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Abstract

Background: Impaction of maxillary central incisors can result in aesthetic problems. The aim of this retrospective study was to examine the periodontal outcomes of impacted maxillary central incisors after surgical exposure and orthodontic extrusion compared to naturally erupted, contralateral incisors (control). Methods: Patients (N=80, 80 central incisors), who had been treated by a surgical-orthodontic approach, underwent a periodontal examination after 6 to 146 months. Periodontal parameters (crown length, keratinized gingival width, gingival scar, and bone loss) of the orthodontically extruded incisors were scored and compared with those of the naturally erupted contralateral incisors (control) in a masked set-up. Results: The extruded maxillary central incisors had longer crowns (Δ = 0.6 mm, p < 0.001), narrower keratinized gingival widths (Δ = - 0.9 mm, p < 0.001), higher incidence of gingival scars (Δ = 14%, p < 0.001), and lower bone levels (Δ = 0.4 mm, p = 0.001 and Δ = 0.5 mm, p < 0.001; respectively for mesial and distal sides) than the controls. Conclusions: The data indicate that surgical-orthodontic treatment of impacted maxillary central incisors does not jeopardize their periodontal health but compromised periodontal aesthetics. This surgical-orthodontic approach should be advocated as the treatment of choice, even for dilacerated incisors in the absence of ankylosis. However, additional periodontal surgery might be needed to improve appearance.

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