Glass ionomer open exposure and closed exposure of palatally displaced canines: a randomised controlled trail comparing postoperative pain perception and complications

Abstract Background The most common surgical interventions for palatally displaced canines (PDCs) are open and closed exposure, yet there is no consensus on which exposure technique is preferable. Objectives To compare glass ionomer open exposure (GOPEX) with closed exposure (CE) in terms of patient-reported outcomes, surgical duration, and complications. Trial design The trial design was a single centre, randomised controlled trial, with a 1:1 allocation of two parallel groups. Methods Patients aged ≤18 years, with a unilateral PDC in sector 2–5, requiring surgical exposure were randomly allocated to GOPEX or CE. Patient-reported outcomes were collected through a questionnaire completed over the phone daily from the day of exposure until symptom resolution. Surgery duration, recorded by the operator, and complications within four weeks, was obtained from the patient’s record. The outcome assessor and the individual conducting the follow-up calls were blinded to group allocation. Repeated measures analyses were used for data collected at multiple time points. Mann–Whitney U-test, chi-square test or Fisher’s exact test, as appropriate was used for other between-group comparisons. Results Of the 92 patients randomised, 83 completed the intervention: 43 in the GOPEX group (13.8 ± 1.5 years) and 40 in the CE group (13.6 ± 1.2 years). Throughout the full postoperative period, the groups did not differ significantly in pain levels, percentage of pain-free patients, analgesic use, or chewing difficulty. During the first postoperative week, however, the GOPEX group reported higher pain (fold change 1.78; 95% CI: 1.07–2.99; P = 0.028). Fewer GOPEX patients were pain-free at one week, and they consumed more analgesics on postoperative days 4 and 5. Surgery duration was similar between groups, and complications were rare and comparable. Conclusions Although the GOPEX group reported more pain during the first postoperative week, overall pain scores and analgesic consumption across the full postoperative period did not differ between groups. No significant differences were found in surgery duration or complications. Trial registration www.researchweb.org/is/sverige, registration number: 279469.