Closed-eruption surgical technique for impacted maxillary incisors: a postorthodontic periodontal evaluation

The aim of this study was to evaluate the clinical appearance and pulpal and periodontal status of impacted maxillary central incisors that had been exposed and aligned after a closed-eruption surgical technique. Twenty-one patients were examined 4.5 years (median) postretention. The treated central incisors showed no significant differences in plaque and gingival indexes, widths of attached gingiva, and crown lengths, whereas a small, but statistically significant, increase was found in the mean pocket depth compared with the contralateral incisors. The bone support was reduced by 5% to 6% in the treated teeth, and, in one third of the cases, an abnormal gingival contour was recorded. The lateral incisors revealed similar plaque and gingival indexes and pocket depths on each side, but the lateral incisors immediately adjacent to the treated tooth showed decreased widths of keratinized gingiva and increased crown lengths. Even though statistically significant differences were found in some of the periodontal parameters measured, the overall clinical consequences of a conservative exposure and orthodontic alignment of impacted incisors by the closed-eruption technique are minimal.