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PubMed2002

Tooth splinting with fiber-reinforced composite materials: achieving predictable aesthetics.

The need to respond to the ever-increasing patient demand for aesthetics, tissue maintenance, and cost efficiency has resulted in the evolution of techniques and materials that allow predictable restoration of teeth that would otherwise be compromised. The development of synthetic dental materials has allowed the incorporation of fiber-reinforced materials to replace metal splints. These contemporary materials provide increased flexural strength, as well as improved aesthetics, to the restoration. This article describes a conservative tooth splinting procedure using polyethylene fibers as reinforcement for both direct and indirect restorations.

Acid Etching, Dental↗
PubMed1996

Effect of splinting on load distribution of extracoronal attachment with distal extension prosthesis in vitro.

Previous reports have suggested that the restoration of distal extension edentulous areas with an extracoronal precision attachment partial denture necessitates splinting of abutments. However, the number of splinted teeth remains controversial. In this study, strain gauge technology was used to monitor stresses induced around the abutment and in the distal extension area under different loads as a function of the number of splinted abutments. Three strain gauges were installed in the outer buccal, lingual, and distal surfaces of the abutment to record stresses in the three planes of motion, and another gauge was placed under the distal extension base. The reduction of the number of splinted units from three to two resulted in an insignificant increase of stresses recorded, whereas reduction of the number from two to one resulted in a significant increase of stresses nine times greater than the three-unit splint values. On the basis of this in vitro model, at least two teeth on each side should be splinted when extracoronal distal extension attachment prostheses are used.

Bite Force↗
PubMed1984

Occlusal splints (MORA) vs. placebos show no difference in strength in symptomatic subjects: double blind/cross-over study.

Many athletes with or without occlusal problems are now using mandibular orthopedic repositioning appliances (MORA) or simply occlusal splints, supposedly to enhance skeletal muscle strength. Recent research to establish these claims has suffered from design inaccuracies. In theory, the MORA reduces temporomandibular stress during clenched jaw efforts. It is suggested that pain in the temporomandibular joint (TMJ) and surrounding musculature could limit a maximum effort during an athletic endeavour. Eight subjects with TMJ disorders were tested for strength changes in 4 muscle groups with a custom MORA and placebo splint in a tightly controlled double-blind cross-over protocol using a Cybex II dynamometer. A two-way analysis of variance (ANOVA) did not show significant differences in strength change between the two splints. Neither were there any trends that would suggest strength benefits from the MORA.

Adult↗
PubMed2005

Indications for splinting implant restorations.

PURPOSE: The purpose of this article was to review the literature concerning the need to splint implants together when restoring them with a provisional restoration immediately after implant placement. METHODS: The literature is reviewed concerning the rationale for splinting teeth and reports concerning the efficacy of splinting implants together. Based on this team's experience with a prospective series of consecutive 2 to 5 unit provisionalization cases, guidelines are included with case examples for understanding the technique. CONCLUSION: As long as canine guidance is present, and occlusion is stable, multiunit single quadrant restorations do not need to be splinted when provisionalized.

Dental Abutments↗
PubMed2002

Comfort and discomfort of dental trauma splints - a comparison of a new device (TTS) with three commonly used splinting techniques.

The present experimental study compared four dental trauma splints in 10 volunteers. The evaluated splints included a wire-composite splint (WCS), a button-bracket splint (BS), a resin splint (RS), and the newly developed titanium trauma splint (TTS). All splints were bonded to the labial surfaces of the maxillary lateral and central incisors and left in place for 1 week. After splint removal, the next splint was placed after a 1-week rest period. The sequence of splint application was randomized for each individual. The following subjective parameters were assessed using a visual analogue scale: sensitiveness of splinted teeth, irritation of the gingival margin, irritation of the lips, impairment of speech, eating and oral hygiene. The results show that the application of BS leads to a significantly higher irritation of the lips and greater impairment of speech compared to other splints (P < 0.05). The RS leads to an increased and significantly higher irritation of the gingiva (P < 0.05) owing to a significant increase in cleaning difficulties (P < 0.05). In conclusion, WCS and TTS appear to be more accepted splints according to a subjective assessment by 10 volunteers.

