Spontaneous repositioning of pathologically migratory mandibular anterior teeth following periodontal surgical treatment: a case report with 4-year follow-up and literature review.

Periodontal health is the foundation of both oral and general health. Consequently, the high global prevalence of periodontitis and its associated complications, such as tooth migration in moderate-to-severe cases, demand serious attention. Early detection and treatment of tooth migration are essential for favorable long-term outcomes. This article discusses a case of localized aggressive periodontitis (classified as stage III, grade C in 2018) that was managed through periodontal surgery. This intervention led to the spontaneous repositioning of the affected mandibular anterior teeth, which had undergone pathological migration. The treatment focused on eliminating occlusal trauma and inflammation by employing occlusal adjustment, subgingival scaling, and root planing (SRP), addressing both internal and external causes. Following this, alveolar bone regeneration was facilitated through guided tissue regeneration (GTR), which restored normal occlusal and maxillary balance, closed interdental spaces, and promoted the spontaneous repositioning of pathologically migrated teeth. In this instance, only periodontal treatment was applied, highlighting the importance of early and personalized interventions for pathological tooth migration (PTM). Such strategies are not only ideal but also cost-effective. Additionally, we include a literature review focusing on the etiology, therapy, and prevention of PTM associated with periodontitis.