Mishaps in Orthodontics: A literature Review

In daily orthodontic practice, we usually face two types of emergencies: headgear injuries and oropharyngeal ingestion of orthodontic components. Inspite of variety of additional devices to control anchorage, facebow still provide anchorage in treatment of variety of malocclusions. There is no any substitute of head gear in restraining growth of maxilla in growing subjects of Class II malocclusion. Unfortunately, many patients get injured by face bow during treatment. Injuries have been associated with catapult effect of extraoral traction causing facebow coming out, resulting into injury of face, head and neck or due to dislodgement of standard face during sleep [1-5]. The injuries range in severity from minor laceration to loss of eyes. Night time disengagement of face bow is a main causative factor in facebow injuries. Occasionally, orthodontic appliances or part of them can compromise the airway and gastrointestinal tract due to the close proximity of these appliances to oropharynx. Such type of emergencies may lead to some serious complications, as accidental death in children [6, 7]. Incidence of ingestion of foreign bodies of dentistry being 3.6-27.7%, the no. being considerably higher in adults than children [8]. The majority of foreign bodies found in the airway in children younger than 3 years are contributed by food materials [9]. Once a foreign body has reached the stomach, it has an 80% to 90% chance of passing through the gut without problems. Chance of gut perforation is very less (<1%) [10]. The recent trends towards the use of micro implants in orthodontics may raise the risk of ingestion or inhalation of such components. In this article, we are going to present a review of such type of injuries and its management perspectives.