Severe localized destruction of the periodontium secondary to subgingival displacement of an elastic band. Report of a case

A seven-year-old male with localized severe periodontal destruction at the maxillary central incisior region presented for treatment. There was a history of acute trauma, but local factors were inconsistent with the clinical picture. Initial treatment consisting of palliative nonsurgical debridement coupled with systemic tetracycline resulted in a more chronic lesion with progressive bone loss. Surgical entry revealed an elastic band close to the apices of the central incisors. Removal of the etiologic agent has resulted in increased radiographic bone density and decreased probing depths. Periodontal lesions induced by elastic bands are difficult to diagnose but have several features in common that may aid in rapid diagnosis and treatment.