Introduction

In 1996, Kokich accurately predicted orthodontists worldwide would experience significant change in their practices: number of adult patients would increase and present a different set of challenges. He warned that adults have worn or abraded teeth, uneven gingival margins, missing papillae, and periodontal bone loss, all of which can jeopardize the esthetic appearance of the teeth after bracket removal. Today, demand for improved quality of life which comes from optimal oral health is increasing. In the United States more and more people are exposed to the importance of oral function, comfort and especially esthetics. The emerging global middle class is likewise exposed to media images featuring vibrant lifestyles which accompany optimal cosmetic and functional dental outcomes. From a business standpoint, these trends suggest orthodontists are about to see the broadest set of challenging cases ever.

Under this backdrop, the American Academy of Periodontology (AAP) and the European Federation of Periodontology(EFP) recently convened to review periodontal classifications set forth in 1999 in light of major advancements since then. The new, innovative model for understanding the periodontium mirrors medical model of personalized health care in that it is based on individual risk for periodontal pathology. Additionally, it addresses the application of stakeholders, like orthodontists, to integrate into their protocols. Periodontics provides diagnostics, risk assessment, and strategies to manage sophisticated cases. Strategies born from grafting, regeneration and implant therapy can be implemented in orthodontic cases.

Delivering care to such broad range of age groups and demanding populations allows the specialized orthodontic practices an opportunity to differentiate from other treatment avenues which may provide limited or compromised orthodontic services. Treating sophisticated cases allows the trained and credentialed orthodontist to showcase innovative diagnosis and treatment planning.