Computer-assisted open exposure of palatally impacted canines for orthodontic eruption: A randomized clinical trial

Objective: This randomized clinical trial aimed to assess the feasibility of computer-assisted open exposure of palatally impacted canines. Materials and methods: Patients aged 11 -30 years who required orthodontic eruption for the full palatal impaction of their canines were included in this study. Exclusion criteria were psychosocial and dental contraindications of orthodontic treatment, congenital craniofacial disorders, and trauma in the patient 's history in the vicinity of the surgical site. Virtual planning software was used to register the intraoral scans and cone-beam computed tomography data and to design a surgical template. In the test group, exposure of the canines was guided by a surgical template, whereas in the control group, the surgeon relied on the surgical plan to localize the impacted canine. The success of the intervention, duration of surgery, and complications, including excessive hemorrhage, damage to the canine or neighboring anatomical landmarks, and postoperative inflammation of the surgical site were assessed. Postoperative pain was reported by the patients using the visual analog pain scale (VAS). Results: Surgery was deemed successful in all patients in both groups. During healing, no complications were observed. The duration of surgery decreased significantly in the test group (4 min 45.1 s +/- 1 min 8.4 s) compared to that in the control group (7 min 22.3 s +/- 56.02 s). No statistically significant differences were observed between the VAS scores of the two study groups. Conclusions: The application of virtual planning and static navigation is a viable approach for the open exposure of palatally impacted canines. Clinical trial registration number: NCT05909254. Clinical significance: Computer-assisted surgery is a feasible method for open exposure of palatally impacted canines, which decreases the duration of surgery compared to the freehand method.