[The Redtenbacher ATR-splint in a periodontally endangered dentition].
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The design and use of fixed partial dentures as a definitive restoration to stabilize and splint teeth have been reviewed. The provisionalization of the splinted patient has been described as it is incorporated into the treatment plan of patients with a weakened periodontium. The current controversy of incorporating implants in the patient requiring splinting was discussed, and recommendations are made. Dentists are encouraged to explain all potential ramifications of splinting with fixed partial dentures, including cost, frequency of office visits, and potential alterations or remakes of the prosthesis should physiologic demands surpass the capabilities of the remaining teeth.
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Teeth with severe periodontitis exhibit alveolar bone loss, teeth mobility and even teeth loss. The author made groove along the buccal and labial surfaces of teeth, twisted the stainless steel wire and placed ultraviolet light polymerized composite resin over the wire. Teeth with mobility 2-3 degree from 39 patients were treated and the effect was evaluated in the period of 2 to 4 years. The results demonstrated that the treatment had advantages of stabiliting very loose teeth and forming a firm unit. It minimized teeth mobility and improved greatly teeth occlusal function. When occlusing, the device could redirect force to other teeth, thereby reduced traumatism and facilitated periodontal tissue repairing and regeneration and protected loose teeth.
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Immediate and late results of periodontitis treatment with the use of various types of joining in 74 patients are analyzed. Traditional casts were employed in 34 cases; in 40 patients fragmentary nonremovable casts with parapulpar fixation were used, as were adhesive one-piece, equatory, and intradental casts. The initial condition of the periodontium was similar in all the patients. Periodontal status was compared over the course of treatment with the use of different casts. Mathematical characteristics were used for analysis: periodontal and gingival indexes; osseous index and hygienic condition index, that were determined before, 30 days, and 12 months after treatment. Only two of the four studied indexes evidenced a reliable improvement of the condition after therapy and joining by traditional techniques, but the effect proved to be unstable, and 12 months after treatment both values significantly grew again. When traditional treatment modalities are used, alleviation of the inflammation and improvement of the hygienic condition of the oral cavity depend not so much on the type of joining but mostly on the initial status of the periodontium. A more manifest and stable reduction of the inflammation and improvement of the oral cavity hygienic status were observed in the patients treated with the use of present-day more physiologic cast designs. This evidence considerable advantages of these new designs vs. the traditional ones.
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A modification of existing designs for resin-bonded retainers has been introduced. This new design is appropriate for the extracoronal splinting of anterior teeth with reduced periodontal support. The design of the splint will accommodate the increased risk of these teeth for endodontic failure. The versatility and advantages of this design have been presented and compared with other anterior splinting techniques. At present, there appears to be no clinically significant difference in the retentiveness of perforated and nonperforated etched metal retainers.
The purpose of this study was to evaluate the effect of splinting teeth on the results of periodontal reconstructive surgery using a specific carbonate bone replacement graft (BRG) material. Forty-five patients were randomly treated with a periodontal surgery approach. Natural coral calcium BRG was utilised in 33 patients. This 33-patient group was divided into three equal groups. In the presplint group, teeth were splinted to at least two rigid teeth before surgery, in the postsplint group, teeth were splinted at suture removal, and in the nonsplint group, the treated teeth were not splinted at all. In 12 patients, teeth were treated with surgical debridement (DEBR) alone and not splinted. Periodontal probing depth (PPD), clinical probing attachment level (CPAL), and tooth mobility were measured using desmodontometry (DDM) and periotest (PTV) with reproducible methods before surgery and at various periods up to 1 year afterwards. A decrease in PPD (5.4 mm, SD 1.4 mm) and tooth mobility (DDM-horizontal 257 microns, SD 60 microns) and a gain of CPAL (5.1 mm, SD 1.4 mm) were seen following the use of BRG in presplint teeth. In the same group, PPD and tooth mobility were significantly reduced compared to nonsplint teeth. DEBR alone showed reductions in tooth mobility and PPD and a significantly smaller gain in CPAL than in presplint teeth treated with BRG. The less favourable improvement in periodontal function of postsplint or nonsplint teeth seemed to be due to the loss of BRG material caused by tooth mobility. These results indicate that an undisturbed wound healing process using BRG together with tooth stability is beneficial to overall clinical success.
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