Periodontal health and esthetic results in impacted teeth exposed by apically positioned flap technique

Abstract

Objectives: This study evaluates the periodontal health status and the esthetic results of teeth subjected to orthodontic traction, after their exposure by an apically positioned flap. Study design: Fifteen patients were included in the study, ages between 11 and 28 years old. The fenestrated teeth and their homologous contralateral normally erupted teeth, used as control, were evaluated. Results: Statistically significant differences were found in the position of the gingival margin (p = 0.005), with an average distance between cemento-enamel junction (CEJ) and gingival margin of 2.47 mm (SD 1.19) in control teeth and of 1 mm (SD 1.31) in the operated teeth, and in the depth of palatal probing (p = 0.031), with 2.1 mm (SD 0.9) for the experimental teeth and 1.7 mm (SD 0.8) for the control teeth. The gingival index, the bleeding during probing and the probing depth did not show statistically significant differences. The patient's subjective esthetic evaluation was more favorable for the control teeth in most of the cases. Conclusions: The surgical approach for the impacted teeth by means of the apically positioned flap resulted to be a predictable technique allowing the maintenance of the periodontal health on a long-term basis.

Management impacted maxillary central incisor and abnormality of labial frenulum in children: case report

“…The available room for tooth alignment was sufficient in this situation, and the tooth was brought into the correct anatomical position in the dental arch. It has been proposed and demonstrated that the “window” technique results in statistically significant loss of attachment, recession, and gingival irritation on the maxillary incisor after surgical exposure [ 11 ]. As a result, either keratinized gingiva or an apical flap must be maintained.…”

“…This method seeks to achieve keratinized gingiva all the way around the emerging tooth. It is critical for a tooth to emerge via connected gingival rather than alveolar mucosa [ 11 ]. If the impacted tooth is diagnosed with its root fully grown or if it is in an unfavorable position, a combination of surgical and orthodontic therapy is required.…”

Recovery of multiple impacted maxillary teeth in a hyperdivergent Class I patient using Temporary Skeletal Anchorage Devices and augmented corticotomy

“…Vermette et al 18 reported the presence of gingival scarring in 90% of open exposure cases. The closed eruption technique is reported 19 to result in better esthetics and periodontal health. To improve the eruption prognosis of the teeth as well as the periodontal health, some surgical procedures were necessary.…”

Orthodontic Management with Traction and Asymmetric Extraction for Multiple Impacted Permanent Maxillary Teeth – A Case Report

“…Vermette [11] referred to this as “gingival scarring”, and reported its presence in 90 percent of their open-exposure cases. To the contrary, closed-eruption is capable of achieving a superior outcome regarding on the aesthetics and periodontal health [12]. In order to improve the eruption prognosis of the tooth as well as its periodontal health and esthetic, the surgeon should keep in mind certain details regarding surgical technique.…”