Splinting- Managing mobile teeth

Splinting refers to "the joining of two or more teeth into a rigid unit by means of fixed or removable restorations or devices." The overall objective is to create an environment where tooth movement can be limited within physiologic limits with simultaneous restoration of function and patient comfort. The splint may be indicated because of individual tooth mobility or mobility of the entire dentition. Splinting may be a way to gain stability, reduce or eliminate the mobility, and relieve the pain and discomfort. Splints may be classified as provisional and definitive. The type of splint depends on the intended goal of therapy.

Temporary splints may be worn for less than 6 months and may not be followed by additional splint therapy. They provide an insight into whether or not stabilization of the teeth provides any benefit before any irreversible definitive treatment is even initiated. These splints typically are fabricated using thin stainless steel wires, and tooth colored composite resin restorative materials. The splint can also be reinforced in several ways using one of the following materials: ligature wire, glass fiber, or a

polyethylene fiber reinforced polymer( Ribbond Fiber). When anterior teeth require splinting, tooth colored restorative resin reinforced with polyethylene fiber is the material of choice. Such an interim restoration not only can improve esthetics, it can restore the occlusal scheme to be incorporated into any definitive prostheses. Only after the interim restoration has been worn by the patient can the design and occlusal form of the final prosthesis be evaluated and incorporated. in the definitive restoration. In patients with a history of bruxism and clenching, special occlusal splints are recommended to help stabilize teeth following selective occlusal adjustment.

Permanent splints maintain long term stability of the dentition. Definitive splints are placed only after stability has been achieved in order to increase functional stability, and improve esthetics on a long-term basis. Such treatment includes conventional fixed prostheses (Dental Bridges) because they provide definitive rigidity and are better able to control and direct occlusal forces than removable splints.

However, the mere presence of tooth mobility does not justify the need to splint teeth. Splinting is best viewed as a preventive treatment measure for teeth that have minimal or no bone loss, yet are clinically mobile. Therefore before treatment is started, the cause of any mobility must be identified. Extraction is an appropriate treatment for extremely mobile teeth.