DEPATRMENT OF ORTHODONTICS.

DETRIMENTAL EFFECTS OF ORTHODONTIC TREATMENT

Presented by : Abhay K Narayane (final BDS) Guided by : Dr. P V Hazare. HOD, Dept. Of Orthodontics Dr. Narendra Sharma. Lect, Dept. Of Orthodontics

CONTENTS.
INTRODUCTION.

CAUSES FOR THE DETRIMENTAL EFFECTS.

THE DETRIMENTAL EFFECTS ON TISSUE.

ITS INCREASED PREDESPOSITION TO DENTAL DISEASE OR DYSFUNCTION.

CONCLUSION.

INTRODUCTION.

Orthodontic treatment is mostly concerned with providing esthetic look to a person and influencing his confidence in society indirectly, but it also has some detrimental effects on the tissues of oral cavity and facial look of some individuals.

As in Medicines, it is said that coin has two sides one may be good another may be bad. Drugs also shows some side effects along with their healing power.

CAUSES FOR THE DETRIMENTAL EFFECTS.

1. On the part of the operator. Incorrect diagnosis. Incorrect treatment plan. Use of excessive forces on the tooth. Inadequate skill / Improper appliance Lack of patient education to maintain his oral hygiene.

2. On the part of the patient. Lack of maintenance of oral hygiene. Not wearing the appliance for adequate time. Damage to the parts of appliance by self manipulating. Not reporting regularly to the dentist (Orthodontist) as per his recall appointments.

THE DETRIMENTAL EFFECTS ON TISSUE ARE AS FOLLOWS.

1. Traumatic ulcer.

2. Periodontal disease.

3. Caries.

4. Root resorption.

5. Pulpal damage.

1. TRAUMATIC ULCER. Pain and abrasions are most common complaints. This tissue trauma is due to sharp ends or any tissue irritating metal which tends to injury and ulcer formation due to break in continuity of the epithelium. Mostly seen with fixed appliance. Eg: Beggs appliance

Treatment/ Preventive measure:

Relief silicone can be placed on the tissue to protect it from sharp end of the orthodontic appliance used.

2. PERIODONTAL DISEASE. Generlized mild to moderate gingivitis occurs within 6 months of placement of fixed orthodontic aplliance. It may persist till the appliance is removed. It may exacerbate if patients compliance is not good Sometimes hyperplastic response is seen which can be florid and demands removal of orthodontic appliance. Loss of attachment 0.51.5mm can be noted in 510% of patients with poor oral hygiene.

Generalized gingivitis

Treatment : o Such incidence can be minimized by having proper patients compliance. o Consult to periodontist may be adviced.

3. CARIES. Generally seen around brackets following debonding. o This is due hypocalcification of enamel as food accumulates around the bracket. Incidence of caries may also be seen in the cases of proximal stripping, due to lack of finishing of the stripped areas.

Preventive measure: o The way to control or limit caries is by maintenance of proper oral hygiene.

4. ROOT RESORPTION. Usually occurs during orthodontic procedure, generally small in amount, irreversible and difficult to predict. Caused due to excessive use of force. When roots are moved beyond cancellous bone. It is seen more in tooth that has undergone Root canal treatment and suffered previous trauma.

5. PULPAL DAMAGE. Seen with application of excessive force by: Overzealous wearing of elastics or inexpert handling of orthodontic appliance. Removable appliance may also cause pulpal damage. Eg : Labial bow i.e excessively activated.

INCREASED PREDESPOSITION TO DENTAL DISEASE OR DYSFUNCTION.

1. PERIODONTAL DISESASE. Extraction spaces open up. Excessive overbite created causing Trauma from occlusion. More frequently seen with removable appliances.

2. MANDIBULAR DYSFUNCTION. No relation generally found between Temperomandibular joint dysfunction and orthodontic appliance used, but still orthodontic treatment is blamed for Temperomandibular joint dysfunction. TO NOTE: o Care must be taken to rule out any Temperomandibular joint problems in adults before starting Orthodontic treatment.

3. FAILED TREATMENT. It may be complete or partial due to: o Underestimation of skeletal discrepancy. o Misjudgement of space required. o Misjudgement of anchorage requirements. o Incorrect choice of appliance. o Faulty technique. o Poor oral hygiene.

CONCLUSION. Orthodontics is an aid in improving oral and facial esthetics, but its detrimental effects which are transient or permanent can be reduced by the efforts of Operator as well as by the patient by following the basic principles in Orthodontics and different disciplines in Dentistry.