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Which surgical approach for palatally displaced canines?
1Department of General Practice, Virginia Commonwealth University, School of Dentistry, Richmond, Virginia, USA.
Evidence-Based Dentistry
|March 24, 2018
Summary
Surgical exposure of palatally displaced canines is effective for orthodontic alignment. However, current evidence does not favor open versus closed surgical techniques, with limited data and high risk of bias in included studies.
Area of Science:
- Oral Surgery
- Orthodontics
- Evidence-Based Dentistry
Background:
- Palatally displaced canines are a common dental anomaly requiring surgical intervention.
- Surgical exposure facilitates orthodontic alignment of these impacted teeth.
Purpose of the Study:
- To systematically review and synthesize evidence comparing open versus closed surgical exposures for palatally displaced canines.
- To assess the efficacy and complications associated with different surgical techniques.
Main Methods:
- A systematic review was conducted, including randomized and quasi-randomized controlled trials.
- Searches covered major databases (Cochrane Oral Health, Medline, Embase) and clinical trial registries.
- Data on eruption success, complications, and aesthetics were extracted and analyzed.
Main Results:
- Three studies (146 participants) were included, with one RCT and two quasi-RCTs.
- No significant difference in successful canine eruption was found between open and closed surgical groups (RR 0.99, 95% CI 0.93-1.06).
- Insufficient data prevented pooling of results for complications or aesthetics due to heterogeneity.
Conclusions:
- Surgical exposure is generally successful for palatally displaced canine eruption and alignment.
- Current evidence does not support a superior surgical approach (open vs. closed).
- The limited evidence base and high risk of bias in some studies necessitate cautious interpretation.
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