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SPLINTINGDr MAYUR KAUSHIK

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DEFINITION Any apparatus, appliance or device

employed to prevent motion or

displacement of fractured or

movable parts

In dentistry, stabilization or splinting

refers to tying teeth together , either

unilaterally or bilaterally, to convey

increased stability to the entire unit.

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GLOSSARY OF PERIODONTIC TERMS (GPT) - 1986

Splint is defined as an appliance

designed to stabilize mobile teeth.

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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

c. Provisional splint

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WIRE AND ACRYLIC SPLINT

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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 & fixed

with cold cure acrylic

A SPLINT

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WIRE & COMPOSITE SPLINT

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WIRE & COMPOSITE SPLINT

Short pieces of wire are placed in

precut Class III cavities

Fixed in place by composite

restorative material

Interproximal spaces are not

occluded

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FIBER SPLINT - RIBBOND

Flexible fiber adapted onto tooth

surfaces & bonded by resin

Easier adaptation & more

comfortable to patient

Economic unfeasiblity

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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 FOR SPLINTING

Control of forces of parafunction or bruxing

Stabilization of mobile teeth for masticatory comfort

Stabilization of mobile teeth during surgical, 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 tooth

when 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

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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 OF SPLINTING

Not time and cost effective even with

simple methods employed

Fixed splints may mask important signs

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 the

antagonists, or lead to functional

occlusal problems

Plaque control especially

interproximal difficult

Tooth preparations involves

otherwise intact teeth and may

induce pulpal injury or hypersenstivity

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Rigid splinting deprives their

periodontal ligaments of functional

stimulation and may lead to

atrophy.