Consumer alert on the use of elastics as “gap bands”
The use of elastics in dentistry is not new. One of the earliest applications was to extract teeth in patients with bleeding disorders, cardiac problems, or mental deficiency. The practitioner simply placed a rubber band around the tooth to be extracted. The rubber band would slowly work its way down the sides of the tooth roots, destroying the bone and soft tissues, and the tooth would just fall out. Elastics have also been used in periodontal research in animals, to destroy the periodontal attachment between the bone and the cementum and produce inflammation and lesions similar to that seen in periodontitis.
So, why is a consumer alert needed today?
The answer can be found on the Internet. A recent search on the term “gap bands” produced links to sites selling elastics directly to consumers, for home use in closing a dental gap. The sites promoted the speed and benefits of this do-it-yourself orthodontic treatment, but spent very little time at all informing potential patients of the risks.
But the risks are quite real, as these images from a 1988 article in the Journal of Periodontology show. For the authors take on this topic 25 years later, see the Editorial in the September issue of the AJO-DO.
|Fig. (Top row) A
7-year-old boy had acutely inflamed tissues and Class III mobility of
the central incisors. The initial radiograph showed localized bone loss,
confined to the distal aspects of the central incisors, with probing
depths up to 10 mm. (Bottom row).
After 18 months of palliative therapy and splinting, close approximation of the root
tips and arc-like pattern of bone loss was evident on the radiograph.
Given the poor prognosis of the central incisors, a
decision was made to perform exploratory periodontal surgery, which
revealed an embedded elastic band. |
The first 3 images were originally published in the Journal of Periodontology and are reproduced
with permission from the American Academy of Periodontology. The final image was not part of the Journal of Periodontology article.
References and Information
Adcock, J.E. Exfoliation of maxillary central incisors due to misapplication of orthodontic rubber bands. Tex Dent J. 1999;116:8-13
Aiello, G. and D'Andria, A. [Iatrogenic risks in orthodontic treatment] Av Odontoestomatol 1991;7:549-551. In Spanish
Almeida, R.C., Carvalho, Fde. A., Almeida, M.A., Capelli J. Jr., and Machado, W.A. Controlled tooth movement to correct an iatrogenic problem. Am J Orthod Dentofacial Orthop. 2011;139:271-278
Al-Qutub, M.N. Orthodontic elastic band-induced periodontitis – A case report. Saudi Dent J. 2012;24:49-53