Tricks of the Trade: Tissue control for bonding to impacted canines

Open exposure for palatally impacted canines is an effective and well documented technique, with the tooth erupting into the palate relatively quickly, and usually without complication.¹ On occasion, it may be necessary to bond an attachment soon after surgery, either to prevent the mucosa re-covering the tooth or to commence alignment. Typically, the ideal position for bonding the attachment is close to the gingival margin due to partial eruption and rotation of the canine.

Difficulty in maintaining good oral hygiene in the immediate post-surgical period means that the mucosa and gingivae are often inflamed and prone to bleeding (Figure 1).

A method which greatly increases bonding success in situations where blood and gingival fluid are present is the placement of retraction cord soaked in styptic around the margin of the tooth. This provides simultaneous haemostasis and retraction of the soft tissues, increasing the surface area available for bonding and reducing contamination.