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Title Open Versus Closed Surgical Exposure of Palatally Impacted Canines
Clinical Question What is the most efficient method for palatally impacted maxillary cuspids into the arch form.
Clinical Bottom Line Two techniques are used clinically to bring palatally impacted maxillary cuspids into the arch form: the open and the closed technique. There is currently no evidence to support either the open or the closed technique being clinically superior. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 18843740Parkin/2008All patients needing surgical treatment to correct palatally impacted canines; excluding patients with craniofacial deformity/syndromes.Cochrane review
Key resultsThere is no evidence to support either the open or the closed technique for exposing palatally ectopic canines as being clinically superior.
Evidence Search Pubmed search: palatally impacted canines ...view in PubMed
Comments on
The Evidence
While the Cochrane review is the highest rated evidence, in this case there are not enough studies that could be included in the review to draw a definitive conclusion.
Applicability Until high quaility studies are conducted and published, methods of exposing canines will be left to the personal choice of the clinician.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Orthodontics) (Pediatric Dentistry) (Periodontics)
Keywords partially impacted cuspid exposure, orthodontics
ID# 285
Date of submission: 01/28/2010spacer
E-mail oliverj2@uthscsa.edu
Author Jarod Oliver
Co-author(s) e-mail
Faculty mentor/Co-author Peter T. Gakunga, BDS, MS, PhD
Faculty mentor/Co-author e-mail GAKUNGA@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Justin Acap (San Antonio, TX) on 04/13/2012
A PubMed search on this topic was done April 2012. A randomized controlled trial (PMID: 18547839) that compared postoperative pain in open and closed surgical exposure concluded that open-surgical exposure has significantly shorter surgical duration compared to closed-surgical exposure. This is evidence addresses the clinical question of which method is most conservative. Publications in the CAT are the best and most recent evidence addressing efficiency and orthodontic movement into the arch.

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