What determines the limits?

What are the limits of orthodontic treatment? When the dentist is confronted with a situation where the only solution is major implant-based oral rehabilitation or a removable denture? When the degeneration has reached a level where orthodontics no longer has a viable role as part of oral rehabilitation?

The limitations can be related to:

In relation to the dental status, the quality, the number and the distribution of teeth are of importance. The quality includes the amount of remaining natural tooth substance, and the presence or absence of active caries and periapical pathological processes. The prognosis of each individual tooth has to be taken into consideration before deciding which teeth should be involved in major oral rehabilitation. Therefore, active caries and periapical pathological processes have to be taken care of before the treatment plan is worked out.

In relation to periodontal status, the absence of clinically active gingivitis and periodontitis is crucial to move a tooth without further deterioration of its periodontal support. Whereas the quality of the attachment is important, no limit has been proposed for the maximum attachment loss beyond which no treatment can be performed. Although the requirements regarding the status of the periodontium differ among authors, optimal periodontal health is a sine qua non when intrusion is intended for the purpose of improving the periodontal status. In order to avoid the tissue reaction generated by the orthodontic appliance leading to a negative balance, pocket dept/>