Side effects of orthodontic treatment: a clinical perspective (2024)

Abstract

Orthodontic treatment is associated with a variety of side effects such as root resorption, pain, pulpal changes, periodontitis and temporomandibular dysfunction (TMD).Inortodontists must be aware of these effects and associated risk factors.Length and form of root, traum history, habits and genetic removal.

Keyword:Rod resorption, pain, periodontitis, pulp vitality, TMD

1. Introduction

Orthodontic treatment is a discipline of dentist, just like many other disciplines in this area, may have the side effects related to the performance of treatment.These effects can be related to the patient or practitioner.Some of these effects are not fully understood, such as root resorption and others are associated with orthodontic treatment without supporting support.Consideration of risk factors before treatment is important.Only risk factors are supported by evidence in the past will be assessed in this article.These side effects include root resorption, pain, pulpal changes, periodontitis, descaling and temporomandibular dysfunction (TMD).

2. Root resorption

Rod resorption is common during Orthodontic Dental Movement (Krishnan, 2005).-S restriced root resorption involving a number of teeth can be considered as a result of orthodontic treatment (Ketcham, 1927).If the patient develops extra pathosis, such as periodontitis, this can further endanger the support of the tooth and the patient can eventually lose that tooth (Ketcham, 1927"Parker, 1997).A shortage of reports in the literature on dental loss as a result of root resorption does not exclude this as a potential risk.

The problem of root resorption as a result of orthodontic treatment was first discussed byKetcham (1927)He was also the first to indicate other factors, such as hormonal disturbance and lack of food in addition to orthodontic treatment variables, which can contribute to root resorption (Davidovitch et al., 1996) .Etiology of root resorption still remains unclear and is complex, including genetic removal and environmental factors (Al Qawasim Dens Al., 2003;Abbas in Hartsfeld, 2007).The genetic removal makes root resorption associated with orthodontic treatment more predictable (Abass en Hartsfield, 2007).

The best approach to root resorption is to consider the risk factors, to discuss the identified factors with the patient looking for orthodontic treatment and includes these factors in the treatment form for the treatment of treatment.Those risk factors include the treatment duration.Krishnan, 2005;Brezniek OG Wasserstein, 1993;Baum Cattle, 1996).Treatment of affected fangs can extend the treatment time or the movement of these fangs can lead to an increase in the risk of root resorption (Krishnan, 2005) .Tynd, tapered tissue and diluted root mororphology results in roots that are more likely to have resorption (Mirabella en Artun, 1995;Levander et al., 1998;Killiany, 1999;Samenhima en Sinclair, 2001).Moreover, the story of trauma increases with the front teeth the risk of root resorption (Malmgren et al., 1982).Inside, documentation of the condition through pre -treatment -Pasis -Röntgenots of maxillary and mandibular incisors is needed.Potential extraction of maxillary and mandibular first or second premolars, as well as the use of intermaxillary elastic during treatment, must also be considered (Mirabrellll og artun, 1995;Samenhima og sinclair, 2001).Redsorption of earlier orthodontic treatment is a risk that can lead to an additional root cover (Brezniak and Wasserstein, 2002).Some habits, such as thumb, occlusal trauma or history of chronic bruxism, can increase the risk of root resorption (Ling and Linger, 1991; Harris, 2000).

Evaluation of the condition due to a progress radiographer at 6-12 months after the start of orthodontic treatment recommended.Dissis can be periapic or panoramic X -rays.Levander et al., 1994).The reimbursem*nt process of root resorption starts two weeks after the active treatment has stopped (Krishnan, 2005).An alternative treatment plan must currently be considered and the treatment must be stopped when serious root resorption is observed.

