Incidence of orthodontic appliance failures during the COVID-19 lockdown period

Introduction As a result of the rapid spread of the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the World Health Organization (WHO) declared a global pandemic on March 11, 2020. Governments around the world adopted various measures to stop or slow the spread of coronavirus disease 2019 (COVID-19). One widely used measure was “lockdown”; workers who could work from home were instructed to do so, and nonessential businesses – including dental clinics -- were closed for weeks or months. The purpose of this investigation was to document the incidence of fixed orthodontic appliance failures and the periodontal health status of patients undergoing fixed orthodontic treatment during and after the lockdown period. Methods The sample comprised 350 orthodontic patients (mean age 16.85 ± 2.59 years; 249 female, 101 male) who underwent orthodontic and periodontal examinations in Adıyaman, Turkey after a mean lockdown period of 103.7 ± 21.3 days. Frequencies of orthodontic bracket, elastic ligature, molar band, and miniscrew failures and of oral ulcers were recorded and periodontal parameters were assessed. The effects of sex, age, and the bracket systems used in the patients on the frequencies of these failures were analyzed. Results It was revealed that 15.42% (n=54) of all patients had at least one bracket bonding failure and 8.16% (n=4) of the patients with miniscrew implantation had at least one miniscrew failure. The incidence of bracket bonding failure was significantly higher in men than in women. No significant relationship was found between periodontal parameters and bracket bonding failure. Plaque and gingival scores were higher than those reported for a similar population before a lockdown. Conclusions The results indicated that orthodontic appliances may have higher frequencies of failure during a lockdown when compared with normal times and lockdown periods may worsen the periodontal health status of the patients.