• Journal of Periodontal and Implant Science
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• v.29 no.3
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• pp.635-645
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• 1999

The present study examines the effects of orthodontic treatment of surgically exposed impacted upper canines or ectopically erupted upper canines to periodontal condition and whether various opening procedures have significant difference in postoperative periodontal status. The subjects included 23 orthodontic patients(7 men, 16 women) with unilateral upper canine impaction treated either with closed eruption technique(group I), with apically positioned flap procedure (group II), and those with canines ectopically erupted through keratinized gingiva (group III). In each subject, the ectopic canine was orthodontically aligned, and changes in periodontal tissue were assessed by measuring keratinized gingival width, attached gingival width, probing depth and bone probing depth. In all three groups, the width of keratinized gingiva was preserved while showed no signs of detrimental periodontal condition such as gingival recession. In all three groups, no significant difference in periodontal pocket depth from control was observed. The width of attached gingiva was significantly greater in patients treated with apically positioned flap procedure(group II) than in patients on other groups.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.4
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• pp.512-518
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• 2010

The impaction of the maxillary permanent incisor is a common clinical problem and is mostly found at the "labial to the alveolar process." Surgical exposure and orthodontic treatment with fixed orthodontic appliances can be considered if normal eruption of the labillay impacted tooth is not expected. Surgical exposure of the impacted tooth, that is usually under the attached gingiva or is surrounded by alveolar bone through gingivectomy and removal of alveolar bone, may give a rise to complications such as diminution in the width of the attached gingiva, inflammation of the gingiva, and the loss of marginal alveolar bone. Therefore, closed eruption technique, which includes surgical exposure and orthodontic treatment with fixed orthodontic appliances followed by repositioning of surgical flap, is preferred. However, apically repositioned flap of the impacted tooth, which is beneath the movable submucosal area or is above the alveolar crestal area, can prevent unwanted exposures and facilitate successful tooth eruption. In this report, we described esthetic results of three patients with unerupted maxillary permanent incisor who were performed with an apically positioned flap without the loss of attached gingiva.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.8 no.2
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• pp.118-121
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• 2012

Down syndrome (DS) is a genetic disease known as trisomy 21. Congenital cardiac anomalies are present in about 40% of DS patients. Dental anomalies are also common among DS patients. In DS patients, canine impaction is 10 times more frequent and transposition of maxillary canine and first premolar is 50 times more common than in general population. A female DS patient with congenital heart disease was diagnosed as having a transposed impacted maxillary canine. Sectional fixed appliance with Nance holding arch was used for the orthodontic treatment. After space was regained for the eruption of the canine, orthodontic button was attached using flap operation with closed technique. Traction and alignment of the tooth followed. To prevent endocarditis, prophylactic antibiotics were prescribed for the recommended dental procedures. Total treatment time was 25 months and no complication was found.