3. Pain associated with orthodontic treatment

Pain and discomfort is a common negative effect associated with orthodontic treatment (Bullet, ௨௦௦௭).Previous studies have shown that 70-95% of orthodontic patients experience pain (Lew, 1993;Scheurer et al., 1996;Firestone et al., 1999).This pain can be a reason to interrupt the treatment;Previous studies have shown that 8% and even up to 30% of orthodontic patients interrupt treatment as a result of pain (Bullet, ௨௦௦௭) .Smethe and discomfort associated with orthodontic treatment is characterized by pressure, tension or tenderness of the teeth (Alone et al., 1989).See pain in the front teeth is larger than the rear teeth (Scheurer et al., 1996).It is reported that pain starts 4 hours after placing separators or orthodontic wire and the worst pain turned out to be on the second treatment day (Ngan et al., 1989;Lew, 1993;Scheurer et al., 1996;Firestone et al., 1999).Normally takes seven days of pain (Alone et al., 1989).Clinical expectation of the need to use fixed devices increases the risk of pain and discomfort (Stewart et al., 1997;Sergl et al., 1998).Managing pain must inform the patient about the possibility of experiencing pain to reduce anxiety.The clinicus can ask the patient to chew plastic slices or chew gums that contain aspirin (White et al., 1984; Hwang et al., 1994; Ngan et al., 1994).Sewing on plastic slices increases the theoretical circulation in the periodontal ligament, which reduces pain and discomfort.Naja Al., 1994; If You, 2000; Tiles at Carmen, 2005).

4. Pulpale changes during orthodontic treatment

Pulpale response to orthodontic forces is minimal.This reaction is in the form of a mild inflammatory response in the short term that has no long -term significance (Decent and Crown, 1972;Kvinnsland et al., 1989).During the loss of pulp vitality during orthodontic treatment, it is found (Yamaguchi Draft D Fire, 2007).Risk factors for loss of pulp vitality include a history of trauma associated with the teeth.Survey -phase X -Rechen of previous traumatized teeth are important for comparative purposes.Moreover, the use of heavy uncontrolled, continuous forces of the orthodontist or around stumbling of teeth vitality.Yamaguchi Draft D Fire, 2007).

5. Periodontitis and orthodontic treatment

Periodontitis includes gingivitis, alveolar bone loss (periodontitis) and loss of attached gum support (Is a long, in 1996).The periodontal reaction to orthodontic devices depends on various factors, such as the resistance of the host, the presence of systemic conditions and the quantity and composition of dental plaque.Lifestyle factors, including smoking, can also endanger periodontal support (Saftkan-Sepala en Ainamo, 1992;Clarke en Hirsch, 1995;Genco, 1996;Sanders, 1999;Krishnan et al., 2007).Moreover, the negative effects of uncontrolled diabetes on periodontal support are well established (Crya-acepali og range, ౧౯౯౨). Sortodontic treatment for uncontrolled diabetes is contraindicated.

Bacteria present in dental plaque is the primary causal agent for periodontitis (Sanders, 1999). Sortodontic treatment with fixed devices is known to induce an increase in the volume of the dental plaque.Indimed time causes fixed orthodontic devices a shift in the type of bacteria (Borsten et al., 1997). The can result orthodontic treatment in local gingivitis, which rarely progresses to periodontitis (Van Gastel et al., 2007).

The factor that determines the condition of the periodontium during orthodontic treatment is the level of oral hygiene.Oral hygiene instructions must be given before the orthodontic treatment is started and reinforced during each visit.Remarkable brushing of the teeth is the first line of defense for the dental plaque to be controlled.Ultrasonic toothbrushes turned out to be superior to be manual to be brushing to control the bacterial plaque on the buckkal surfaces and reduce gingivitis (Costa et al., 2007).Use of an interproximal brush next to the orthodontic brush is needed (Arici et al., 2007).Fluoride concentration in the toothpaste used for brushing should not be less than 0.1%.The use of toothpaste with Stanneous Fluor produced a higher inhibiting effect on the development of toothpick and gingivitis (OGAARD et al., 2006).Use of fluorine and chlorhexidine -lacquers reduces the levels of bacterial plaque (Are home., 2003).Anal hygiene during orthodontic treatment is the key to the maintenance of a healthy periodontium (Alstad EN Zachrisson, 1979).

Orthodontic treatment of patients with active periodontitis has been contraindicated because the risk of further collapse of periodontal has been considerably increased (Zachrisson en Alnaes, 1973;Cardaropoli a Givglio, 2007).Full evaluation of periodontal status, especially in adult patients, required, and control of periodontal status is necessary before the orthodontic treatment is started.

