SPLINTING

A boon or A
bane..???
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.

principles
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.

objectives
To provide rest
For redirection of forces
For redistribution of forces
To preserve arch integrity

CONTINUE
Restore 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.

classification

According to the period of stabilizati

According to the type of material

According to the location on the toot

ACCORDING TO THE PERIOD OF

STABILIZATION
Temporary stabilization

(worn for less than 6

months)
Removable

fixed

Occlusal splint with wire

Hawley with splinting arch wire

Intra coronal

Amalgam
Amalgam & wire
Amalgam , wire, resin
Composite, resin, wire

Extra coronal

Ss wire with resins

Wire & resin with & acid etching

Enamel etching & composite

resin

Ortho soldered bands

Brackets& wire

PROVISIONAL STABILZATION

To be used for months up to several years e.g.

acrylic splints, metal band

permanent splints ; used definitely

Removable / fixed

Extra / Intra coronal

Full / Partial veneer crowns
soldered together
Inlay / Onlay soldered together

ACCORDING TO THE TYPE OF

MATERIAL

Bonded composite resin button splint.

Braided wire splint.
A- SPLINTS

ACCORDING TO THE LOCATION ON THE

TOOTH

Intra coronal

Composite resin with wire

Inlays
Nylon wire

Extra coronal

Tooth bonded plastic

Night guard
Welded bands

COMMONLY USED SPLINTS

Direct bonding system

Splinting for anterior teeth

Intra coronal wire

Acrylic wire resin splint

Intra coronal amalgam wire splin

Splinting of posterior teeth

Bite guard
Rigid occlusal splint
Composite splint

Splinting of anterior tee

Splintee
Tooth that needs support

Splinters
Adjacent teeth that provide supp

Direct bonding system

Acid etching

Composite curing

Bonding agent

INTRA CORONAL WIRE SPLINT

Slot preparation

Ss wire adapted into the slot

Sealed with resin

VARIATION 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) GUARD

Bruxism 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
SPLINT

Head & 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 splinting

PROCEDURE
Coronoplasty

Acid etching

Flowable composite

 It have good flexural strength

and do not require mechanical
retention.
Faster & easier technique.
Composite curing

Superior in all properties

compared to all other
Post operative
splinters.

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

REFRENCES

World 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 2 nd ed 82- 85.

Doubts???