHVJG&GRCTVOGPVQH2GTKQFQPVKEU

&'2G+QH(170#/YKVJFKCIPQUKUQHYKFGURTGCF UGXGTGEJTQPKERGTKQFQPVKVKU6JGTGCUQPHQTVJG SWGT[ KU n+ YCPV VQ UGG KH + ECP FQ YKVJQWV O[

CPFTGSWGUVGFFKCIPQUVKECKFUKPENWFKPIUVWF[

(KIWTG

2TGVTGCVOGPVRJQVQITCRJU

&+#)015+5

(GOCNGRCVKGPV[GCTUQHCIGFQNKEJQHCEKCN

EQPXGZRTQHKNGUMGNGVCNENCUU++DKNCVGTCNOQNCTCPF

ECPKPGENCUU++RTQENKPCVKQPCPFRTQVTWUKQPQHWRRGT

KPEKUQTUURCEKPINKRKPEQORGVGPEGIKPIKXCNUOKNG

CPFRGTKQFQPVCNKPXQNXGOGPV

64'#6/'062.#0

1TVJQFQPVKEVTGCVOGPVYKVJCEEGNGTCVGFEQTVKEQVQO[ PQGZVTCEVKQPUCPFŒ4QVJſZGFCRRNKCPEGUYCU UWIIGUVGF

+PVGTEQPUWNVCVKQP YKVJ VJG &GRCTVOGPV QH 2GTKQFQPVKEUYCUEQPFWEVGFCPFEQPXGPVKQPCNRJCUG +RGTKQFQPVCNVTGCVOGPVVJCVKPENWFGFRGTUQPCNRNCSWG EQPVTQNGNKOKPCVKQPQHECNEWNWUFGPVCNRQNKUJKPITQQV UECNKPICPFRNCPPKPIQHVJGRGTKQFQPVCNN[KPXQNXGF VGGVJCPFGZVTCEVKQPUQHFGPVCNQTICPUPWODGTCPF

YCUECTTKGFQWV1PEGRGTKQFQPVCNTGCUUGUUOGPV YCURGTHQTOGFVJGUWTIGT[YCUUEJGFWNGF

%QTVKEQVQO[YCUVJGPRGTHQTOGFYKVJCRKG\QGNGEVTKE UECNRGNKP&1CPFVYQYGGMUNCVGTKVYCU RGTHQTOGFKPVJGNQYGTCTEJKPFGPVCNQTICPU CRRNKCPEGUYGTGRNCEGFKPVJGNQYGTVGGVJ

Ŗ 2JCUG+CNKIPOGPVCPFNGXGNKPI

 Œ0K6KVQŒ55 Ŗ 2JCUG++EQQTFKPCVKQPPFCPFTFQTFGTOQXGOGPVU

 ŒZŒ0K6KVQŒZŒ0K6K

(KIWTG+PKVKCNOQFGNU

(KIWTG

+PKVKCNTCFKQITCRJU

(KIWTG

%QTVKEQVQOKGU

(KIWTG

6TGCVOGPV

Ŗ 2JCUG+++EQPUQNKFCVKQPCPFUVCDKNK\CVKQP

 ŒZŒ55

Ŗ 4GVGPVKQP

64'#6/'06

+PCEEQTFCPEGYKVJVJGCTEJUGSWGPEGGUVCDNKUJGFKP

VJGVTGCVOGPVRNCPQTVJQFQPVKEVTGCVOGPVYCUECTTKGF

QWV(QTURCEGENQUWTGQRGPEQKNUGNCUVKEVJTGCFCPF

ENQUGFCPFKPVGTOGFKCVGGNCUVKEEJCKPUYGTGWUGF

%QPVTCEVKQPNQQRUCPF„ŒOGFKWOENCUU++GNCUVKEUYGTG

CPFſPCNN[NCDKCNWRRGTCPFNQYGTſZGFTGVCKPGTUYGTG

4'57.65

#VVJGGPFQHVJGVTGCVOGPVCGUVJGVKEHWPEVKQPCNCPF RCVKGPVFKFPQVTGHGTCP[6/,U[ORVQOCVQNQI['ORJCUKU YCUOCFGQPVJGKORQTVCPEGQHEQPVKPWKPIHQNNQYWR CRRQKPVOGPVUCVVJG&GRCTVOGPVQH2GTKQFQPVKEUVQ GPUWTGRGTKQFQPVCNJGCNVJCPFQTVJQFQPVKEVTGCVOGPV UVCDKNKV[YKVJVJGPGEGUUCT[ECTGQHVJGTGVCKPGTU

