Dental Complications During Orthodontic Preparation and Orthognathic Surgery

Serge Ketoff · Nicolas Sigaux · Monique Raberin · Pierre Bouletreau

Orthod Fr · 2018 · 89(2):137-144

A well-conducted orthodontic–surgical treatment remains safe, but it is not without risk for the teeth and periodontium. Dr Serge Ketoff, first author of this article in the French Orthodontic journal, reviews these rare but avoidable complications and how to anticipate them.

In brief

  • Dental complications of orthodontic–surgical treatment are rare but can compromise a treatment plan.
  • Knowing them allows prevention and proper patient information.
  • The key: close orthodontist–surgeon collaboration at every step.

Why this article?

Orthodontic preparation followed by orthognathic surgery moves the teeth and alveolar bone over several months. The incidence of complications remains low, but when they occur they can delay or weaken the outcome. The authors review at-risk situations to help clinicians factor them in from the planning stage.

The main complications described

  • Periodontal damage (gingival recessions, bony dehiscences) during decompensation tooth movements.
  • Root resorption promoted by large or prolonged displacements.
  • Alveolar ridge damage at the osteotomy lines.
  • Pulp injury or loss of vitality in teeth close to the osteotomies.

What it changes in practice

Patient information must explicitly mention these dental and periodontal risks. Prevention relies on prior periodontal assessment, controlled orthodontic movements and ongoing coordination between orthodontist and surgeon to adapt osteotomy lines to root anatomy.

Key points

  • Low but real risk to teeth and periodontium.
  • Periodontal and root assessment before starting.
  • Informed consent including dental risk.
  • Orthodontist–surgeon collaboration essential.

Reference : Ketoff S, Sigaux N, Raberin M, Bouletreau P. Complications dentaires lors de la préparation orthodontique et de la chirurgie orthognathique. Orthod Fr. 2018;89(2):137-144.

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