Periodontal Problems Associated with the Surgical Exposure of Unerupted Teeth

Abstract

Conventional excisional surgical exposure of an unerupted tooth into the mobile non-keratinized alveolar mucosa results in elongation of the clinical crown, a narrow and non-functional buccal gingival zone, and a predisposition to chronic inflammation of the affected oral mucosa. Use of alternative flap techniques designed to conserve a keratinized mucosa in relation to the crown are only partially successful in avoiding these problems. Surgical exposure of teeth therefore should be avoided whenever possible. On the rare occasions when it becomes necessary, a flap technique must be used to minimise postoperative periodontal pathology.

Periodontal health of palatally displaced canines treated with open or closed surgical technique: A multicenter, randomized controlled trial

“…Whereas orthodontic treatment has been found to be mildly detrimental to the periodontium, 3 case reports have described severe periodontal destruction in some cases of aligned palatally displaced canines (PDC). 4 Burden and colleagues 5 highlighted controversy in the literature regarding the periodontal outcome of an Open or Closed surgical exposure and subsequent orthodontic alignment of the PDC. Reported periodontal problems included loss of alveolar bone height, increase in pocket probing depths and loss of attached gingivae.…”

Surgical and orthodontic treatment of an impacted permanent incisor: case report

“…Ankylosis, nonvital pulps and root resorptions may occur with this method (14). Gingival recession, delay in periodontal healing, gingivitis, bone loss and decrease in the width of keratinized gingiva are the periodontal complications of orthodontically erupted teeth (9,(15)(16)(17)(18). These periodontal complications occur most commonly when an extensive amount of bone is removed or an open approach method is used to expose the impacted teeth, surgically.…”

Conventional wisdom and the surgical exposure of impacted teeth

“…Nevertheless, clinical research performed over the past 30 years has demonstrated that a radical open exposure approach is potentially harmful to the periodontal outcome of the resolved impaction. The research also illustrates that a more conservative alternative is available, producing successful outcomes in terms of both health and appearance (3–23).…”