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Adverse outcomes of orthodontic treatment have been reported in the literature, yet there are currently no systematic reviews on the subject. We undertook a comprehensive review of the literature using the Medline and Ovid electronic databases, complemented by manual searching. The occurrence of unforeseen iatrogenic traumatic complications due to orthodontic treatment was used as the primary outcome. Traumatic iatrogenic complications associated with orthodontic treatment are infrequent. The most common complication reported is ingestion of orthodontic components. In the majority of the cases, management of the offending agent resulted in complete recovery without further complaint. The exception to this is ocular injury sustained as a result of improper use of or accidental injuries related to orthodontic headgear. These injuries are potentially devastating for the patient.
CPD/Clinical Relevance: Orthodontic treatment is carried out routinely and it is important to be aware of the unexpected complications that can occur during treatment and their consequences.
Article
Complications associated with orthodontic treatment are known, yet their occurrence cannot be completely eliminated. As these complications can adversely affect the patient–clinician relationship and prolong treatment time, every effort should be made to avoid them. In addition, discussion of potential unexpected outcomes of treatment is particularly important in view of the Montgomery ruling (Montgomery v Lanarkshire Health Board, 2015, SC 11.1AC 1430). Established in 2015, this ruling reinforced the importance of informed consent, material risk and recognizing patients as key decisionmakers.
Commonly discussed adverse outcomes of orthodontic treatment can be divided into those affecting hard tissue and soft tissue. These are summarized in Table 1.1
Traumatic iatrogenic complications (TICs) in orthodontics are less frequent and less documented. TICs can either be caused due to incorrect use of the device(s) or following accidental injuries from the device(s). These can potentially lead to devastating outcomes for the patient.
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