4 - Splinting
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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.