Unintended Errors in Orthodontic Clinical Practice: A Cross-sectional Survey

Abstract

 Background: The use of fixed orthodontic appliance is usually accompanied with complex mechanotherapy involving several steps. The complex processes involve band placement, bonding of orthodontic brackets, archwire selection and ligation amongst others. This study aims to estimate the incidence and the causes of unintended errors during fixed orthodontic treatment among orthodontic practitioners.

Methods: This study was an electronic questionnaire-based survey conducted among 53 orthodontics practitioners. Data was collected over a 7-month period (September, 2022 to March, 2023). Simple descriptive analysis of the data was done on Statistical Package for the Social Sciences (SPSS) version 22.

Results: Wrong bracket positioning 53 (100%), missed bracket ligation 51 (96.2%) and non-placement of bend-backs (when indicated) 51 (96.2%) were the errors mostly reported by the respondents while the least reported errors were: placement of bend-back when not indicated 23 (43.4%), unintentional use of wrong archwire materials 28 (52.8%) and swapping archwires between the arches, 28 (52.8%). Majority of the participants were of the opinion that stressful working environment (67.9%), inadequate materials (52.8%) and shortage of manpower (35.8%) were responsible for the mistakes commonly encountered. Majority of the participants also agreed that orthodontic checklist would help to reduce the incidence [30 (56.6%)] of the unintended errors and were willing to apply [35(66.0)] the orthodontic checklist in their practices.

Conclusion: Wrong bracket position was the most occurring error among the participants and majority of the participants agreed that orthodontic checklist would reduce the incidence of the errors. Therefore, there is the need to develop a workable orthodontic checklist.