The purpose of this study was to examine the esthetic and periodontal
differences between two methods of uncovering labially impacted maxill
ary anterior teeth:the apically positioned flap and closed-eruption te
chniques. The sample consisted of 30 patients who were recalled a mini
mum of three months after orthodontic treatment of a unilateral labial
ly impacted maxillary anterior tooth. Eighteen of the patients had und
ergone an apically positioned flap (APF) procedure, and the remaining
twelve had undergone the closed-eruption (CE) technique. In the CE gro
up, clinical examination showed less width of attached gingiva on the
distal surface and increased probing bone level on the facial surface
of the uncovered teeth relative to their contralateral controls. Uncov
ered teeth in the APF group showed more apical gingival margins on the
mesial and facial surfaces; greater crown length on the midfacial sur
face; increased probing attachment level on the facial surface; increa
sed width of attached gingiva on the facial surface; increased probing
bone level on mesial, facial, and distal surfaces; and gingival scarr
ing. Radiographic examination showed shorter roots on the uncovered te
eth in both groups. Photographic examination revealed vertical relapse
of the uncovered teeth in the APF group. We conclude that labially im
pacted maxillary anterior teeth uncovered with an apically positioned
flap technique have more unesthetic sequalae than those uncovered with
a closed-eruption technique.