Exposure and bond for orthodontic patients
If your orthodontist has identified an impacted tooth — usually a canine — that won't come down on its own, the fix is a procedure called exposure and bond. An oral surgeon exposes the tooth surgically and attaches a small bracket so the orthodontist can pull it into position over the following months. Done well, the patient ends up with a full, properly aligned arch and no one ever sees a scar.
Dr. Ramon Perez-Rosich performs exposure and bond procedures regularly at OMS Associates, in close coordination with referring orthodontists across South Florida.
When exposure and bond is needed
- Impacted canine (most common) that won't erupt naturally
- Impacted incisor or premolar blocking orthodontic alignment
- Supernumerary (extra) tooth blocking eruption of a permanent tooth
- A tooth identified on a panoramic X-ray during orthodontic workup that's heading the wrong direction
How the procedure works
- Pre-op planning with your orthodontist on which tooth, which direction to pull, and which bracket to attach
- Outpatient procedure, typically under local anesthesia or light sedation
- Small surgical access to the impacted tooth
- Bracket bonded to the tooth with an attached gold chain
- Tissue closed with dissolvable sutures
- The orthodontist begins applying gentle traction at the next adjustment
Most patients return to school or work the next day. The orthodontic pull-down takes anywhere from six to eighteen months depending on how far the tooth needs to travel.
Why surgical technique matters for this procedure
Exposure and bond looks simple. It isn't. The bracket has to be placed where the orthodontic vector will actually engage. The amount of gum tissue removed matters for the long-term aesthetics of the eventual gumline. The bond has to hold for a year-plus under continuous tension. Cases where the bond fails mid-treatment cost the patient months and often a second surgery.
This is one of the procedures where doing many of them, alongside the orthodontists who follow them, really matters.
For referring orthodontists
We send same-week consult availability for impacted canine cases, share post-op imaging directly with your practice, and call you with anything unexpected. We can perform the procedure at either our Southwest Ranches or Kendall office, whichever is closer to your patient. Reach Dr. Perez-Rosich's direct referral line via the contact page.
Frequently asked questions
How long is recovery?
Most patients are back to school or work the next day. Some minor swelling for two to three days; full healing within a couple of weeks.
Does the patient feel the bracket?
Some pressure for the first day, then no. The orthodontic chain is much smaller than it sounds.
What if the bond fails?
Re-bonding is straightforward and can usually be done in a short follow-up visit. We aim to make this a one-and-done procedure for the patient.
Schedule a consult
Patients: call 954-693-0026 (Southwest Ranches) or 786-210-6160 (Kendall). Referring orthodontists: ask us about same-week consult slots and direct surgeon-to-orthodontist communication.