The surgical exposure and application of direct traction of unerupted teeth

This article presents a retrospective study of patients treated for impacted maxillary canines by a combined surgical and orthodontic approach. All patients were assessed radiographically by means of a lateral skull radiograph and an orthopantograph. No posteroanterior radiographs were taken. Facial or lingual position within the arch was not determined, the height and inclination of the canine being deemed more important. At surgery, a facial flap was raised first in all cases. Only if access and isolation were poor was a palatal flap raised. Bone was removed as necessary. One contention of this article is that the amount of bone removed is not important. It is the manner in which the soft tissues and, in particular, the periosteum are handled that ultimately affects the results of the surgical treatment. An attachment was bonded onto the tooth and the wound closed. The tooth was then actively extruded, a removable appliance being preferable because more vertical control of anchorage is possible.