potential risks and complications with orthodontic treatment in dental treatment explained.

1. Potential risks &
complication in
orthdonics
Internship - ACU,
Orthodontic dep.
Nov.2020

2. At the end of this lecture you will be able to :
1. Identify the risks accompanied with orthodontic treatment
2. The main complications as results of orthodontic treatment;
● Main dental complications
● Periodontal complications
● Soft tissue alterations
● TMDs
● Speech problems
4. orthodontic treatment and it’s relation a part of conceptual framework
5. Allergic reactions
6. Infective endocarditis
7. Risks management within orthodontic treatment
ILOS

3. Contents
Orthodontic treatment
as part of conceptual
framework
Risks & Main
complications
introduction
Allergic reaction
03
02 04
05
06
Infective
endocarditis
Risks management
01

4. Orthodontic treatment of
malocclusions and
craniofacial abnormalities
Like any other medical
intervention, it associated
risks and complications.
Introduction

6.  Patient features
 Orthodontists related
factors
 Doctor-patient
relationship
General therapeutic
context
Specific therapeutic
context
Risks occurring orthodontic treatment
 Orthodontic appliances
placements and their
mechanism of actions
 Relation of orthodontic
appliances to oral
structure
 Material properties
 Technical features of
orthodontic appliances

7. • Age
• gender
• Environment
• Physio pathological status
• Genetic predisposition
• Psychological type
• Particularities related to malocclusion (type, etiology, severity)
• craniofacial features.

8. Orthodontic intervention
Usually complications in which occur from;
• Errors of diagnosis,
• Treatment planning
• Treatment management.

9. Doctor-patient relationship
 orthodontic treatment begins the physician, patient
and person with the legal authority for minors
become a team with a common goal “ insuring the
health status for identified problems .
 Communication is a key element in achieving quality
results.

10. What shall we do as
orthodontist?
It is recommended the clear
presentation of the medical
information to the patient, in a clear
language, avoiding the usage of
specialized terminology.
(Teodora et al., 2012)

11.  Patient features
 Orthodontists related
factors
 Doctor-patient
relationship
General therapeutic
context
Specific therapeutic
context
Risks occurring orthodontic treatment
 Orthodontic appliances
placements and their
mechanism of actions
 Relation of orthodontic
appliances to oral
structure
 Material properties
 Technical features of
orthodontic appliances

12. Orthodontic devices
come into contact with the oral tissues and fluids,
temperature fluctuations, mechanical loading during
mastication and devices activation, physical or chemical
interactions.
 lower nickel content, with a good resistance to
corrosion and, in order to avoid corrosion of titanium
based components, to limit the use of high
concentration fluor-based products.
Specific therapeutic context

13. Orthodontic appliances and materials must have special standards.
Specific therapeutic context

16. Related to the bonding and debonding technique
I. Enamel damage
Self-etch adhesives / RMGI

17.  promoting plaque accumulation
and inhibiting oral hygiene
 White spot lesions
II. Carious activity

18.  Primary prevention
 Secondary prevention
How to prevent teeth from
decay during orthodontic
treatment?

19.  Spontaneous remineralization
 fluor or casein phosphopeptide based products
 Chew sugar-free gums.
 Microabrasion may be used.
Treatment approaches for
white spot lesions;

20.  Technique of treatment. (fixed vs
removable app. )
 Irreversible changes within enamel
surface morphology
 Adhesive resins usage
 Food dyes
 UV light.
 Corrosion products
 Force to induce pulp vascularization
abnormalities.
III. Color alteration

21. Secondary to the contact between teeth and brackets or tubes.
It’s also a higher sever form in patients with ceramic brackets,
severity ranging from 9 to 38 times higher compared to the metallic
one.
IV. Dental wear

22. V. External apical root
resorption
Patient
characteristic Orthodontic
technique

23. Maxillary teeth are more prone
to develop root resorption
compared to the mandibular
ones, and frontal teeth more
prone than lateral ones.
V. External apical root
resorption

