{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T09:30:42Z","timestamp":1762075842135,"version":"build-2065373602"},"reference-count":32,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,11,23]],"date-time":"2022-11-23T00:00:00Z","timestamp":1669161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Background: The present study aims to define through questionnaires the frequency and the variety of accidental incidents occurring in orthodontic clinical practice among Greek practicing orthodontists. Methods: A questionnaire survey was conducted among orthodontists from the registry of orthodontists in Greece. The questionnaire was divided into two parts. The first part involved three questions relating to the socio-demographic status and the background of the orthodontist, and the second part concerned exclusively the frequency of accidental incidents that have occurred during clinical practice with three possible answers: never, once, more than once. Results: From the 200 initially distributed questionnaires, 124 were finally completed and sent back (response rate: 62%). The results showed that orthodontists with more years of clinical practice had faced more accidental incidents. Among the ingestion incidents caused by foreign objects, the most frequently occurring was the ingestion of elastic separators, followed by the ingestion of elastic ligatures and ingestion of hooks. The most commonly reported traumatic incidents were the trauma-lesion of the mucosa by the orthodontic wire or part of it, followed by trauma-lesion by hooks and wire ligatures. The reported number of incidents with further complications and with patients referred to an emergency room was very low. Conclusions: The results of the present study determined a high frequency of accidental incidents among Greek orthodontists. The longer clinical experience was accompanied by more accidental incidents. Orthodontists, like other health professionals, must learn and continuously update their knowledge regarding the management protocols of medical emergencies.<\/jats:p>","DOI":"10.3390\/children9121801","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T01:46:56Z","timestamp":1669254416000},"page":"1801","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Frequency and Management of Accidental Incidents in Orthodontics"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5435-4889","authenticated-orcid":false,"given":"Ioannis A.","family":"Tsolakis","sequence":"first","affiliation":[{"name":"Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isidora","family":"Christopoulou","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, National and Kapodistrian University of Athens, 15772 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7064-5312","authenticated-orcid":false,"given":"Kalliopi","family":"Siotou","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, National and Kapodistrian University of Athens, 15772 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3331-1633","authenticated-orcid":false,"given":"Antigoni","family":"Alexiou","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, National and Kapodistrian University of Athens, 15772 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasilis","family":"Psarras","sequence":"additional","affiliation":[{"name":"Department of Stomatognathic Physiology, Orofacial Pain Clinic, National and Kapodistrian University of Athens, 15772 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erofili","family":"Papadopoulou","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine & Pathology and Hospital Dentistry, School of Dentistry, National and Kapodistrian University of Athens, 10679 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3019-5438","authenticated-orcid":false,"given":"Apostolos I.","family":"Tsolakis","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, National and Kapodistrian University of Athens, 15772 Athens, Greece"},{"name":"Department of Orthodontics, Case Western Reserve University, Cleveland, OH 44106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"561","DOI":"10.12968\/denu.2006.33.9.561","article-title":"Foreign body ingestion and aspiration in dentistry: A review of the literature and reports of three cases","volume":"33","year":"2006","journal-title":"Dent. Update"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Tsolakis, I.A., Gizani, S., Tsolakis, A.I., and Panayi, N. (2022). Three-Dimensional-Printed Customized Orthodontic and Pedodontic Appliances: A Critical Review of a New Era for Treatment. Children, 9.","DOI":"10.3390\/children9081107"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Tsolakis, I.A., Gizani, S., Panayi, N., Antonopoulos, G., and Tsolakis, A.I. (2022). Three-Dimensional Printing Technology in Orthodontics for Dental Models: A Systematic Review. Children, 9.","DOI":"10.3390\/children9081106"},{"key":"ref_4","first-page":"22","article-title":"Accidental aspiration of a cast crown during attempted delivery","volume":"67","author":"Lanning","year":"1988","journal-title":"J. Indian Dent. Assoc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.14219\/jada.archive.1996.0415","article-title":"Foreign body aspiration in dentistry: A review","volume":"127","author":"Cameron","year":"1996","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/0016-5085(88)90632-4","article-title":"Management of foreign bodies of the upper gastrointestinal tract","volume":"94","author":"Webb","year":"1988","journal-title":"Gastroenterology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/S0300-9785(86)80116-8","article-title":"Foreign bodies of dental origin in the air and food passages","volume":"15","author":"Tamura","year":"1986","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/0889-5406(87)90295-2","article-title":"Ingested retainer: A case report","volume":"92","author":"Hinkle","year":"1987","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_9","first-page":"126","article-title":"Accidental swallowing of orthodontic expansion appliance keys: A report of two cases","volume":"50","author":"Nazif","year":"1983","journal-title":"ASDC J. Dent. Child."