The Adverse Effects of Orthodontic Treatment



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THE ADVERSE EFFECTS OF ORTHODONTIC TREATMENT By The Adverse Effects of Orthodontic Treatment William F. Holt and Judith B. Rose From Riolo, M. and Avery, J. Eds., Essentials for Orthodontic Practice, EFOP Press of EFOP, LLC. Ann Arbor and Grand Haven, Michigan, U.S.A., 2003. Introduction CHAPTER 22 Pages 617-632 1

- Tooth Decay and Enamel Decalcification - Periodontal Disease - External Apical Root Resorption (EARR) - Patient Injuries from Orthodontic Appliances - Length of Treatment may vary from Estimate - Temporo-Mandibular Joint Disorders may Occur - Aspiration or Ingestion of Orthodontic Appliances - Injury from Dental Instruments - Abnormal Wear of Tooth Structure and Debonding Fractures - Nickel Allergy - Bacteremia after Orthodontic Banding - Pain and Discomfort - Impacted Teeth 3rd Molars may Still Occur - Tooth Mass Discrepancies may not be Resolved - Extraction of Teeth and Supplemental Orthognathic Surgery may be Necessary - Abnormal Growth Patterns of the Jaws - Teeth with Questionable Vitality may be Adversely Affected - Post Treatment Changes in Alignment Tooth Decay and Enamel Decalcification Decalcification and tooth decay associated with poor oral hygiene during orthodontic treatment 2

Periodontal Disease External Apical Root Resorption (EARR) Crestal bone loss occuring with orthodontic treatment associated with poor oral hygiene Pre-orthodontic treatment full-mouth radiographs 3

External Apical Root Resorption (EARR) External Apical Root Resorption (EARR) Post-orthodontic treatment full-mouth radiographs demonstrating EARR of incisors Impacted maxillary canine in close proximity to lateral incisor apex 4

External Apical Root Resorption (EARR) Patient Injuries from Orthodontic Appliances Safety release mechanisms on head gear attachment J-hook headgear Resorption of the lateral incisor apex by the impacted maxillary canine 5

Extraction of Teeth and Supplemental Orthognathic Surgery - Length of Treatment may vary from Estimate - Temporo-Mandibular Joint Disorders may Occur - Aspiration or Ingestion of Orthodontic Appliances - Injury from Dental Instruments - Abnormal Wear of Tooth Structure and Debonding Fractures - Nickel Allergy - Bacteremia after Orthodontic Banding - Pain and Discomfort - Impacted Teeth 3rd Molars may Still Occur - Tooth Mass Discrepancies may not be Resolved Pre-surgical correction of severe Class II malocclusion 6

Extraction of Teeth and Supplemental Orthognathic Surgery Extraction of Teeth and Supplemental Orthognathic Surgery Pre-surgical correction of severe Class II malocclusion Post-surgical correction of severe Class II malocclusion 7

Extraction of Teeth and Supplemental Orthognathic Surgery Abnormal Growth Patterns of the Jaws Post-surgical correction of severe Class II malocclusion Pre-orthodontic treatment headplate demonstrating anterior open bite Post orthodontic treatment demonstrating relapse of open bite treatment 8

Abnormal Growth Patterns of the Jaws Post Treatment Changes in Alignment Pre-orthodontic treatment Completion of orthodontic treatment Post-orthodontic treatment relapse Final surgical correction due to abnormal mandibular growth 9