Severe bone loss caused by orthodontic rubber bands; management and nine-year follow-up: report of case.

This case reports the early diagnosis and treatment of an iatrogenic acute localized periodontitis arising from the incorrect use of orthodontic elastic rubber bands to close a maxillary midline diastema in an eight-year-old girl. The case illustrates the misdiagnosis and mismanagement of a transitional diastema in the "ugly duckling" stage of the mixed dentition. The nine-year follow-up shows that thorough periodontal and orthodontic management has allowed successful retention of both maxillary permanent central incisors, which had initially pathological grade 3 vertical mobility, little remaining alveolar bone, and a hopeless prognosis.