Accidental orthodontic elastic band-induced periodontitis: orthodontic and laser treatment

Periodontal repair for advanced bone loss caused by orthodontic elastic bands: A case report with 7-year follow-up and literature review

A 16-year-old girl developed severe acute periodontitis involving the maxillary central incisor and lateral incisor caused by elastic bands. Periodontal surgical interventions and orthodontic adjustment achieved good outcomes which were maintained for 7 years. This report demonstrates the criticality of correct diagnosis, early periodontal surgery, and interdisciplinary approach.

Localized Bone Loss Resulted from an Unlikely Cause in an 11-Year-Old Child

Periodontal diseases have several causes, amongst them, by foreign bodies. In this case report, an 11-year-old child who lived in a rural area and has never been treated by a dentist presented an extensive horizontal bone loss and edema on the region of tooth 44. The diagnosis of foreign body was obtained after biopsy, since an elastic band around the middle of the root tooth was found. The elastic band was not radiopaque, and the patient did not inform that she found the elastic band on the floor of the school and introduced the tooth by herself. Based on the case reported, it is concluded that anamnesis and clinical and radiographic examination are fundamental strategies to obtain the diagnosis, but sometimes, especially in children, there may be inconsistencies that can be elucidated by a biopsy.

Elastic band causing exfoliation of the upper permanent central incisors

Objective. This study reports a case in which elastic band use culminated in the loss of the incisors. Case Report. An 11-year-old white girl was seen complaining of pain, with purulent discharge and severe tooth mobility. The bone destruction detected radiographically in the region, despite its single location and absence in posterior quadrants of the maxilla and/or mandible, was similar to that observed in Langerhans cell disease. To our surprise, an elastic band involving the midportion of the roots of the two upper central incisors was found during biopsy. The debris was removed and a metal wire was placed in permanent maxillary right and left incisors. The patient was followed up, but no improvement in tooth mobility was observed. Bone loss increased, and internal resorption and root exposure occurred, which culminated in the extraction of permanent maxillary right and left incisors. Conclusion. The present case highlights the fact that professionals sometimes are confronted by anamnestic reports never seen before.

Evaluation of plasticity and radiopacity of elastic separators by means of traction tests and radiography

INTRODUCTION: Elastic separators are widely used in the orthodontic clinic, in different sizes and thicknesses. Their function is to promote the separation between the teeth that will receive orthodontic bands, however, when subgingivally lost, they may cause periodontal problems and, ultimately, cause tooth extraction. OBJECTIVE: Concerned not only about their function but also about their properties, this experimental work was performed in order to evaluate, with a clinical perspective, the plasticity and radiopacity of the elastic separators, usually used in orthodontic clinic, through physical traction tests and radiographs. METHODS: Six different brands were analyzed and divided in two groups: extruded separators (American Orthodontics, GH, Morelli Blue and Morelli Green) and modular separators (Abzil, Dentaurum, GAC, Blue Modular Morelli and Green Modular Morelli). The plasticity was evaluated after physical traction tests, stretching the separators to 3 times their initial diameter. While the radiopacity was assessed using x-rays. RESULTS: When stretched to three times their inner diameter (ID), the extruded separators American Orthodontics, GH, Morelli Blue and Morelli Green and the modular ones Dentaurum, Morelli Blue Modular and Morelli Green Modular, presented elastic deformation, recovering their original inner diameter. The modular separators from Abzil and GAC showed permanent plastic deformation. With respect to radiopacity, the Abzil, American Orthodontics, Dentaurum, GAC and GH separators were radiopaque. CONCLUSION: Correlating the results concerning the plasticity and radiopacity, the separators which showed the most satisfactory results on both tests were, among the extruded separators, American Orthodontics and GH, and among the modular separators, GAC and Dentaurum.

Tooth separation: a risk-free procedure?

This article reports the case of a 12-year-old patient with tooth extrusion, pain, gingival bleeding, and localized periodontitis near the maxillary second premolar. Despite probing and radiographic examination, it was not possible to establish the etiology. Tooth extraction was indicated because of the severe tooth mobility and extrusion. Curettage of the tooth socket revealed a rubber separator. Preventive approaches are suggested to avoid iatrogenesis and legal problems.

Orthodontic elastic separator-induced periodontal abscess: a case report

Aim. Orthodontic elastic bands were proposed as being the source of gingival abscesses that can rapidly lead to bone loss and teeth exfoliation. We report an adolescent, otherwise, healthy patient whose periodontal status was sound. Shortly after undergoing preparations for orthodontic treatment consisting of orthodontic separators, he presented with a periodontal abscess for which there was no apparent etiology. A non-orthoradial X-ray was inconclusive, but an appropriate one revealed a subgingival orthodontic separator as the cause of the abscess. Removal of the separator and thorough scaling led to complete resolution of the abscess, but there was already residual mild damage to the alveolar bone. Summary. Failure to use appropriate imaging to reveal the cause of gingival abscesses can result in the delay of implementing treatment and halting irreversible alveolar bone loss. An inflammatory process restricted to the gingiva and refractive to conventional therapy should raise the possibility of a foreign body etiology.

Orthodontic elastic band-induced periodontitis - A case report

Periodontal problems due to the use of elastic bands have been documented in the past. A 9-year-old girl reported to a periodontist with complaints of bleeding from gums and tooth mobility of upper right central incisor. This case, reports the early diagnosis and treatment of an acute localized periodontitis arising from the incorrect use of orthodontic elastic rubber bands to close a maxillary midline diastema. The elastic band induced periodontitis was treated with a combination of surgery, splinting, antibiotics and orthodontics. Removal of the etiologic agent improved the condition of the tooth.