Acrylic Resins↗
PubMed1980

A 3-month study in monkeys of occlusal dysfunction and stress.

A dysfunctional occlusal relationship was produced in six Macaca irus monkeys by insertion of occlusal splints in the maxilla which raised the vertical dimension of occlusion by 3-4 mm and incorporated interferences into the occlusion (test side). Cortisol levels of plasma and urine were measured by competitive protein binding analysis. At week 1 and week 3 after insertion of the splints there was a significant increase of 24 h urinary cortisol excretion rate and plasma cortisol concentration, indicating emotional stress. Furthermore, there was evidence of acute trauma from occlusion of the mandibular teeth of the test side, including a significant increase of tooth mobility and GI; radiographically there were signs of breakdown of margial and interradicular alveolar bone. One animal developed periodontal pockets of 4-5 mm adjacent to the teeth of the test side. At week 6 and week 12 urinary and plasma cortisol levels had declined to basal values whereas tooth mobility, GI and PI remained elevated. There was no clinical or radiographic evidence of further loss of bone or increase of pocket depth adjacent to the teeth of the test side during the latter part of the experimental period. The results suggest that emotional stress may be involved in periodontal reactions associated with acute trauma from occlusion.

Animals↗
PubMed2003

Assessing revascularization of avulsed permanent maxillary incisors by laser Doppler flowmetry.

BACKGROUND: Laser Doppler flowmetry, or LDF, is a noninvasive method used to assess pulpal blood flow, or PBF. Dental avulsion is associated with loss of pulpal sensitivity. The authors conducted this study to assess whether LDF could be used to detect revascularization of replanted teeth. METHODS: The authors used LDF to assess the PBF values of avulsed permanent maxillary incisors treated using replantation and splinting in 17 subjects. They took measurements at four sessions: on the day of splint removal and at 12 weeks, 24 weeks and 36 weeks after splint removal. Five vital control teeth and five nonvital control teeth were used to assess the background signal. At 36 weeks, the authors determined clinically and radiographically whether revascularization had occurred. RESULTS: LDF readings correctly predicted the pulp status in 88.2 percent of the readings. Of the readings for vital teeth, 100 percent were correct, and of the readings for nonvital teeth, 80 percent were correct. Univariate analysis of variance demonstrated that in revascularized teeth, the PBF value increased significantly from splint removal to week 12 after splint removal and from week 24 to week 36 after splint removal. In the teeth that failed to revascularize, the PBF value dropped significantly from week 24 to week 36 after splint removal. CONCLUSIONS: The results of this study suggest that LDF accurately diagnoses revascularization of avulsed maxillary incisors after replantation and splinting. CLINICAL IMPLICATIONS: LDF may become useful in detecting revascularization much earlier than standard sensitivity tests.

Analysis of Variance↗
PubMed2002

[Fractures of the atrophic mandible--our experience at Tel-Aviv Medical Center].

UNLABELLED: Fractures of the atrophic edentulous mandible are relatively uncommon. The treatment poses a real challenge due to the underlying medical condition of the geriatric population affected. The complication rate such as infection or malunion is higher compared to fractures in younger patients. Twenty-three cases of fractures of edentulous mandible were reviewed and analyzed. CONCLUSION: The geriatric maxillofacial trauma patients can be treated with open reduction and rigid fixation which allows a quick return to normal function. The conservative approach "close reduction with Gunning-type splints is still an adequate mode of treatment in clinical settings where a more aggressive surgical approach is contraindicated.

Accidental Falls↗
PubMed2000

[Semi-rigid bracket splinting of teeth after traumatic luxation].

We describe a non-rigid procedure using brackets for splinting teeth after traumatic avulsion. This type of appliance preserves alveolodental ligament physiology and enables immediate mastication without occlusal obstruction. Installation is easy, except when severe bleeding or alveolar fracture occurs.

Dental Pulp Necrosis↗
PubMed1989

[Tooth reimplantation].

At the Clinics of Oral Surgery of the Semmelweis Medical University Budapest 16 teeth were reimplanted during the last four years. According to experiences improved by splinting the reimplanted tooth with passive wire arch fastened to brackets, and by filling the root channel with Ca(OH)2. The Favourable therapeutic effect of Ca(OH)2 means impediment of almost always developing resorption.

