Open v/s Closed Surgical Exposure Technique for Impacted Maxillary Canine Surgical and Orthodontic Perspective

Abstract

Objectives: To compare open and closed surgical exposure techniques for impacted maxillary canines in terms of postoperative pain, dislodgement of bonding bracket, food impaction, and overall patient satisfaction

Materials and Methods: A quasi-experimental study was conducted at Dental College HITEC (IMS) Taxilla Cantt for 18 months, from 1st Aug 2020 to 31st Jan 2022. The sample size for the study was 32, which was calculated using the Open EPI Sample Size Calculator, with a confidence level of 95% and prevalence of impacted canine as 1.2%. A nonprobability (purposive) sampling technique was used and the patients were screened from the OPD of the Oral & Maxillofacial Surgery Department, who were candidates for surgical exposure of impacted canine followed by orthodontic traction. They were divided into two groups, group A was surgically exposed with an open surgical technique, and group B patients were exposed via closed surgical technique. The outcome of both techniques was compared in terms of postoperative pain, complaint of food impaction at the surgical site and dislodgment of the bonding device.

Results: A total of 32 patients, and 58 impacted maxillary canines were treated with open and closed surgical exposure technique, postoperative outcome of both techniques were compared. Pain on postoperative day 2, according to Visual Analogue Scale, was moderate in 10 patients and severe in 6 for group A. Group B patients had mild pain in 10 patients while 6 had moderate pain. The orthodontic bonding device was dislodged in 6 patients of Group A and in 1 patient of Group B. 12 patients from Group A and 3 from Group B complained of food impaction at the site of surgical exposure.
Conclusion: The closed surgical exposure technique was found to be more beneficial and superior when compared with the open surgical technique in terms of postoperative pain, food impaction at the exposure site, and dislodgment of the traction device.