This procedure involves the oral surgeon carefully exposing the crown of the impacted tooth within the bone and then, in collaboration with the orthodontist, bonding a small bracket and chain to it. The chain is then connected to the orthodontic archwire, which allows the orthodontist to apply gentle, constant force to slowly pull the tooth into its proper alignment over several months.
For the best prognosis, Expose and Bond is typically recommended for teenagers and young adults, when the bone is more pliable.
The process begins with your orthodontist’s recommendation and initial alignment of the surrounding teeth to create space for the impacted tooth. X-rays and 3D imaging are used to precisely locate the tooth and determine the best approach. You will consult with the oral surgeon to discuss the procedure and Anesthesia options. Pre-operative instructions will include guidelines on diet and medications, and you must arrange for transportation home if Sedation is planned.
The Expose and Bond procedure is performed under local anesthesia, often with the addition of Nitrous Oxide or IV Sedation. The surgeon makes a small incision in the gum tissue to locate and expose the crown of the impacted tooth. Once the tooth is clean and dry, the orthodontist’s bracket and chain are bonded to it. The incision may be closed around the tooth, leaving only the small chain visible, or the tooth may be left uncovered. The chain is then engaged by the orthodontist to begin the slow traction process.
Post-operative discomfort is usually minor and manageable with over-the-counter pain relievers. Swelling is typically minimal. You should adhere to a soft-food diet for a few days and follow the surgeon’s instructions for keeping the surgical site clean. The patient then returns to the orthodontist, who will activate the chain to begin guiding the tooth into place. This orthodontic movement is a slow process that will be monitored closely during follow-up visits.
