Non-Cochrane · intervention · PM42604397
Closed Versus Open Surgical Exposure of Palatally Displaced Canines: A Systematic Review and Meta-Analysis.
Aldoseri Yousef T, Alkhawari Dalal, Ashour Yousef, et al. · Cureus · 2026 · PubMed · doi:10.7759/cureus.112792
Findings
23 findings
| Population | ||||
|---|---|---|---|---|
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Overall complications Surgical-orthodontic management | RR 0.88 [0.21, 3.66] GRADE not reported 3 studies · 243 participants |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Postoperative pain score 7-10 days · Surgical-orthodontic management · Sensitivity: leave-one-out omitting Færøvig 2025 | SMD -0.26 [-0.54, 0.02] GRADE not reported 3 studies |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Analgesic consumption (patients using analgesics) 7-10 days · Surgical-orthodontic management · Follow-up 7-10 days | RR 0.83 [0.68, 1.02] GRADE not reported 4 studies · 375 participants |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Minor complications Surgical-orthodontic management · Minor complications | RR 1.71 [0.71, 4.12] GRADE not reported 2 studies · 172 participants |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Canine eruption time (months) Surgical-orthodontic management | MD 3.37 [2.02, 4.73] GRADE not reported 2 studies · 162 participants |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Major complications Surgical-orthodontic management · Major complications | RR 0.96 [0.14, 6.38] GRADE not reported 2 studies · 172 participants |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Postoperative pain score 7-10 days · Surgical-orthodontic management · Follow-up 7-10 days | SMD -0.65 [-1.46, 0.17] GRADE not reported 4 studies · 375 participants |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Surgical time (minutes) Surgical-orthodontic management · Combined (mixed unilateral and bilateral) trials | MD 5.09 [1.35, 8.82] GRADE not reported 2 studies · 211 participants |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Postoperative pain score 7-10 days · Surgical-orthodontic management · Sensitivity: leave-one-out omitting Parkin 2012 | SMD -0.86 [-1.86, 0.14] GRADE not reported 3 studies |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Overall complications Surgical-orthodontic management · Sensitivity: leave-one-out omitting Dahlén 2026 | RR 0.54 [0.09, 3.34] GRADE not reported 2 studies |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Postoperative discomfort Surgical-orthodontic management | SMD -0.25 [-0.42, -0.07] GRADE not reported 3 studies · 503 participants |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Gingival recession, midbuccal Surgical-orthodontic management | MD 0.04 [-0.15, 0.23] GRADE not reported 2 studies · 105 participants |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Postoperative pain score 1 day · Surgical-orthodontic management · Sensitivity: leave-one-out omitting Færøvig 2025 | SMD -0.56 [-0.84, -0.28] GRADE not reported 2 studies |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Overall complications Surgical-orthodontic management · Sensitivity: leave-one-out omitting Björksved 2018 | RR 0.71 [0.05, 9.28] GRADE not reported 2 studies |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Postoperative pain score 1 day · Surgical-orthodontic management · Follow-up 1 day | SMD -0.39 [-0.75, -0.04] GRADE not reported 3 studies · 294 participants |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Analgesic consumption (patients using analgesics) 1 day · Surgical-orthodontic management · Follow-up 1 day | RR 0.98 [0.89, 1.07] GRADE not reported 3 studies · 294 participants |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Postoperative pain score 1 day · Surgical-orthodontic management · Sensitivity: leave-one-out omitting Dahlén 2026 | SMD -0.28 [-0.73, 0.17] GRADE not reported 2 studies |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Overall complications Surgical-orthodontic management · Sensitivity: leave-one-out omitting Færøvig 2025 | RR 1.51 [0.69, 3.3] GRADE not reported 2 studies |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Postoperative pain score 7-10 days · Surgical-orthodontic management · Sensitivity: leave-one-out omitting Dahlén 2026 | SMD -0.78 [-1.88, 0.32] GRADE not reported 3 studies |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Postoperative pain score 7-10 days · Surgical-orthodontic management · Sensitivity: leave-one-out omitting Björksved 2018 | SMD -0.7 [-1.86, 0.46] GRADE not reported 3 studies |
| Children and adolescents with palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Postoperative pain score 1 day · Surgical-orthodontic management · Sensitivity: leave-one-out omitting Björksved 2018 | SMD -0.34 [-0.94, 0.26] GRADE not reported 2 studies |
