Traumatology

Splinting is an important part of efficient treatment of dental injuries where stabilizing teeth after traumatic injuries is required.

Treatment Objectives of Splinting for Common Dental Injuries

  • Reposition and stabilize the injured tooth or its fragment in its anatomically correct position to adjanced teeth with a splint to optimize healing of the PDL while maintaining esthetic and functional integrity.

Function of the Splint:

  • Shift of the portion of the load
  • Three dimensional action
  • Change of orientation of the forces along the horizontal axis
  • Stabilization of the teeth

General Features of an Ideal Trauma Splint Include:

  • Easily and fast fabricated without additional trauma - Dentapreg™ Splint complies
  • Passive - Dentapreg™ Splint complies
  • Allows physiologic mobility - Dentapreg™ Splint complies
  • Doesn´t interfere with occlusion - Dentapreg™ Splint complies
  • Nonirrigating to soft issues - Dentapreg™ Splint complies
  • Allows endodontic treatment - Dentapreg™ Splint complies
  • Esthetics - Dentapreg™ Splint complies
  • Easily cleansed - DentapregTM Splint complies
  • Easily removed  - Dentapreg™ Splint complies

Biomechanics of Splint:

Splinting teeth to each other provides loosen teeth support by neighbouring sound abutment teeth. Splint is a part of frame where abutment teeth serve as vertical beam and splint itself serves as horizontal beam which bears the loading from loosen teeth. Major loading forces are horizontal forces perpendicular to dental arch acting thanks to loosen teeth mobility. Stabilizing capacity of the splint is directly proportional to the stiffness of the splint and  its adhesion to mobile and abutment teeth. From the other hand splint should allow physiological movement of the teeth.


Typical Situations for Clinical Use of Dentapreg™ Splint in Traumatology:


Splinting is an required treatment of following dental injuries (according to WHO System modified by Andreasen and Andreasen):
  • Injuries to the hard dental tissues and the pulp
             Crown-root fracture (suggested splinting time: 3 months)
        The emergency treatment objective is to stabilize the coronal fragment n its anatomically correct position to adjanced  teeth with a splint to optimize healing of the PDL while maintaining esthetic and functional integrity. Further treatment depends on comlexity of the injury.


              Root fracture (suggested splinting time: 3 months)
        Treatment objectives: to reposition and stabilize the coronal fragment in its anatomically correct position to adjanced teeth with a splint to optimize healing of the PDL while maintaining esthetic and functional integrity


  • Injuries to periodontal tissues
             Subluxation (loosening) (suggested splinting time: 7-10 days)
            Treatment objectives: to optimize healing of the PDL by stabilizing loosen tooth to adjanced teeth with a splint.
 

              Lateral luxation isolated (suggested splinting time: 2-3 weeks)
              Lateral luxation Alveolar fx (suggested splinting time: 6-8 weeks)
       Lateral luxation – treatment objectives: to reposition and stabilize the coronal fragment in its anatomically correct position to adjanced teeth with a splint to optimize healing of the PDL while maintaining esthetic and functional integrity.

               Extrusive luxation (suggested splinting time: 2-3 weeks)
         Treatment objectives: to reposition and stabilize the coronal fragment in its anatomically correct position to adjanced teeth with a splint to optimize healing of the PDL while maintaining esthetic and functional integrity

               Intrusive luxation (suggested splinting time: 2-3 weeks)
         Treatment objectives : to reposition and stabilize the coronal fragment in its anatomically correct position to adjanced teeth with a splint to optimize healing of the PDL while maintaining esthetic and functional integrity

               Avulsion (suggested splinting time 1-2 weeks)
            Treatment objectives: to replant and then to stabilize the replanted tooth  in its anatomically correct position to adjanced teeth with a splint to optimize healing of the PDL while maintaining esthetic and functional integrity
  • Injuries to the supporting bone
             Fracture of the alveolar process (suggested splinting time: 6-8 weeks)
             Treatment objectives: reposition the fragment and stabilizing it to adjanced teeth with a splint.

             Fracture of Mandible (suggested splinting time: 6-8 weeks)
             Treatment objectives: immobilization mandibular fractures. There are two option for splinting:

               a) splinting teeth in the mandible (simple fracture of mandible body or alveolar process, patient
                    cooperation necessary!)
                b) maxillomandibullar fixation - closed reduction

Note:
Suggested splinting time means minimum time for splinting. Real splinting time should reflect the healing process of the individual clinical situation.

Positioning of Dentapreg™  Splints:

  • Vestibular – as close as possible to middle third of the crown
  • Vestibular and oral – for splinting teeth in mandible (immobilization of mandibular fracture)

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