Optimal Surgical Approach for Exposing Impacted Canines in Children: Open Technique Proven Superior by Recent Study

A recent comprehensive study has provided valuable insights into the most effective surgical method for exposing impacted canine teeth in children, an issue that has long been debated among orthodontists and oral surgeons. The research, published in the American Journal of Orthodontics and Dentofacial Orthopedics, compares the open and closed surgical techniques, offering evidence-based guidance for clinical decision-making.

Impacted canine teeth are a common concern, affecting approximately 2–3% of children. These teeth fail to erupt normally and instead become trapped within the jawbone, often on the palate side, potentially leading to damage of neighboring teeth roots if left untreated. Managing impacted canines involves surgical exposure followed by orthodontic repositioning, but until now, there was little conclusive evidence favoring one surgical approach over the other.

The study was a randomized controlled trial involving 100 children aged 10 to 16. Participants were randomly assigned to undergo either the open surgical technique, in which gum and bone are removed to allow the tooth to erupt naturally, or the closed technique, where a small chain is attached to the tooth, and the gum is sutured back, initiating tooth movement within two weeks with braces.

Key findings indicated that the open technique is quicker, often reducing procedure time by several minutes. However, children recovering from the open approach experienced more pain, particularly in the first three days, with some reporting discomfort extending over a week. Additionally, the open method was associated with higher rates of bleeding and loss of the surgical dressing, which could delay healing.

Conversely, the closed technique, while taking slightly longer to perform, was reported to be more comfortable for patients with less postoperative pain. Interestingly, the study found that patients in this group used fewer pain medications after the initial days, despite the surgical dressing and suture removal being potentially more uncomfortable.

Overall, the research concluded that the open technique offers the advantage of shorter operation times but at the expense of increased postoperative discomfort and bleeding risk. The closed approach, although slightly more time-consuming, tends to cause less pain and fewer complications, making it preferable in many cases.

These findings empower clinicians and patients with better information, enabling personalized treatment plans. As Dr. Fernandes Færøvig from the University of Oslo explains, "Both methods still have their places, and treatment should be tailored to each child's needs and circumstances."

This study has already impacted clinical practice, illustrating how rigorous research can directly improve patient outcomes. It underscores the importance of evidence-based medicine in orthodontics and highlights the valuable role of clinical trials in shaping treatment standards.

Source: https://medicalxpress.com/news/2025-06-technique-surgical-approach-exposing-impacted.html