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A boon or A bane..???SPLINTING BY VIGNESH PRABHU.T C.R.I WHAT IS SPLINT..???It is defined as rigid or flexible device that maintains in position of a displaced or movable part , also used to keep in place and protect an injured part.

Splinting in dentistry ..??the joining of 2 or more teeth into a rigid unit by means of fixed or removable restorations or devices.

History..!!! A Phoenician mandible from 500BC found in modern day Lebanon which has two carved ivory teeth attached to four natural teeth by gold wire.Obin and Arvin's (1951) -self curing internal splint.Harrington(1957) modified the splint by incorporating cemented stainless steel wire.

Ward & Weinberg (1961) developed new techniques using a plastic matrix or using wire reinforcement. Splints have thus come a far way to INTRACORONAL BONDABLE FIBER SPLINTING of the present.

Should reduce movement 3 dimensionally

Centre of rotation of the affected teeth must be located in the remaining supporting bone.

No inflammation Minimum one third of bone support remaining.

Should allow for oral hygiene methods

Should not irritate soft tissues.principles

objectivesTo provide rest

For redirection of forces

For redistribution of forces

To preserve arch integrity6ContinueRestore of functional stability

Psychological well being

To stabilize mobile teeth during surgery , especially during regenerative therapy

To prevent the eruption of unopposed teeth

Indications To stabilize moderate to advance tooth mobility, that cannot be reduced by other means that has not responded to occlusal adjustment and periodontal therapy.

Stabilize teeth in secondary occlusal trauma

Stabilize teeth with increased mobility which interfere with normal masticatory function

Facilitate scaling and surgical procedures.

Prevent tipping & drifting of teeth.

Prevent extrusion of unopposed teeth.

Stabilize teeth after acute dental trauma i.e. .sub luxation , avulsion.etc. Contra indications

Moderate to severe tooth mobility in the presence of periodontal inflammation & or primary occlusal trauma

Insufficient number of firm/ sufficient firm teeth to stabilize mobile teeth.

Prior occlusal adjustment has not been done on teeth with occlusal trauma or interferences.

Patient not maintaining oral hygiene.

When the sole objective of splinting is to decrease tooth mobility following the removal of splint.

classificationAccording to the period of stabilization

According to the type of material

According to the location on the tooth According to the period of stabilization Temporary stabilization (worn for less than 6 months) RemovablefixedOcclusal splint with wireHawley with splinting arch wireIntra coronalExtra coronalSs wire with resinsWire & resin with & acid etchingEnamel etching & composite resinOrtho soldered bandsBrackets& wireAmalgam Amalgam & wireAmalgam , wire, resinComposite, resin, wirePROVISIONAL STABILZATIONTo be used for months up to several years e.g. acrylic splints, metal band

permanent splints ; used definitelyRemovable / fixedExtra / Intra coronalFull / Partial veneer crowns soldered togetherInlay / Onlay soldered togetherAccording to the type of materialBonded composite resin button splint.

Braided wire splint.

A- SPLINTSACCORDING TO THE LOCATION ON THE TOOTHIntra coronalExtra coronalTooth bonded plasticNight guardWelded bandsComposite resin with wireInlaysNylon wireCommonly used splintsSplinting for anterior teeth

Splinting of posterior teethDirect bonding systemIntra coronal wireAcrylic wire resin splintIntra coronal amalgam wire splintsBite guardRigid occlusal splintComposite splint

Splinting of anterior teeth

Splintee Tooth that needs supportSplinters Adjacent teeth that provide support.

Direct bonding systemAcid etchingBonding agentComposite curingIntra coronal wire splint

Slot preparationSs wire adapted into the slotSealed with resinVariation of the a splint

A 1mm deep M / D box is prepared parallel to the long axis of tooth

SnF/CA(OH)2 varnish is applies & threaded pin is then placed.

Ss is wire is adapted around the pin .

Splinting for posterior teeth

Intra coronal amalgam wire splints

Bite(night) guardBruxism with occlusal wear

Primary or secondary occlusal traumatism.

Anterior open bite with trauma.

Impinging over bite with periodontal involvement.

Following orthodontic treatment.( as retainer).

Rigid occlusal splintHead & neck pain as a result of muscle spasm is usually treated with maxillary occlusal splint.

Rigid & covers all occlusal surfaces.

Designed such that all opposing teeth contact the splint in centric relations.

Fiber reinforced splinting

Fibre reinforced splintingPROCEDURE

Coronoplasty Acid etchingFlowable composite

It have good flexural strength and do not require mechanical retention.

Faster & easier technique.

Superior in all properties compared to all other splinters.

Composite curingPost operative

Strength May establish final stability & comfort for patient with occlusal trauma.

Helpful to decrease mobility and accelerate healing following acute trauma to the teeth.

Allows remodelling of alveolar bone and PDL for orthodontically , splinted teeth.

Helpful in decreasing mobility favouring regenerative therapy.

Distributes occlusal forces over a wider area.

Weakness Hygienic

Mechanical

Biological refrencesWorld workshop 1989 iii -4

Lemmerman k; rationale for stabilization JP 1976; 47 (7) : 405 411.

Trochtchberg delhi : combined amalgam wire acrylic splint jp 198: 39 : 255 259/

Singer B : intracoronal aesthetic splinting comp. 1996: 17 (5) : 459- 48.

Leib et al : occlusal bite splint comp .1996: 17 (11) : 1081 -1090.

The periodontics syallabus 2nd ed 82- 85.

Doubts???`