Surgical exposure, orthodontic movement, and final tooth position as factors in periodontal breakdown of treated palatally impacted canines

Twenty-three patients who had completed orthodontic treatment for the resolution of unilateral palatal canine impactions were examined 2.3 years (mean) after all appliances were discarded. The patients were divided into two groups on the basis of whether the surgical exposure was "light" or "heavy". The whole group was also divided according to the type of orthodontic movement that was carried out-"light" for tipping, extrusive, and rotating movements and "heavy" for root movements. Final position of the teeth was classified as ideal or incomplete if rotations or spaces were present. The results showed marked deteriorative changes where the surgery had been more radical and where the tooth movement involved active alteration of root position. No change due to abnormal tooth position was seen. It is suggested that, in these cases, surgical procedures be limited in scope and that exposure of the cementoenamel junction be avoided.