&+5%755+10

8GTEGNNQVVK KP  UWIIGUVGF RKG\QGNGEVTKE EQTVKEQVQO[ +P  &KDCTV RWDNKUJGF C NGUU

(VWHGRFXPHQWRHVHODERUDGRSRU0HGLJUDSKLF

(KIWTG

(KZGFTGVCKPGTU

(KIWTG(KPCNRJQVQITCRJU

(KIWTG

(KPCNTCFKQITCRJU

(KIWTG

(KPCNOQFGNUCPFUWRGTKORQUKVKQP

KPXCUKXGVTCPUOWEQUCNEQTVKEQVQO[VGEJPKSWGECNNGF

2KG\QEKUKQP6JGCWVJQTUOGPVKQPGFCVQ

VTGCVOGPVVKOGTGFWEVKQPKPEQORCTKUQPYKVJVTCFKVKQPCN

QTVJQFQPVKEU+VKUCRJ[UKQNQIKECNVTGCVOGPVDCUGF

QPVJGTGIKQPCNCEEGNGTCVKQPRJGPQOGPQPCPFVJG

OCKPVGPCPEGQHCPCFGSWCVGDNQQFUWRRN[YJKEJKU

GUUGPVKCN6JKURTQEGFWTGKUCPCNVGTPCVKXGHQTCFWNV

RCVKGPVU YKVJ TGFWEGF RGTKQFQPVKWO CPFQT [QWPI RCVKGPVUYKVJCEQORNGVGRGTKQFQPVKWO

%10%.75+105

2GTKQFQPVCNN[EQORTQOKUGFRCVKGPVUECPDGVTGCVGF UWEEGUUHWNN[EQTTGEVKPIVJGKTOCNQEENWUKQPYJGPCP

(KIWTG

+PKVKCNCPFſPCNRJQVQITCRJU

KPVGTFKUEKRNKPCT[CRRTQCEJKUWUGF6JGEQTVKEQVQO[

RTQEGFWTGKPVJKUECUGTGFWEGFQTVJQFQPVKEVTGCVOGPV

VKOGYKVJOKPKOCNVTCWOCVQVJGVKUUWGUFGURKVGVJG

HCEVVJCVVJGRGTKQFQPVKWOYCUTGFWEGF6JGTGUWNVU

QDVCKPGFVJKUECUGKPFKECVGVJCVVJGTGCTGPQCFXGTUG

GHHGEVU KP VJG RGTKQFQPVKWO CPF VJKU KU ENKPKECNN[

GXKFGPV%QTVKEQVQOKGURTQXKFGFGHſEKGPE[CPFUVCDKNKV[

KPQTVJQFQPVKEOQXGOGPVUVJWUUKIPKſECPVN[CXQKFKPI

TQQVTGUQTRVKQP

4'('4'0%'5

 CDCPEC/#\\QNC(8KPEK44QFGNNC.(2KG\QGNGEVTKEUWTIGT[

VYGPV[[GCTUQHWUG$TKVKUJ,QWTPCNQH1TCNCPF/CZKNNQHCEKCN

5WTIGT[

 5QJP&#JP/.GG9;GQ&.KO52KG\QGNGEVTKEQUVGQVQO[

HQTKPVTCQTCNJCTXGUVKPIQHDQPGDNQEMU,2GTKQFQPVKEU4GUVQTCVKXG

&GPV

 <CEJTKUUQP $7 6QQVJ OQXGOGPVU KP VJG RGTKQFQPVCNN[

EQORTQOKUGFRCVKGPV+P.KPFJG,-CTTKPI6.CPI02GFKVQTU

%NKPKECNRGTKQFQPVQNQI[CPFKORNCPVFGPVKUVT[VJGFKVKQP1ZHQTF

$NCEMYGNN/WPMUICCTFRR

 8GTEGNNQVVK 6 2QFGUVC # 1TVJQFQPVKE OKETQUWTIGT[ C PGY

UWTIKECNN[ IWKFGF VGEJPKSWGU HQT FGPVCN OQXGOGPV +PV ,

2GTKQFQPVKEU4GUVQTCVKXG&GPV

 -ÑNG*5WTIKECNQRGTCVKQPUQPVJGCNXGQNCTTKFIGVQEQTTGEV

QEENWUCNCDPQTOCNKVKGU1TCN5WTIGT[1TCN/GFKEKPGCPF1TCN

2CVJQNQI[

 )CPVGU$4CVJDWP'#PJQNO/'HHGEVUQPVJGRGTKQFQPVKWO

HQNNQYKPIEQTVKEQVQO[HCEKNKVCVGFQTVJQFQPVKEU%CUGTGRQTVU,

2GTKQFQPVQN

 -KO52CTM;-CPI5'HHGEVUQHEQTVKUQPGQPRGTKQFQPVCN

TGOQFGNKPIKPQTVJQFQPVKEVQQVJOQXGOGPV#PING1TVJQF



 4QDNGG 4& $QNFKPI 5. CPFGTU ,/ 5WTIKECNN[ HCEKNKVCVGF QTVJQFQPVKEVJGTCR[CPGYVQQNHQTQRVKOCNKPVGTFKUEKRNKPCT[

 9KNEMQ/69KNEMQ9/2WNXGT,,$KUUCFC0($QWSWQV,'

#EEGNGTCVGF QUVGQIGPKE QTVJQFQPVKEU VGEJPKSWG C  UVCIG UWTIKECNN[HCEKNKVCVGFTCRKFQTVJQFQPVKEVGEJPKSWGYKVJCNXGQNCT CWIOGPVCVKQP#OGTKECP#UUQEKCVKQPQH1TCNCPF/CZKNNQHCEKCN

5WTIGQPU,1TCN/CZKNNQHCE5WTI

&KDCTV55GDCQWP,&5WTOGPKCP,2KG\QEKUKQPCOKPKOCNN[ KPXCUKXGRGTKQFQPVCNN[CEEGNGTCVGFQTVJQFQPVKEVQQVJOQXGOGPV



*QTVQP,'6CTRNG[6/,CEQYC[,4%NKPKECNCRRNKECVKQPUQH

WNVTCUQPKEKPUVTWOGPVCVKQPKPVJGUWTIKECNTGOQXCNQHDQPG,1TCN

/CKNKPICFFTGUU

2CVTKEKC5CPVQ[Q4KXCU

'OCKNRCVTKEKCUCPVQ[QTKXCUA"JQVOCKNEQO

(KIWTG

2TGVTGCVOGPVRJQVQITCRJU

&+#)015+5...

%QTVKEQVQOKGU

(KIWTG

6TGCVOGPV

Ŗ... class="text_page_counter">Trang 7

(KIWTG

+PKVKCNCPFſPCNRJQVQITCRJU