Exposure of unerupted palatal canines: A survey of current practice in the United Kingdom, and experience of a gingival-sparing procedure

Patients with impacted ectopic canines often present to Orthodontic and Oral and Maxillofacial units, with 85% being displaced palatally. Current orthodontic opinion suggests that the creation of adequate space ultimately allows the spontaneous eruption of most impacted canines, but we are often requested to operate to facilitate their eruption. There are several approaches, techniques that vary depending on whether orthodontically assisted or spontaneous eruption is expected. There are few publications that describe either the techniques or their merits. We have used a gingival-sparing technique for more than 10 years in this unit. To determine current practice, we carried out a national postal survey of consultant oral and maxillofacial surgeons and staff grade/associate specialists. A total of 564 questionnaires were sent, and 353 replies were received (63%). There was considerable variation in the design of mucosal flaps used for exposure of the canines. Only 9% of clinicians avoided the gingival margin of the adjacent erupted teeth during operation. We describe this unit's practice of sparing the gingival margins, and highlight the merits of this technique.