Tunnel traction of infraosseous impacted maxillary canines. A three-year periodontal follow-up.

A surgical orthodontic procedure was used to treat deep infraosseous impacted canines (test teeth) associated with the persistence of the deciduous tooth in 15 patients who had the contralateral canine normally erupted (control teeth). The periodontal outcome was evaluated at the end of the orthodontic treatment and 3 years later. After extraction of the deciduous canine, a mucoperiosteal flap was raised on the buccal (seven cases) or palatal (eight cases) aspect, to expose the cusp of the impacted tooth. The empty socket of the deciduous tooth was extended to reach the impacted cusp and to form an osseous tunnel. A chain was passed through the tunnel and fixed to a bonded device on the impacted cusp. The flap was sutured back into its original position. The chain was used for traction to the impacted canine toward the center of the alveolar ridge. No attachment loss and no recession were observed at the end of the active therapy or 3 years later. No significant differences in keratinized tissue width were observed between test and control teeth at the follow-up examination.