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      Iatrogenic possibilities of orthodontic treatment and modalities of prevention

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          Abstract

          The benefits of orthodontic treatment are numerous and in most cases, the benefits outweigh the possible disadvantages. Orthodontic treatment can play an important role in enhancing esthetics, function, and self-esteem in patients. However, it carries with it the risks of enamel demineralization, tissue damage, root resorption, open gingival embrasures in the form of triangular spaces, allergic reactions to nickel, and treatment failure in the form of relapse. These potential complications are easily avoidable by undertaking certain precautions and timely interventions by both the orthodontist and the patient. The orthodontist must ensure that the patient is aware of the associated risks and stress the importance of the patient's role in preventing these untoward outcomes. The decision whether to proceed with the orthodontic treatment is essentially a risk-benefit analysis, where the perceived benefits of commencing treatment outweigh the potential risks. This article provides an overview of the iatrogenic possibilities of orthodontic treatment and the role of the patient as well as the orthodontist in preventing the associated risks.

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          EXPERIMENTAL GINGIVITIS IN MAN.

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            The six keys to normal occlusion.

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              Incidence of white spot formation after bonding and banding.

              White spot or areas of decalcification are carious lesions of varying extent. The incidence and severity of white spots after a full term of orthodontic treatment were studied among patients in the separate private practices of two of the authors. To establish a base line of comparison, the presence of white spots in a random sample of untreated persons was observed. The incidence of white spots among patients treated by a multibonded technique was recorded at the time of debonding. In addition, white spots were sought in the before- and after-treatment Kodachrome slides of persons whose maxillary incisors had been handed. It was found that individual teeth, banded or bonded, exhibited significantly more white spot formation than was found in the control group. For the teeth studied, there was no difference in white spot formation in those that were banded or bonded. The labiogingival area of the maxillary lateral incisors had the highest incidence of white spots. When studied by segments, the highest incidence occurred among the maxillary incisors; the lowest was in the maxillary posterior segment. No white spots were found on the lingual surfaces of mandibular canines and incisors after prolonged use of a canine-to-canine bonded retainer. These findings suggest a relationship between resistance to white spot formation and the rate of salivary flow. Despite the lack of any preventive fluoride program among the study groups, 50% of the patients demonstrated resistance to white spot formation. The obvious degree of latrogenic damage during orthodontic treatment suggests the need for preventive programs using fluoride. Further clinical research is needed.
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                Author and article information

                Journal
                J Orthod Sci
                J Orthod Sci
                JOS
                Journal of Orthodontic Science
                Medknow Publications & Media Pvt Ltd (India )
                2278-1897
                2278-0203
                Jul-Sep 2013
                : 2
                : 3
                : 73-86
                Affiliations
                [1]Department of Orthodontics and Dentofacial Orthopedics, Priyadarshini Dental College and Hospital, Thiruvallur, Tamil Nadu, India
                Author notes
                Address for correspondence: Dr. Nazeer Ahmed Meeran, Priyadarshini Dental College and Hospital, Pandur, Thiruvallur, Tamil Nadu, India. E-mail: nazeerortho@ 123456yahoo.co.in
                Article
                JOS-2-73
                10.4103/2278-0203.119678
                4072383
                24987646
                435b6931-4302-4473-a148-41bf6a42e2ce
                Copyright: © Journal of Orthodontic Science

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Review Article

                decalcification,iatrogenic effects,orthodontic treatment

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