Case report: orthodontic separators as periodontal ligatures in periodontal bone loss

Periodontal destruction due to subgingival elastic bands was first reported in the dental literature nearly 130 years ago, and has involved over 20 cases. Destruction due to orthodontic separators used during fixed appliance therapy is a less common occurrence. A case report is presented which illustrates the severe periodontal destruction, which can occur when separators are misused. The subsequent treatment of this problem is also described. Emphasis is placed on the correct use of these orthodontic adjuncts and, appropriate monitoring of the gingival health of orthodontic patients.