A retrospective long-term pulpal, periodontal, and esthetic, follow-up of palatally impacted canines treated with an open or closed surgical exposure technique using the Maxillary Canine Aesthetic Index.

Introduction: The primary objective of this study was to compare the aesthetic outcome of palatally impacted canines treated with an open or closed surgical exposure technique using the Maxillary Canine Aesthetic Index (MCAI) at least 1 year after debonding. Secondary objectives were set on the periodontal outcome, tooth color, pulpal status, and self-reported contentment.

Methods: The sample of this retrospective study consisted of 53 patients with an average age of 20 years and 7 months at the time of the investigation. A total of 53 canines were investigated. All canines were aesthetically scored with the MCAI. Other outcome variables were investigated, such as gingival inflammation, pocket probing depth, vitality, percussion sensitivity, and tooth color. All patients received a questionnaire to evaluate their appraisal of different parameters.

Results: A statistically significant difference (P < 0.001) was found between the groups treated with an open and closed technique in terms of the MCAI. The closed technique scored excellent in terms of aesthetics, whereas the open technique scored good. The closed technique had more discoloration (P < 0.001) and a delayed response to the cold test (P = 0.021). In general, patients were satisfied with both techniques but considered the treatment time to be very long.

Conclusions: A closed surgical exposure of palatally impacted maxillary canines is preferred in terms of aesthetics when measured with the MCAI. There was no difference between the 2 techniques in terms of periodontal outcome. Canines treated with a closed exposure tended to have a darker color and delayed response to cold testing.