25. Importance
of maintaining a good oral hygiene, to
monitories the periodontal status
(at least every 3 months to do an
examination and dental cleaning)
In forms of
• gingivitis
• Periodontitis
• Dehiscence
• Fenestrations
• gingival recession
• Overgrowth
• black triangles

27. Erosions and ulcerations on the buccal, labial,
lingual or gingival mucosa.
Pain and discomfort are associated
using orthodontic wax

28. Improper hygiene of the removable orthodontic
appliances is sometimes associated with stomatitis
appearance, which may sometimes be over
infected with Candida Albicans.
Headgear appliance was linked to facial and
intraoral trauma.

30. premature occlusal contacts present
during therapy, there is a greater risk
for this complication to appear Before
starting orthodontic treatment.
 every patient must be examined in
order to detect previous
temporomandibular disorders and
identify high risk patients

32. Impeding the articulation
of sounds or indirectly by
affecting the physical and
mental health of a person.

33. Risk of orthodontic
treatment as a conceptual
framework.

35. Types I and IV
Hypersensitivity reactions
small rash on skin or
mucosa, to generalized
dermatitis
Nickel Latex

36. Nickel allergy – Mucosa Latex allergy – Tounge

38. The American Heart
Association

39. proactive management
items
(measures for avoiding
and preventing the risk)
Management

42. CREDITS: This presentation template was
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Thanks
Stay safe!

43. Our Team
Dr. Kholoud
Khaled
Dr. Mostafa saber
Dr. Mohammed
Abo-Al Naga
intern intern intern

44. References
1. Al Maaitah, E. F., Adeyemi, A. A., Higham, S. M., Pender, N., & Harrison, J. E. (2011). Factors affecting
demineralization during orthodontic treatment: A post-hoc analysis of RCT recruits. American Journal of
Orthodontics and Dentofacial Orthopedics. https://doi.org/10.1016/j.ajodo.2009.08.028
2. Atai, Z., & Atai, M. (2007). Side effects and complications of dental materials on oral cavity. American Journal
of Applied Sciences. https://doi.org/10.3844/ajassp.2007.946.949
3. Bastos Lages, E. M., Drummond, A. F., Pretti, H., Costa, F. O., Lages, E. J. P., Gontijo, A. I., Miranda Cota, L. O.,
& Brito, R. B. (2009). Association of functional gene polymorphism IL-1β in patients with external apical root
resorption. American Journal of Orthodontics and Dentofacial Orthopedics.
https://doi.org/10.1016/j.ajodo.2007.10.051
4. Benson, P. E., Parkin, N., Millett, D. T., Dyer, F., Vine, S., & Shah, A. (2004). Fluorides for the prevention of
white spots on teeth during fixed brace treatment. In Cochrane Database of Systematic Reviews.
https://doi.org/10.1002/14651858.cd003809.pub2
5. Brezniak, N., & Wasserstein, A. (2002). Orthodontically Induced Inflammatory Root Resorption. Part I: The
Basic Science Aspects. In Angle Orthodontist. https://doi.org/10.1043/0003-
3219(2002)072<0175:OIIRRP>2.0.CO;2
6. Cash, A. (2005). Review: Risk management in orthodontics: experts’ guide to malpractice (2004). The
European Journal of Orthodontics. https://doi.org/10.1093/ejo/cji036
7. Chapman, J. A., Roberts, W. E., Eckert, G. J., Kula, K. S., & González-Cabezas, C. (2010). Risk factors for
incidence and severity of white spot lesions during treatment with fixed orthodontic appliances. American
Journal of Orthodontics and Dentofacial Orthopedics. https://doi.org/10.1016/j.ajodo.2008.10.019

