Several reasons should be analyzed to explain the growing number of cases of iatrogenics in Orthodontics.
Iatrogenics usually occurs due to inaccurate growth prediction, incorrect choice of orthodontic appliances, technical failure by the dentist, poor patient cooperation or lack of control of space and anchorage, particularly when teeth are extracted for orthodontic reasons.
Iatrogenics may be described as a situation that leads to reversible or irreversible damage to patients that undergo any type of treatment.
In 1996, Behrents defined iatrogenics as something unintentionally induced by treatment.
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All procedures involve a large number of relevant variables determined by patient characteristics, such as the dynamics of facial development and growth, the biomechanical interactions between appliances, dentition and bones, the dynamics of the dentist-patient-family interaction, the large variety of treatment approaches and the continuity of follow-up during the retention phase.
Other difficulties in the conduction of a treatment may occur as a result of inadequate choice of dental procedures, incorrect treatment indication, adoption of hazardous treatment strategies, inadequate treatment performance, incorrect decision about treatment time, not changing treatment plan when necessary, not achieving a resolution of malocclusion, inappropriate follow-up during the retention phase, and not establishing good communication with the patient.
All these failures may significantly affect outcomes, quality and stability of correction.
Gustavo Mattos Barreto / Henrique Oliveira Feitosa
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