Adolescent↗
PubMed1998

The evolution of temporary fixed splints--the A-splint.

This article presents a review of the evaluation of the temporary splint leading up to the present-day acid-etched composite, wire-reinforced, internal splint called the "A-splint." Nine general uses for the A-splint in the modern dental practice and some common problems are presented.

Dental Care↗
PubMed1979

Predicting by electromyography the results of nonsurgical treatment of temporomandibular joint syndrome.

This study of 308 patients demonstrated that reliance upon physical findings alone is not reliable for the diagnosis and the prediction of treatment success in TMJS. However, those patients who had a lengthened masseteric silent period on the EMG had a 93% success rate from treatment with occlusal splint and occlusal adjustment. In contrast, those patients who had a normal masseteric silent period on the EMG had only a 21 percent success rate from the same therapy.

Adolescent↗
PubMed1985

Cross-arch splinting with resin-bonded retainers.

The procedure described can provide innovative cross-arch splinting for patients. The longevity of resin-bonded restorations has not been determined, but the procedure is promising, economical, and reversible. These facts should be made available to patients during presentation of the treatment plan.

Composite Resins↗
PubMed2002

Use of a removable splint in the treatment of subluxated, luxated and root fractured anterior permanent teeth in children.

AIM: The aim of this study was to evaluate the prognosis of subluxated, luxated and root fractured teeth in children treated by removable splints, designed to stabilize mobile anterior teeth and eliminate occlusal trauma due to malocclusion. MATERIAL AND METHODS: A total of 227 traumatized anterior teeth (91 subluxated, 105 luxated and 31 root fractured teeth) treated with a removable splint were observed for 3 years. The traumatized teeth were from 79 children aged between 6-12 years (mean 8 years 5 months). If a traumatized tooth was extremely mobile, a fixed splint was first made before the impression was taken for the removable splint. Two weeks after completion of the removable splint treatment, an impression was taken again to evaluate the occlusal relationship of pre- versus post-treatment of removable splint. RESULTS: The treatment period with a removable splint averaged 3 weeks in subluxated teeth, 3-5 weeks in luxated teeth, 4-6 weeks in apical third root fracture injuries, and more than 5 weeks in middle third root fracture injuries. All the subluxated teeth and 74.1% of the luxated teeth maintained their pulp vitality during the 3-year follow-up period. Two of 21 (9.5%) apical third root fracture teeth and three of five (60%) middle third root fracture teeth had pulp necrosis in the coronal fragments. Internal resorption was not found in any of the traumatized teeth. External replacement resorption was not found in subluxated and luxated teeth. All the root fractured teeth displayed transient external resorption around the fracture lines. The surface resorption appeared to be self-limiting and not to threaten the retention of the tooth. Inflammatory resorption was observed in teeth with pulp necrosis, but in all cases this was reversed with endodontic treatment. Eight of 23 (39%) apical third root fractured teeth displayed replacement resorption in their apical fragments, but the resorption was not serious enough to extract the tooth. No obvious alteration in the occlusal relationship was found comparing pre- and post-treatment casts. The removable splints appeared to positively affect healing after traumatic injuries, as evidenced by the low number of complications at the 3-year follow-up period.

Child↗
PubMed1995

[Therapy of narrow canine teeth using a methacrylate orthodontic splint].

32 cases of narrow canine teeth were treated with an orthodontic splint similar to the Becker-splint (1965). The splints are either fixed only to one or two teeth using adhesive bone of to both canine teeth and incisors. They can be made simply within short time and may treat different orthodontic problems.

Animals↗
PubMed2000

Fibre-reinforced materials.

This paper considers the role of fibres in the reinforcement of composite materials, and the significance of the form the fibre takes and the material from which it is made. The current dental applications of fibre reinforcement, including dental cements and splints, fibres made into structures for use in composites, denture bases and the contemporary use of fibres in fixed partial dentures, are reviewed. Their role in biomedical implants is surveyed and their future forecast.

Carbon↗