45. 1. Chaturvedi, T. P., & Upadhayay, S. N. (2010). An overview of orthodontic material degradation in oral cavity.
Indian Journal of Dental Research. https://doi.org/10.4103/0970-9290.66648
2. Faltermeier, A., Rosentritt, M., Reicheneder, C., & Behr, M. (2008). Discolouration of orthodontic adhesives
caused by food dyes and ultraviolet light. European Journal of Orthodontics. https://doi.org/10.1093/ejo/cjm058
3. Fjeld, M., & Øgaard, B. (2006). Scanning electron microscopic evaluation of enamel surfaces exposed to 3
orthodontic bonding systems. American Journal of Orthodontics and Dentofacial Orthopedics.
https://doi.org/10.1016/j.ajodo.2006.07.002
4. Ionescu, E., Teodorescu, E., Badarau, A., Grigore, R., & Popa, M. (2008). Prevention perspective in orthodontics
and dento-facial orthopedics. Journal of Medicine and Life.
5. Kalkwarf, K. L., Krejci, R. F., & Pao, Y. C. (1986). Effect of apical root resorption on periodontal support. The
Journal of Prosthetic Dentistry. https://doi.org/10.1016/0022-3913(86)90011-9
6. Karamouzos, A., Athanasiou, A. E., Papadopoulos, M. A., & Kolokithas, G. (2010). Tooth-color assessment after
orthodontic treatment: A prospective clinical trial. American Journal of Orthodontics and Dentofacial Orthopedics.
https://doi.org/10.1016/j.ajodo.2010.03.026
7. Klukowska, M., Bader, A., Erbe, C., Bellamy, P., White, D. J., Anastasia, M. K., & Wehrbein, H. (2011). Plaque
levels of patients with fixed orthodontic appliances measured by digital plaque image analysis. American
Journal of Orthodontics and Dentofacial Orthopedics. https://doi.org/10.1016/j.ajodo.2010.05.019
References

46. 1. Leite, L. P., & Bell, R. A. (2004). Adverse hypersensitivity reactions in orthodontics. Seminars in Orthodontics,
10(4), 240–243. https://doi.org/10.1053/j.sodo.2004.09.002
2. Preoteasa, C. T., Ionescu, E., Didilescu, A. C., Meleşcanu-Imre, M., Bencze, M. A., & Preoteasa, E. (2011).
Undesirable dental hard tissue effects hypothetically linked to orthodontics - A microscopic study. Romanian
Journal of Morphology and Embryology.
3. Segal, G. R., Schiffman, P. H., & Tuncay, O. C. (2004). Meta analysis of the treatment-related factors of external
apical root resorption. Orthodontics and Craniofacial Research. https://doi.org/10.1111/j.1601-
6343.2004.00286.x
4. Teodora, C., Ionescu, E., & Preoteas, E. (2012). Risks and Complications Associated with Orthodontic
Treatment. Orthodontics - Basic Aspects and Clinical Considerations. https://doi.org/10.5772/31692
5. Vizitiu, T. C., & Ionescu, E. (2010). Microbiological Changes in Orthodontically Treated Patients. Therapeutics,
Pharmacology and Clinical Toxicology.
6. Wilson, W., Taubert, K. A., Gewitz, M., Lockhart, P. B., Baddour, L. M., Levison, M., Bolger, A., Cabell, C. H.,
Takahashi, M., Baltimore, R. S., Newburger, J. W., Strom, B. L., Tani, L. Y., Gerber, M., Bonow, R. O., Pallasch, T.,
Shulman, S. T., Rowley, A. H., Burns, J. C., … American Dental Association. (2007). Prevention of infective
endocarditis: guidelines from the American Heart Association: a guideline from the American Heart
Association Rheumatic Fever, Endocarditis and Kawasaki Disease Committee, Council on Cardiovascular
Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and
Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. Journal of the
American Dental Association (1939), 138(6), 739–745, 747–760. https://doi.org/10.14219/jada.archive.2007.0262
7. Wishney, M. (2017). Potential risks of orthodontic therapy: a critical review and conceptual framework.
Australian Dental Journal, 62, 86–96. https://doi.org/10.1111/adj.12486
References