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This report presents a 60\u2010year\u2010old woman with stage IV periodontitis, upper anterior protrusion (overjet 7.5\u2009mm), crowding, and advanced vertical bone loss. Treatment with a maxillary fixed appliance and skeletal anchorage over 9\u2009months enabled intrusion and retraction of the anterior teeth, closure of a lateral diastema, and reduction of overjet, achieving functional and aesthetic improvement without compromising periodontal support. Orthodontic treatment is achievable and effective in patients in later adulthood with advanced periodontitis. Using only small, segmented appliances with a controlled force vector guided by skeletal anchorage allows controlled and secure anterior tooth movement. Considering the incisor\/lip interaction according to the FAOP enables reliable tooth movements, improving function, aesthetics, and long\u2010term tooth preservation.<\/jats:p>","DOI":"10.1002\/ccr3.72702","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T03:57:49Z","timestamp":1779940669000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Soft\u2010Tissue\u2010Focused Orthodontics in Patients With Stage\n                    <scp>IV<\/scp>\n                    Periodontitis: Segmented Arch Technique and Skeletal Anchorage: A Case Report"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3380-9844","authenticated-orcid":false,"given":"Lisa\u2010Marie","family":"Mai","sequence":"first","affiliation":[{"name":"Department of Orthodontics University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Wiechens","sequence":"additional","affiliation":[{"name":"Department of Orthodontics University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja","family":"Quast","sequence":"additional","affiliation":[{"name":"Department of Orthodontics University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaayathiri","family":"Suntharalingam","sequence":"additional","affiliation":[{"name":"Department of Orthodontics University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Hrasky","sequence":"additional","affiliation":[{"name":"Department of Preventive Dentistry, Periodontology, and Cariology University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philipp","family":"Meyer\u2010Marcotty","sequence":"additional","affiliation":[{"name":"Department of Orthodontics University Medical Center G\u00f6ttingen  G\u00f6ttingen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/0972-124X.131325"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.18-0578"},{"key":"e_1_2_14_4_1","volume-title":"F\u00fcnfte Deutsche Mundgesundheitsstudie (DMS V) (Fifth German Oral Health Study (DMS V))","author":"Cholmakow\u2010Bodechtel C.","year":"2016"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2005.76.6.859"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00784-021-03936-2"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jcpe.13639"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adaj.2016.10.001"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajodo.2020.01.015"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/edt.12481"},{"key":"e_1_2_14_11_1","unstructured":"J. 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