Mucogingival interceptive surgery of buccally-erupted premolars in patients scheduled for orthodontic treatment I. A 7-year longitudinal study

Background: Mucogingival interceptive therapy in patients with buccally eru pting teeth is performed to prevent the ectopic permanent tooth from develo ping periodontal lesions. The keratinized tissue entrapped between the erup ting tooth and the deciduous tooth is retained to maintain a satisfactory w idth of the gingiva for the permanent tooth. The aim of the present study o n buccally-erupted premolars scheduled for orthodontics was to evaluate the keratinized tissue width 3 months, 2 years, and 7 years subsequent to muco gingival interceptive therapy and orthodontic treatment. Methods: Twenty-nine patients participated. Three different surgical techni ques were used according to specific indications. Eight patients were treat ed with double pedicle flaps (DPF), 10 patients with apically positioned fl aps (APF), and 11 with free gingival grafts (FGG). Results: The amount of keratinized tissue on the treated (test) sites was n ot significantly less than on the control (untreated) sites showing normall y erupting premolars at all observation periods. All 3 surgical procedures appeared to be effective in saving the keratinized tissue for the permanent tooth. Preoperative periodontal parameters such as gingival width, probing depth, and bleeding on probing significantly influenced the outcome 3 mont hs after surgery (P <0.01). Conclusions: Mucogingival interceptive surgery is an effective approach to conserve the keratinized buccal gingiva of ectopically erupting premolars.