Comparison of surgical and non-surgical methods of treating palatally impacted canines. I. Periodontal and pulpal outcomes.
BACKGROUND
Inferior periodontal and pulpal outcomes may follow surgical exposure of palatally impacted maxillary canines.


OBJECTIVE
To compare the periodontal and pulpal health of palatally impacted maxillary canines following either surgical exposure and assisted eruption (SE) or unassisted eruption following extraction of the overlying deciduous canine and orthodontic creation of space in the arch (OT).


METHODS
Twenty-eight subjects (OT group: N = 14; SE group: N = 14) with unilateral palatally impacted canines were examined at least six months after orthodontic treatment. The gingival index score, plaque index score, pocket depth, attachment loss, tenderness to percussion, pulpal responses to stimuli and radiographic assessment of changes in the pulpal cavities and peri-radicular areas were collected on the maxillary canines, lateral incisors and premolars. The contralateral teeth were used as controls.


RESULTS
There were no significant differences in the plaque index scores, the gingival index scores or the periodontal outcomes between the impacted canines in the two groups (SE and OT). More impacted canines than control canines had lost some periodontal attachment in the SE group (p = 0.004). Although more lateral incisors, canines and premolars on the impacted side had partially obliterated pulps than the corresponding teeth on the control side, the teeth in both groups had similar pulpal responses (p = 0.064).


CONCLUSIONS
Natural eruption and conservative surgical exposure with orthodontic alignment have minor effects on the periodontium. Impacted canines treated surgically and non-surgically had a higher prevalence of pulpal changes than the control canines. Ultimately, the choice of treatment may depend on the clinical indications, the patient's and the orthodontist's preferences.
Ling
Kwok K
KK
School of Dentistry, University of Queensland and Specialist Practice, Brisbane, Australia.
Ho
Christopher T C
CT
Kravchuk
Olena
O
Olive
Richard J
RJ
D000293:Adolescent; D003481:Cuspid / Q000473:pathology*; D003774:Dental Plaque Index; D003784:Dental Pulp Calcification / Q000209:etiology*; D003791:Dental Pulp Test; D005260:Female; D006801:Humans; D008297:Male; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D050793:Orthodontic Extrusion / Q000009:adverse effects; D017622:Periodontal Attachment Loss / Q000209:etiology*; D010512:Periodontal Index; D011861:Radiography, Dental; D012189:Retrospective Studies; D013027:Space Maintenance, Orthodontic; D018709:Statistics, Nonparametric; D014078:Tooth Eruption; D014081:Tooth Extraction; D014087:Tooth Movement Techniques / Q000009:adverse effects*; D014094:Tooth, Deciduous / Q000601:surgery; D014095:Tooth, Impacted / Q000601:surgery / Q000628:therapy*