Determinants of orthodontic emergency events in patients treated with fixed appliances: A single-center retrospective cohort study

Introduction An orthodontic emergency refers to an unexpected issue related to an orthodontic device that requires a prompt, unscheduled visit to a dental professional for proper treatment. The purpose of the current investigation was to explore determinants of emergency events during fixed orthodontic treatment. Material and methods This retrospective cohort study analysed patient treatment data from a private orthodontic clinic over the past decade, using linear regression models to identify factors associated with orthodontic emergency events. Results A total of 373 patients were included, with a median age of 14 years (IQR: 12, 17) and most were female ( n = 222, 59.5%). An emergency occurrence rate of 28.4 per cent was documented. Most emergencies occurred during the first year of treatment ( n = 166, 67.2%) and were documented in the mandible ( n = 184, 74.5%). Four main categories were detected: 1) Orthodontic appliance failure, 2) Ligation system malfunction, 3) Archwire complications and 4) Oral lesions. Most events were in the first category ( n = 151, 61.1%), with debonded bracket ( n = 109, 44.1%) being the predominant. Multivariable linear regressions revealed that male sex ( P < 0.001) and hypodivergent Vertical skeletal pattern ( P = 0.004) were associated with increased emergency events, while male sex ( P < 0.001) was associated with increased appliance failures, but adults ( P = 0.03) were associated with decreased appliance failures. Conclusions An emergency occurrence rate of 28.4 per cent was documented. Sex and vertical skeletal pattern were significant factors of increased emergencies, with males and hypodivergent patients having more orthodontic emergency events. Sex and age were significant factors of increased appliance failures, with females and adults demonstrating fewer appliance failures.