Orthodontic bracket lost in the airway during orthognathic surgery

In orthodontic treatment before orthognathic surgery, all erupted molars should be banded or bonded to prevent the creation of an occlusal step. Bonded attachments are often used rather than bands because it is easier to bond to partially erupted teeth, there is no need for orthodontic separation or cementation, and they offer improved periodontal health and patient comfort. However, bonded brackets can fail during conventional orthodontic treatment, and the chance of failure might be greater during surgical procedures. Our purpose in this article was to report an intraoperative second-molar bracket failure in the airway during orthognathic surgery. Although there are advantages of bonding relative to banding for molars, the technique should be used with caution in patients who will require surgery because of the high failure rate of molar bonds and the potential for serious consequences associated with failure during surgery, including contamination or infection.