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Published on: August 16, 2019
Uncovering labially impacted teeth: apically positioned flap and closed-eruption techniques
M E Vermette1, V G Kokich, D B Kennedy
1Department of Orthodontics. University of Washington, SM-46, Seattle 98195, USA.
The Angle Orthodontist
|January 1, 1995
Summary
The closed-eruption technique for uncovering impacted teeth results in better esthetics and fewer periodontal issues compared to the apically positioned flap method. This finding aids in selecting optimal surgical approaches for impacted maxillary anterior teeth.
Area of Science:
- Dentistry
- Orthodontics
- Periodontology
Background:
- Labially impacted maxillary anterior teeth require surgical uncovering for orthodontic treatment.
- Two common techniques are the apically positioned flap (APF) and closed-eruption (CE).
- Esthetic and periodontal outcomes following these procedures require detailed comparison.
Purpose of the Study:
- To compare the esthetic and periodontal outcomes of APF versus CE techniques for uncovering labially impacted maxillary anterior teeth.
- To evaluate differences in gingival margins, attachment levels, bone levels, and root length.
- To assess long-term esthetic results, including gingival scarring and tooth relapse.
Main Methods:
- A comparative study of 30 patients with unilateral labially impacted maxillary anterior teeth.
- Patients were divided into APF (18) and CE (12) groups.
- Clinical, radiographic, and photographic assessments were performed at least three months post-treatment.
Main Results:
- CE group: Less attached gingiva width and increased probing bone level on the facial surface.
- APF group: Apical gingival margins, increased crown length, probing attachment level, and attached gingiva width; gingival scarring.
- Both groups: Shorter roots; APF group showed vertical tooth relapse.
Conclusions:
- The apically positioned flap technique leads to more unesthetic outcomes than the closed-eruption technique for uncovering labially impacted maxillary anterior teeth.
- CE technique offers superior esthetic results and fewer periodontal complications.
- These findings guide the selection of surgical techniques for improved patient outcomes.

