<p>Orthodontic treatment can significantly impact periodontium, particularly in dentitions with a thin periodontal phenotype. Under such vulnerable anatomical conditions, orthodontic tooth movement may lead to iatrogenic complications, including the development or exacerbation of bony dehiscences and fenestrations, which can manifest as loss of periodontal support and gingival recession.Periodontally accelerated osteogenic orthodontics offers the potential to reduce overall orthodontic treatment duration while enhancing hard tissue outcomes in the dentition. This case report presents the outcomes of Periodontally accelerated osteogenic orthodontics combined with injectable platelet-rich fibrin in an adult patient with dental crowding, gingival recession, and severe alveolar bone loss. At the five-year follow-up, the patient demonstrated substantial improvements in both soft and hard tissue parameters.</p>