25 Splinting

7/30/2019 25 Splinting

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SPLINTING


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DEFINITION

Any apparatus, appliance or device

employed to prevent motion or

displacement of fractured ormovable parts

In dentistry, stabilization or

splintingrefers to tying teethtogether , either unilaterally or

bilaterally, to convey increased

stability to the entire unit.


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TYPES OF SPLINTS

TEMPORARY

PROVISIONAL

PERMANENT

REMOVABLE

FIXED


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TEMPORARY SPLINTS- worn for

less than 6 months and may not be

followed by additional splint therapy

PROVISIONAL SPLINTS- for

months up to several years with a

definitive end to splint therapy

PERMANENT SPLINTS- long term

stability of the dentition


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TEMPORARY SPLINTS

1. EXTRACORONAL

a. Wire and acrylic splint

b. Orthodontic band splint

c. Acid-etch splint

2. INTRACORONAL

a. A-splint

b. Composite and wire splint


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WIRE AND ACRYLICSPLINT


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A SPLINT


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Placement of interproximal

amalgam restorations is essential A retentive channel is cut through

amalgam

Stainless steel wire placed & fixedwith cold cure acrylic

A SPLINT


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WIRE & COMPOSITESPLINT


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FIBER SPLINT -RIBBOND

Flexible fiber adapted onto tooth

surfaces & bonded by resin

Easier adaptation & more

comfortable to patient

Economic unfeasibility


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PROVISIONAL SPLINTS

It is eventually replaced by

permanent full coverage crowns so

minimal preparation of the teeth is

required.


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FIXED SPLINTS

Cast metal partial dentures

Resin retained cast metal splints

Cast restorations

Partial veneer crowns


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RATIONALE FORSPLINTING

Control of forces of parafunction or

bruxing

Stabilization of mobile teeth for

masticatory comfort

Stabilization of mobile teeth during

surgical phase, especially

regenerative therapy


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Cross arch stabilization of an intact

or virtually intact natural dentition or

preservation of arch integrity

Stabilization of a severely

periodontally compromised toothwhen more definitive treatment is

not possible


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Restoration of the vertical

dimension of occlusion in a case

of posterior bite collapse

Prevention of the eruption of an

unopposed tooth

Post-orthodontic retention


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No satisfactory evidence that

splinting has a biological effect on

the progression of periodontal

disease.

It is no more than a mechanical

means to control mobility and tooth

position

CURRENT STATUS


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ADVANTAGES OF SPLINTING

Enhances the functional comfort of

the patient by reducing excessive

mobility

Renewed sense of confidence and

security to the patient

Achievement of a functional criteria

of acceptable occlusion

Teeth with diminished periodontal

support can function as abutments


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DISADVANTAGES OFSPLINTING

Not time and cost effective even

with simple methods employed

Fixed splints may mask importantsigns of continuing disease so that

they escape detection at

reassessment Removable splints are less

effective in providing stabilization

and may lead to increased mobility


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May apply excessive forces on theantagonists, or lead to functional

occlusal problems

Plaque control especiallyinterproximal difficult

Tooth preparations involves

otherwise intact teeth and mayinduce pulpal injury or

hypersenstivity


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Rigid splinting deprives their

periodontal ligaments of functional

stimulation and may lead to

atrophy.

25 Splinting

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