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.ajodo.2011.05.009","article-title":"Accidental swallowing of orthodontic expansion appliance key","volume":"140","author":"Maia","year":"2011","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1016\/j.ajodo.2009.04.026","article-title":"Foreign body ingestion of orthodontic origin","volume":"139","author":"Tripathi","year":"2011","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1179\/bjo.18.1.51","article-title":"Medical complications in orthodontics","volume":"18","author":"Parkhouse","year":"1991","journal-title":"Br. J. Orthod."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1259\/dmfr.24.2.9515387","article-title":"The location and tracking of swallowed dental appliances: The role of radiology","volume":"24","author":"Absi","year":"1995","journal-title":"Dentomaxillofac. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.ajodo.2009.04.025","article-title":"Accidental ingestion of a fractured Twin- block appliance","volume":"139","author":"Rohida","year":"2011","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_15","first-page":"169","article-title":"Case report\u2014Swallowed piece of archwire","volume":"12","author":"Lee","year":"1992","journal-title":"Aust. Dent. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/S1079-2104(99)70004-1","article-title":"Foreign body ingestion and aspiration","volume":"88","author":"Zitzmann","year":"1999","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endodontol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1179\/146531207225022131","article-title":"Ingestion of a quadhelix appliance requiring surgical removal: A case report","volume":"34","author":"Allwork","year":"2007","journal-title":"J. Orthod."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1097\/00007611-198107000-00038","article-title":"Fatal ingestion of a radiolucent prosthesis","volume":"74","author":"Raff","year":"1981","journal-title":"South. Med. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1097\/00007611-197511000-00027","article-title":"Historical aspects of foreign bodies in the air and food passages","volume":"68","author":"Clerf","year":"1975","journal-title":"South. Med. J."},{"key":"ref_20","first-page":"203","article-title":"A lethal ectopic denture: An unusual case of sigmoid perforation due to unnoticed swallowed dental plate","volume":"44","author":"Ghori","year":"1999","journal-title":"J. R. Coll. Surg. Edinb."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1038\/sj.bdj.4801046a","article-title":"Ingested foreign bodies associated with orthodontic treatment: Report of three cases and review of ingestion\/aspiration incident management","volume":"190","author":"Milton","year":"2001","journal-title":"Br. Dent. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1093\/ortho\/27.4.295","article-title":"Hazards of Orthodontics Appliances and the Oropharynx","volume":"27","author":"Dibiase","year":"2000","journal-title":"J. Orthod."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"408","DOI":"10.3109\/00016357.2014.971867","article-title":"Inhalation or ingestion of orthodontic objects in Finland","volume":"73","author":"Varho","year":"2015","journal-title":"Acta Odontol. Scand."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1111\/j.1365-263X.2010.01078.x","article-title":"Oral mucosal lesions during orthodontic treatment","volume":"21","author":"Baricevic","year":"2011","journal-title":"Int. J. Paediatr. Dent."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1038\/sj.bdj.4810891","article-title":"Orthodontics. Part 6: Risks in orthodontic treatment","volume":"19","author":"Travess","year":"2004","journal-title":"Br. Dent. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"115","DOI":"10.5152\/TurkJOrthod.2019.18001","article-title":"Accidental Swallowing of a Molar Band","volume":"32","author":"Mahto","year":"2019","journal-title":"Turk. J. Orthod."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1067\/mhn.2002.123834","article-title":"Unrecognized aspiration of a dental retainer: A case report","volume":"126","author":"Klein","year":"2002","journal-title":"Otolaryngol.-Head Neck Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1093\/ejo\/cjm089","article-title":"Eighteen-month bracket survival rate: Conventional versus self-etch adhesive","volume":"30","author":"Reis","year":"2008","journal-title":"Eur. J. Orthod."},{"key":"ref_29","first-page":"863","article-title":"Six-month bracket survival with a self-etch adhesive","volume":"76","author":"Quioca","year":"2006","journal-title":"Angle Orthod."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1017\/S0022215100117025","article-title":"Inhalation of dental plates\u2014A hazard of radiolucent materials","volume":"105","author":"Knowles","year":"1991","journal-title":"J. Laryngol. Otol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"45","DOI":"10.14219\/jada.archive.2011.0027","article-title":"Medical emergencies in a dental office: Inhalation and ingestion of orthodontic objects","volume":"142","author":"Bilder","year":"2011","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_32","first-page":"21","article-title":"Emergency orthodontic care","volume":"22","author":"Sachan","year":"2011","journal-title":"Int. J. Orthod."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/12\/1801\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:25:09Z","timestamp":1760145909000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/9\/12\/1801"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,23]]},"references-count":32,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["children9121801"],"URL":"https:\/\/doi.org\/10.3390\/children9121801","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2022,11,23]]}}}