title: Periodontal status after surgical-orthodontic treatment of labially impacted canines with different surgical techniques: A systematic review.
abstract: BACKGROUND
  Good periodontal status is essential for a successful treatment outcome of impacted maxillary canines. Whereas the surgical technique used for tooth uncovering has been shown not to affect the final periodontal status of palatally impacted canines, its effect on labially impacted canines is still unclear.
  
  
  METHODS
  Searches of electronic databases through January 2015 and reference lists of relevant publications were used to identify studies evaluating the periodontal status of labially impacted canines after combined surgical-orthodontic treatment. Two reviewers independently screened the articles, extracted data, and ascertained the quality of the studies.
  
  
  RESULTS
  Ninety-one studies were identified; 3 were included in the review. No included study examined the periodontal outcome of the closed eruption technique. Excisional uncovering was reported to have a detrimental effect on the periodontium (bleeding of the gingival margin, 29% vs 7% in the control group; gingival recession, -0.5 mm [SD, 1.0] vs -1.5 mm [SD, 0.8] in the control group; and width of keratinized gingiva, 2.6 mm [SD, 1.4] vs 4.1 mm [SD, 1.5] in the control group). Impacted canines uncovered with an apically positioned flap had periodontal outcomes comparable with those of untreated teeth.
  
  
  CONCLUSIONS
  The current literature is insufficient to determine which surgical procedure is better for periodontal health for uncovering labially impacted canines.
authors.affiliation: PhD student, Unit of Orthodontics, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Incerti-Parenti
authors.affiliation: Researcher, Department of Medical Sciences, University of Trieste, Trieste, Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Checchi
authors.affiliation: Postgraduate student, Department of Orthodontics, School of Dentistry, University of Brescia, Brescia, Italy.
authors.forename: Daniela Rita
authors.initials: DR
authors.lastname: Ippolito
authors.affiliation: Assistant professor, Department of Neuroscience, University of Padua, Padua, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gracco
authors.affiliation: Associate professor, Unit of Orthodontics, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy. Electronic address: giulio.alessandri@unibo.it.
authors.forename: Giulio
authors.initials: G
authors.lastname: Alessandri-Bonetti
mesh_terms: D003481:Cuspid / Q000601:surgery*; D005881:Gingiva / Q000473:pathology; D005884:Gingival Hemorrhage / Q000209:etiology; D005889:Gingival Recession / Q000209:etiology; D006801:Humans; D007633:Keratins; D050793:Orthodontic Extrusion / Q000379:methods*; D010512:Periodontal Index; D013524:Surgical Flaps / Q000601:surgery; D014095:Tooth, Impacted / Q000601:surgery* / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D007633:Keratins