Abstract
Background: There is a lack of knowledge of how surgical management of permanent maxillary ectopic canines (PMECs) may affect the gingival aesthetics of those teeth.
Objective: To investigate whether PMEC gingival aesthetics are associated with a) surgery technique; and b) original tooth position.
Methods: Clinical audit and outcome survey of University of Otago, Faculty of Dentistry clinical records for patients who had undergone maxillary canine exposure surgery from 2011-2021. Included cases were PMEC cases managed by an open or closed exposure surgery technique. Clinical records, radiographs, and any intraoral/extraoral photographs taken were evaluated. Photographs of the exposed and contralateral canines were assessed by an orthodontist, a periodontist and a prosthodontist using the Maxillary Canine Aesthetic Index (MCAI).
Results: Out of a total size of 305 patients, 61 consented to participate and were screened, with 29 meeting the inclusion criteria. Of these 29, 22 had been managed via open surgery, and 7 via closed surgery. Evaluation of the 29 cases varied between the specialists, with the orthodontist consistently scoring participants higher on the MCAI scale (i.e., more aesthetically critical) than the other two examiners. MCAI scores managed by closed exposure exhibited significantly better gingival aesthetics than those managed by open exposure. MCAI scores did not differ significantly according to buccal/ palatal (original) positioning of the canine.
Conclusions: This study found gingival aesthetic outcomes for the closed exposure technique to be more favourable than the open exposure technique. Inter-examiner differences in gingival aesthetic scores highlighted variation in case evaluation among practitioners.