Purpose: The aim of this retrospective study was to compare the postretention clinical appearance and the pulpal and periodontal status of surgically exposed and orthodontically aligned impacted maxillary central incisors, treated by 2 different surgical techniques-open eruption (OE) versus closed eruption (CE). Patients and Methods: The OE group consisted of 11 patients, age 15 to 38 years. The 11 patients in the CE sample (aged 14-28 years) were selected from a larger group of patients treated by this method, by carefully matching them to the patients in the OE group, in terms of cause and height of impaction. The length of the follow-up period was comparable for both groups (median of 9 years for the CE group and 10 years for the OE group). The clinical and radiographic variables were compared by paired t and χ2 tests. Results: The only parameters where statistically significant differences between the 2 study groups were found were crown length and bone support; that is, the central incisors uncovered by the OE technique had longer clinical crowns (by a mean of 1.37 mm) and decreased bone support (7.5% less on the mesial side) compared with those treated with the CE technique. Pulp changes with crown discoloration were only seen in the trauma-related group, independent of surgical technique. Conclusions: The choice of surgical technique in the exposure of impacted central incisors has important implications in the success of the orthodontic treatment of impacted incisors, in the long term, in relation to periodontal support and to appearance.