Open and closed approach for palatally impacted canines
Smailiene D, Kavaliauskiene A, Pacauskiene I, Zasciurinskiene E, Bjerklin K. Palatally impacted maxillary canines: choice of surgical-orthodontic treatment method does not influence post-treatment periodontal status. A controlled prospective study. Eur J Orthod 2013;35:803-10
Two surgical procedures for exposing palatally impacted maxillary canines are frequently used today: the open technique with free eruption and the closed technique. Currently, it is unclear which approach is more advantageous. The goal of this study was to compare palatally impacted canines exposed by both open and closed techniques with naturally erupted canines. Patients were treated for unilateral palatally impacted maxillary canines with either the open technique with free eruption (n = 22) or the closed technique (n = 21). The surgically exposed canine and the naturally erupted canine in the contralateral quadrant were compared 3 to 6 months after deband by measurements including periodontal pocket depths, gingival recession, width of keratinized tissue, and bone support. The results indicated no difference between periodontal pocket depth of impacted canines exposed by the closed or open technique, but naturally erupted canines did have significantly smaller pocket depths (average difference, 0.19 mm). Differences in gingival recession between canines exposed by either technique and naturally erupted canines were not significant. Canines exposed by the open technique displayed a greater width of keratinized tissue, although not significantly greater than those exposed by the closed technique or the naturally erupted canines. There was no significant difference in bone support between impacted canines exposed by the open or the closed technique. Although periodontal measurements did not indicate any clinically relevant differences between the closed and open exposure techniques, the mean time for canine eruption in the open technique group was significantly less (>3 months less) than in the closed technique group. It was concluded that both open and closed surgical approaches to palatally impacted canines provide clinically satisfactory and comparable periodontal status with naturally erupted canines.
Reviewed by Brandon Huang and Christine Hammer
Open bite and root resorption
Motokawa M, Terao A, Kaku M, Kawata T, Gonzales C, Darendeliler MA, et al. Open bite as a risk factor for orthodontic root resorption. Eur J Orthod 2013;35:790-5
Orthodontic root resorption has long been of interest to practitioners because of its prevalence and multifactorial nature. This retrospective study aimed to investigate the prevalence and severity of root resorption in open-bite malocclusions. A population of 111 patients treated nonsurgically with fixed edgewise appliances was split into a nonopen-bite group (n = 57) and an open-bite group (n = 54). In the open-bite group, all teeth were classified as functional or hypofunctional based on the presence or absence of occlusal contacts. Periapical radiographs were taken before and after orthodontic treatment; by using blind evaluation, the teeth were graded on the severity of root resorption and root shape with 5-point scales. Multiple linear regression analyses showed that both open bite and abnormal root shape were associated with root resorption. The open-bite group had a significantly higher prevalence of root resorption in both number of patients and teeth than did the nonopen-bite group; there was no significant difference in severe root resorption between the groups. Additionally, there was a significant difference in the prevalence of abnormal root shape between hypofunctional and functional teeth and a higher prevalence of root resorption in hypofunctional teeth. These results supplement previous research that found open bites to be a risk factor for root resorption, because the greater prevalence of root resorption in hypofunctional teeth suggests that occlusal function might be a protective factor. It is interesting to consider whether devices with vibrating technology can simulate occlusal contacts, thereby reducing the risk of root resorption in an orthodontic patient with open bite.
Reviewed by Natalia Menjivar and Kyle Knudsen
Open bite and root resorption
Motokawa M, Terao A, Kaku M, Kawata T, Gonzales C, Darendeliler MA, et al. Open bite as a risk factor for orthodontic root resorption. Eur J Orthod 2013;35:790-5
Orthodontic root resorption has long been of interest to practitioners because of its prevalence and multifactorial nature. This retrospective study aimed to investigate the prevalence and severity of root resorption in open-bite malocclusions. A population of 111 patients treated nonsurgically with fixed edgewise appliances was split into a nonopen-bite group (n = 57) and an open-bite group (n = 54). In the open-bite group, all teeth were classified as functional or hypofunctional based on the presence or absence of occlusal contacts. Periapical radiographs were taken before and after orthodontic treatment; by using blind evaluation, the teeth were graded on the severity of root resorption and root shape with 5-point scales. Multiple linear regression analyses showed that both open bite and abnormal root shape were associated with root resorption. The open-bite group had a significantly higher prevalence of root resorption in both number of patients and teeth than did the nonopen-bite group; there was no significant difference in severe root resorption between the groups. Additionally, there was a significant difference in the prevalence of abnormal root shape between hypofunctional and functional teeth and a higher prevalence of root resorption in hypofunctional teeth. These results supplement previous research that found open bites to be a risk factor for root resorption, because the greater prevalence of root resorption in hypofunctional teeth suggests that occlusal function might be a protective factor. It is interesting to consider whether devices with vibrating technology can simulate occlusal contacts, thereby reducing the risk of root resorption in an orthodontic patient with open bite.
Reviewed by Natalia Menjivar and Kyle Knudsen
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