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

Introduction: The aim of this study was to investigate differences in the periodontal outcomes of palatally displaced canines (PDC) exposed with either an open or a closed surgical technique.

Methods: A multicenter, randomized controlled trial was undertaken in 3 hospitals in the United Kingdom, involving 2 parallel groups. Patients with unilateral PDC were randomly allocated to receive either an open or a closed surgical exposure. Periodontal health was assessed 3 months after removal of fixed appliances. Parameters measured included clinical attachment levels, recession, alveolar bone levels, and clinical crown height.

Results: Data from 62 participants (closed, 29; open, 33) were analyzed. There was no difference between PDC exposed with an open vs a closed surgical technique (mean difference, 0.1 mm; 95% confidence interval [CI], -0.2-0.5). There was, however, a statistical difference in mean attachment loss between the operated and unoperated (contralateral) canines (mean difference, 0.5 mm; 96% CI, 0.4-0.7; P <0.001). Twenty of the 62 subjects had some recession on the palatal aspect of the operated canine, whereas only 4 subjects had some visible root surface on the palatal aspect on the unoperated side (P = 0.001).

Conclusions: There is a periodontal impact when a unilateral PDC is exposed and aligned. This impact is small and unlikely to have clinical relevance in the short term; however, the long-term significance is unknown. When the open and closed techniques were compared, no difference in periodontal health was found.