| Children and adolescents with unilateral palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Surgical time (minutes) Surgical-orthodontic management · Unilateral cases | MD 2.91 [0.49, 5.33] GRADE not reported 5 studies · 356 participants |
| Children and adolescents with bilateral palatally displaced maxillary canines | Closed surgical exposure (attachment bonded, flap repositioned) | Open surgical exposure (crown left exposed) | Surgical time (minutes) Surgical-orthodontic management · Bilateral cases | MD 8.27 [0.84, 15.69] GRADE not reported 2 studies · 51 participants |
Included primary studies 15
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Bjorksved 2018 Closed vs open surgical exposure of palatally displaced canines: surgery time, postoperative complications, and patients’ perceptions: a… DOI:10.1093/ejo/cjy070 | 2018 | this review only | not stated | not extracted yet |
| Björksved 2018 Closed vs open surgical exposure of palatally displaced canines: surgery time, postoperative complications, and patients' perceptions: a… PMID:30321323 | 2018 | this review only | not stated | not extracted yet |
| Björksved 2021 Open vs closed surgical exposure of palatally displaced canines: a comparison of clinical and patient-reported outcomes-a multicentre,… PMID:34114630 | 2021 | this review only | not stated | not extracted yet |
| Dahlen 2026 Glass ionomer open exposure and closed exposure of palatally displaced canines: a randomised controlled trial comparing postoperative pain… DOI:10.1093/ejo/cjag011 | 2026 | this review only | not stated | not extracted yet |
| Dahlén 2026 Glass ionomer open exposure and closed exposure of palatally displaced canines: a randomised controlled trail comparing postoperative pain… PMID:41843643 | 2026 | this review only | not stated | not extracted yet |
| Faerovig 2025 Closed vs open surgical exposure of palatally displaced canines: Patients’ perceptions of recovery, operating time, and complications—A… DOI:10.1016/j.ajodo.2024.11.014 | 2025 | this review only | not stated | not extracted yet |
| Færøvig 2025 Closed vs open surgical exposure of palatally displaced canines: Patients' perceptions of recovery, operating time, and complications-A… PMID:40157786 | 2025 | this review only | not stated | not extracted yet |
| Gharaibeh 2008 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Gharaibeh 2008 Active-site-directed reagents of glycolytic enzymes. PMID:200825 | 1977 | this review only | not stated | not extracted yet |
| Parkin 2012 No Difference in Surgical Outcomes Between Open and Closed Exposure of Palatally Displaced Maxillary Canines DOI:10.1016/j.joms.2012.02.028 | 2012 | this review only | not stated | not extracted yet |
| Parkin 2012 No difference in surgical outcomes between open and closed exposure of palatally displaced maxillary canines. PMID:22677328 | 2012 | this review only | not stated | not extracted yet |
| Parkin 2013 Periodontal health of palatally displaced canines treated with open or closed surgical technique: a multicenter, randomized controlled… PMID:23910198 | 2013 | this review only | not stated | not extracted yet |
| Parkin 2015 Esthetic judgments of palatally displaced canines 3 months postdebond after surgical exposure with either a closed or an open technique. PMID:25636550 | 2015 | this review only | not stated | not extracted yet |
| Smailiene 2013 Palatally impacted maxillary canines: choice of surgical-orthodontic treatment method does not influence post-treatment periodontal… DOI:10.1093/ejo/cjs102 | 2013 | this review only | not stated | not extracted yet |
| Smailiene 2013 Palatally impacted maxillary canines: choice of surgical-orthodontic treatment method does not influence post-treatment periodontal… PMID:23349422 | 2013 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children, adolescents or adults with unilateral or bilateral palatally displaced maxillary canines | Pediatric and adolescent patients with maxillary PDC, mean age 12.9 to 17.6 years (n=450) |
| Intervention | Closed surgical exposure with attachment bonding and flap repositioning | Closed surgical exposure (n=6 studies) |
| Comparison | Open surgical exposure with crown left exposed | Open surgical exposure (n=6 studies) |
| Outcomes | Postoperative pain, discomfort, analgesic consumption, surgery time, overall complications, periodontal outcomes, eruption duration | Pain, discomfort, surgical time, analgesic consumption, gingival recession, eruption time, overall, major and minor complications |
| Study designs | RCTs and prospective controlled clinical studies | 5 RCTs and 1 prospective controlled study (9 reports) |
| Timing | Not specified | Follow-up 1 week to 12 months |