Facilitated orthodontic tooth movement with periodontal intervention: A case report

Maxillary central incisors play a significant role in the facial aesthetics as it forms a major component of smile. We report a 27 years old male patient undergoing orthodontic treatment for the forceful traction of impacted maxillary central incisors into the occlusion who presented with a fusion of the gingiva and lips in the maxillary anterior region obliterating the maxillary labial vestibule and entrapping the orthodontic retractors earlier placed. Vestibuloplasty was carried out using scalpel and electrocautery to regain the vestibular depth followed by exposure and traction of the impacted maxillary central incisors into occlusion. The patient achieved excellent results which was realised at one-year follow-up, by which time orthodontic treatment was also completed. The case is being described because of the unusual fusion of lips and gingiva, and hence requires careful treatment planning for successful outcomes.