Careful examination of the level of attached gums before extensive orthodontic treatment is necessary.The level of connected gums is measured from the free gums margin to the mucous membrane connection minus the depth of gingival sulcus.Tooth -movement in the Labio -language direction can be carried out within the envelope of periodontium without harmful effects at the level of the attached gingiva (Wennstorm, 1990).If an insufficient level of corresponding gingiva is present before Orthodontic treatment, a periodontic consultation must be carried out, especially if labial movement is expected from the teeth (Wennstorm, 1990, 1996).

6. Discharge and caries associated with orthodontic treatment

Calfalking of email (white spots) is a common negative effect of orthodontic treatment.Defamation is considered the first step in the direction of cavitation.Calfaling of enamel occurs in 50% of orthodontic patients and the most affected teeth are the maxillary boundaries (Gorelick et al., 1982).Moreover, these lesions can develop within four weeks, which is the typical time of Orthodontic followers -Up (Ogaard et al., 1988a, b).

The prevention protocol for descaling includes plaque control by brushing the teeth with fluoridated toothpaste.Daily rinsing with a 0.02% or 0.05% sodium fluoride solution can also minimize the phasing out of email.In addition, fluoride solutions can slow down the development of Laies (((Ogaard et al., 1988a, b, 2006; Geiger et al., 1992((OGAARD et al., 2001).

If it is observed after removing the orthodontic devices, the doctor should not hurry in the control of these lesions.There should be time for possible re-mineralization of these white spots.In these cases, the patient must be instructed to continue with the plaque control protocol. Rinse daily with fluoridated solutions.Nonety Fluorlaker must be applied to the lesion on this point because it will arrest the lesion and the chance of re-mineralization will be reduced.

7. TMD and Orthodontic treatment

TMD is a condition that can include chewing muscle pain, internal decline of the temporomandibular LED (TMJ) disk and degenerative TMJ disorders as separate problems or can be a combination.A symptom of TMD.Osterberg EN Carlesson, 1979;Solberg et al., 1979;Swanljung EN Rantanen, 1979;Pullinger et al., 1988) .Etiology of TMD is complex and cannot be explained by reason and consequence.Osteoarthritis TMJ patients.There is no evidence that the overbite or overjet plays a role in the pathophysiology of non -arthetic disorders.A loss of molar support can be associated with the presence and severity of osteoarthrosis.Seligman a Pullinger, 1991).Fish characteristics, such as the front open bite in patients with osteoarthrosis, were considered a result of TMD instead of etiological factors for suffering (Pullinger et al., 1993).A combination of at least two to five occlusal variables has contributed to the TMD found in patient groups.Selectively significant increase in the risk of front open bite, one -sided maxillary lingual crossbiet, transferred with more than 6-7 mm, more than 5 --6 missing back teeth and withdrawn Cuspal position (RCP) to the Initial Corspal position (ICP) sliding controllerFrom more end 2 mm (Pullinger et al., 1993).The total contribution of occlusal factors to TMD is considered 10-20%, while 80-90% are related to other factors (Pullinger et al., 1993).

Orthodontic treatment in adolescence does not increase the risk of TMD (Sadsky and Bogole, 1980;Sadsky Andbason, 1984;Kecar Th.1992a, f;Russell /., 1992;Eggermak and Al.2005).Extraction of teeth for orthodontic treatment purposes increases the risk of the development of TMD drawing and symptoms does not (Sudsk is).Moreover, there is no increased risk of TMD due to the use of a certain orthodontic mechanics or devices (Dibbets and Van der Weele, 1987, 1992;Mohlin et al., 2007).

Orthodontic treatment should not be started in patients with acute signs and symptoms of TMD.The orthodontic treatment must be postponed after the attack has been checked.If the patient develops and develops symptoms during orthodontic treatment, all active forces must be interrupted without the need for removal of the fixed orthodontic devices.After that, the signs and symptoms of TMD must be checked using a conservative approach.When the signs and symptoms are under control, the practitioner must re -assess the goals of the treatment.In some cases, the orthodontic treatment must be completed if the signs and symptoms cannot be checked.

8. Conclusion

Orthodontic treatment is like any other treatment that can be associated with adverse side effects.Knowledge of these side effects is important for the orthodontist and the patient who is willing to have orthodontic treatment.To get an informed permission from the patient, the treatment plan is just as important as implementing.

References