Abstract
AimTwo eruption surgical techniques are commonly described for the treatment of upper impacted central incisors (ICIs): Open and closed. Currently, the closed-eruption surgical technique (CEST) is the most commonly used, as it allows for the best esthetic and periodontal results.The aim of this study was to determine the effect of traction discontinuation on maxillary central incisor sulcal depth and alveolar bone ridge levels compared with contralateral incisors, when CEST is used.Materials and methodsOur study involved 28 unilateral impacted maxillary central incisors treated by CEST. Thirteen teeth were subjected to traction interruption for a month at the time of emergence of the crown, while 15 teeth underwent continuous traction. One year after treatment, periapical digital X-rays, anterosuperior cone beam computerized tomography (CBCT) scanning, and periodontal probing of the ICIs and contralateral central incisors (CCIs) were performed. Student’s t-test was used to study whether a statistically significant difference between continuous and interrupted tractions takes place while using the CCI measurements as reference.ResultsThere was a statistically significant difference between the two techniques only for the following measurements: Mesial probing (p-value 0.039352), labial bone level (p-value 2.58E-08), and palatal bone level (p-value 2.56E-06).LimitationsA larger sample size and longer term follow-up are needed to draw more robust conclusions.ConclusionA temporary discontinuation during traction of the tooth appears to positively impact treatment outcome on ICIs.Clinical significance• The CEST leads to the best periodontal status for ICIs.• The discontinuation of traction at the emergence of the tooth allows the supracrestal fibers to insert into the cement in a proper way.How to cite this article: Sfeir E, Gholmieh M, Skaf Z, Mourad A. Alveolar Bone and Epithelial Attachment Status following Two Different Closed-eruption Surgical Techniques for Impacted Maxillary Central Incisors. Int J Clin Pediatr Dent 2018;11(4):317-322.
Highlights
Impaction of maxillary central incisors is part of the eruption failure of permanent teeth and remains relatively rare with a frequency ranging from 0.06 to 0.2%.1 Numerous causes can be responsible for impaction, including the presence of odontomas, supernumerary teeth, dentigerous cysts, history of trauma of the temporary incisor, or root dilaceration in the incisor.[2,3,4,5,6,7] After addressing the cause, 63.6% of impacted teeth may proceed to their normal eruption.[8,9] many impacted ones still do not erupt.[10]
The closed-eruption surgical technique (CEST) leads to the best periodontal status for ICIs
The discontinuation of traction at the emergence of the tooth allows the supracrestal fibers to insert into the cement in a proper way
Summary
Impaction of maxillary central incisors is part of the eruption failure of permanent teeth and remains relatively rare with a frequency ranging from 0.06 to 0.2%.1 Numerous causes can be responsible for impaction, including the presence of odontomas, supernumerary teeth, dentigerous cysts, history of trauma of the temporary incisor, or root dilaceration in the incisor.[2,3,4,5,6,7] After addressing the cause, 63.6% of impacted teeth may proceed to their normal eruption.[8,9] many impacted ones still do not erupt.[10]. Impaction of maxillary central incisors is part of the eruption failure of permanent teeth and remains relatively rare with a frequency ranging from 0.06 to 0.2%.1. Two surgical techniques are described in the orthodontic literature for the resolution of impacted maxillary central incisors. The CEST, which involves fully replacing the mucoperiostal flap in its former position after an attachment has been bonded to the impacted tooth.[10,11,12] With the CEST, superior outcomes are obtained in terms of the gingival, periodontal, and pulp status. The open-eruption surgical technique (OEST) involves suturing a full thickness of the flap apically, while leaving a portion of the labial surface of the incisor uncovered.[13]
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