The purpose of this study was to evaluate the periodontal variables of impacted maxillary canines that were treated with a combined surgical and orthodontic approach aimed at reproducing the physiologic eruption pattern of canines. Twenty-five patients who presented with unilateral impacted maxillary canines were consecutively enrolled (age range, 13.2 to 23.2 years). They were treated with a surgical flap and orthodontic traction directed to the center of the crest and were evaluated periodontally at the end of treatment and again at a follow-up visit (2 to 5 years posttreatment). Pocket depth, keratinized tissue width, and gingival recession were recorded. At the end of orthodontic treatment, all 25 treated canines presented with normal pocket depth (2.0 ± 0.3 mm) and a normal amount of keratinized tissue (5.0 ± 1.2 mm). No sites showed gingival recession. At the follow-up visit, both pocket depths and keratinized tissues were slightly reduced. The combined technique permits traction of the impacted canines to the center of the crest, simulating the physiologic eruption pattern and resulting in correct alignment and good periodontal status.