Petiodontal status following the alignment of’buccally ectopic maxillary canine teeth David Kohavi, D.M.D.,* Yerucham Zilberman, D.M.D.,** and Adrian Becker, B.D.S., L.D.S., D.D.O.*** Jerusalem, Isrwl Twenty-nine patients who had completed orthodontic treatment to resolve buccal displacement of maxillary canine teeth were examined 2.9 years (mean) after all appliances had been discarded. Thirteen of these patients had unilateral displacement, and sixteen were bilaterally affected. In the unilateral cases only the width of attached gingiva was significantly less than in the controls. In the bilateral cases the same observation was made, but here the gingival index and pocket depth also showed statistically significant increases, although the expression of these values was found to have doubtful clinical significance. Posttreatment periodontal assessment is recommended for these cases. Key words: Buccally displaced canines, orthodontic treatment. periodontal breakdown, loss of attached gingiva I n the context of maxillary successional teeth, the last tooth to erupt is usually the permanent canine, and its normal path of eruption is slightly buc- cal to the line of the arch.‘. 2 In its early stages of de- scent this tooth is normally palpable high in the buccal sulcus as early as the age of 8 to 9 years, and it finally erupts in a more buccal position than its recently shed deciduous predecessor. It is not surprising, therefore, that in the presence of crowding this buccal eruption path becomes exaggerated because of lack of space and the tooth erupts more buccally and higher in the alveo- lar process, either through the attachedgingiva at a higher level than is normal or into the alveolar mucosa. There also are many cases in which there is ade- quate space in the arch but an abnormal buccally dis- placed eruptionpath of the permanent canine is evi- dent. This leads to similar ectopic eruption. In either of these cases, and following alignment of the ectopic tooth, the relationship of the tooth and its investing tissues may not be the same as with other teeth. This situation may give rise to changes in the health and status of these periodontal tissues. In the works of Vanarsdall and Corn:’ and of McBride,4 attention is paid to the periodontal problems From the Hebrew University-Hadassah School of Dental Medicine (founded by the Alpha Omega fraternity). *Lecturer, Department of Oral Rehabilitation. **Senior Lecturer, Department of Orthodontics. ***Clinical Senior Lecturer, Department of Orthodontics. 78 that are associated with severely impacted buccal canines. Those investigators suggest modification of the exposure technique to minimize these problems. The purpose of this article is to investigate the peri- odontal condition of buccally ectopic canines after their orthodontic alignment, in quantitative terms. MATERIALS AND METHODS The material consisted of 29 patients,thirteen of these had originally displayed unilateral buccal dis- placementof a maxillary canine (group l), while in 16 patients the displacement was bilateral(group 2). All patients had completed treatment for alignment of these teeth by conventional orthodontic multibanded tech- niques, withor withoutthe remedial extraction of per- manent teeth, and applianceshad been discarded an average of 2.8 years prior to examination. For group1, the contralateral, normally placed canines comprised the control group. For the bilateral cases, the unaf- fected sides from the material of an earlier report of unilateral treated palatal canines” were used as controls. The criteria for defining buccal displacement of these teeth were as follows: (1) The tip of the erupted or partially erupted canine was found to be 2.5 mm or more buccal to the bucco-occlusal line angle of the remainingteeth of that side or (2) the tip of the erupting canine was seen to emerge through the gingiva in the vertical part of the alveolar process on the buccal side, above the level of the free gingival margin of the adja- cent teeth.