Montiel-López PA, García-Nuñez JC, Muro-Jiménez ML, Soto-Chávez AA, Martínez-Rodríguez VM, Rodríguez-Montaño R, Ruiz-Gutiérrez AC. Management of intrabony defects associated with the iatrogenic use of orthodontic elastic bands: A case report. World J Clin Cases 2025; 13(20): 105685 [DOI: 10.12998/wjcc.v13.i20.105685]
Corresponding Author of This Article
Alondra C Ruiz-Gutiérrez, PhD, Periodontics Program, Department of Integrated Dentistry Clinics, University Center of Health Sciences, University of Guadalajara, Sierra Mojada 950, Guadalajara 44340, Jalisco, Mexico. alondra.rgutierrez@academicos.udg.mx
Research Domain of This Article
Dentistry, Oral Surgery & Medicine
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jul 16, 2025; 13(20): 105685 Published online Jul 16, 2025. doi: 10.12998/wjcc.v13.i20.105685
Management of intrabony defects associated with the iatrogenic use of orthodontic elastic bands: A case report
Patricia A Montiel-López, Juan C García-Nuñez, Mari L Muro-Jiménez, Alma A Soto-Chávez, Vianeth M Martínez-Rodríguez, Ruth Rodríguez-Montaño, Alondra C Ruiz-Gutiérrez
Patricia A Montiel-López, Juan C García-Nuñez, Mari L Muro-Jiménez, Alma A Soto-Chávez, Vianeth M Martínez-Rodríguez, Alondra C Ruiz-Gutiérrez, Periodontics Program, Department of Integrated Dentistry Clinics, University Center of Health Sciences, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
Ruth Rodríguez-Montaño, Department of Health and Illness as an Individual and Collective Process, University Center of Tlajomulco, University of Guadalajara, Tlajomulco de Zuñiga 45641, Jalisco, Mexico
Author contributions: Montiel-López PA, García-Nuñez JC, Muro-Jimenez ML, and Ruiz-Gutiérrez AC contributed to the diagnosis, surgical treatment, and management of the patient; Montiel-López PA, Soto-Chávez AA, and Martínez-Rodriguez VM contributed to data acquisition and analysis; Rodríguez-Montaño R and Ruiz-Gutiérrez AC drafted and critically revised the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: The patient signed the informed consent form, fully aware of the use of the images for publication.
Conflict-of-interest statement: We report no conflicts of interest in managing and writing this case report.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Alondra C Ruiz-Gutiérrez, PhD, Periodontics Program, Department of Integrated Dentistry Clinics, University Center of Health Sciences, University of Guadalajara, Sierra Mojada 950, Guadalajara 44340, Jalisco, Mexico. alondra.rgutierrez@academicos.udg.mx
Received: February 4, 2025 Revised: February 22, 2025 Accepted: March 10, 2025 Published online: July 16, 2025 Processing time: 64 Days and 7.1 Hours
Abstract
BACKGROUND
The generation of intrabony defects due to the iatrogenic use of elastic bands is an undesirable situation that can result in persistent gingival inflammation with subsequent bone degradation, thus ultimately leading to tooth loss.
CASE SUMMARY
This clinical case involved a 27-year-old male patient who complained of persistent inflammation and bleeding in the upper anterior region of the gums, despite having undergone dental cleaning for at least 4 years. The dental and medical history indicated the use of removable orthodontic appliances for 8 years, after which braces were placed for 2 years. The intraoral evaluation revealed inflammation and localized suppuration in teeth 11 and 12. Measurements of 2-7 mm for probing depth and 1-5 mm for clinical attachment loss were detected, and combined bone loss was observed via radiographs. Based on the clinical and radiographic findings, localized stage III, grade C periodontitis was diagnosed. During subgingival debridement, two elastic bands emerged around the involved teeth. The bone defects persisted; therefore, they were surgically addressed using a papilla preservation flap and guided tissue regeneration (GTR).
CONCLUSION
The use of elastic bands of various sizes and elasticities is often essential in multiple orthodontic treatments. However, it is crucial to perform a thorough check-up for each patient during treatment and at the end of treatment to remove any remaining residue of resin, metal bands, or orthodontic bands. Additionally, it is imperative to inform the patients of the importance of attending their follow-up appointments. The use of elastic bands in orthodontics requires special care; moreover, GTR is a management option for intrabony defects associated with the iatrogenic use of bands.
Core Tip: Intrabony defects caused by the iatrogenic use of elastic bands are undesirable. They can result in inflammation, suppuration, and persistent gingival bleeding; these effects, lead to bone degradation and can increase risks to the quality of life of teeth. In the present case, it was impossible to identify the duration in which the elastic bands were invaginated in the periodontal tissue; specifically, the bands may have been invaginated for many years, according to the patient's report. The use of guided tissue regeneration favored the reconstruction of the intrabony defects that were generated by these elastic bands. The use of elastic bands in orthodontics requires special care by both clinicians and patients to avoid iatrogenic effects.
