Severe periodontal destruction caused by orthodontic elastic bands: A case report and review of the literature

Abstract

Background:The present article describes a case of extensive periodontal destruction caused by orthodontic elastic bands slipping apically into the periodontal ligament space.Case description: Twelve years after placement of the orthodontic elastic bands the patient presented with severe iatrogenic damage to the periodontium of all four maxillary incisors rendering this, to the best of our knowledge, the longest period reported during which elastics were left lodged in situ. Removal of the bands was possible through the orifices of established sinuses and non-surgical periodontal treatment was attempted. At a subsequent visit, open flap debridement followed. At six months post-operatively, reduction of pockets, resolution of inflammation and sealing of the sinuses had occurred.Conclusions: This report describes the pathology caused when orthodontic elastic bands get wedged into the periodontium and discusses the possible differential diagnosis. It emphasizes the importance of informing the patients on the correct use of elastics and suggests measures to prevent their displacement.

Accidental Periodontitis Induced by Orthodontic Treatment: A Review

“…This is why the bands tend to creep down the narrower end of the crown of the tooth. 12 and move thereby apically creating an expected periodontal ligament destruction resulting in bone loss due to periodontitis and subsequently, the extrusive movement of the tooth. This happens because the elastic bands act as foreign material causing an inflammatory reaction of the soft tissues leading to the weakening of periodontal attachment.…”