This document provides an overview of splinting of traumatized teeth. It discusses the history, definitions, rationale, principles, indications, objectives, and classifications of splinting. Various splint types are described in detail, including wire ligatures, arch bars, composite and wire, orthodontic wire and brackets, fibre, titanium trauma splints, and more. Flexible splints that allow physiological movement are preferred to rigid splints. The optimal duration of splinting depends on the specific injury but is typically 4-6 weeks. Longer immobilization can lead to bone loss from periodontal issues.
Biodentin is a calcium silicate-based dental cement that forms reactionary dentin when used for pulp capping and other endodontic procedures. It has a short setting time of 9-12 minutes and excellent biocompatibility properties. Biodentin bonds mechanically and through ionic exchange with dentin, has superior mechanical properties to other cements, and provides a good seal with antibacterial effects due to the alkaline pH released during setting. Its main advantages are its biocompatibility, short setting time, and versatility for uses such as pulpotomy, apexification, and pulp capping.
Splinting is one of the oldest forms of aids to periodontal therapy. By redistribution of forces on the affected teeth the splint minimizes the effects caused by loss of support. Splinting teeth to each other allows weakened teeth to be supported by neighbouring teeth. This presentation reviews the rationale, techniques, advantages and ill effects of stabilization of teeth by splinting as an aid to periodontal therapy. With the acceptance and clinical predictability of adhesive procedures, the use of conservative bonding techniques to splint teeth offers a useful alternative to more invasive restorative procedures. Loss of tooth-supporting structures results in tooth mobility. Increased tooth mobility adversely affects function, aesthetics, and the patient’s comfort. Splints are used to overcome all these problems. When faced with the dilemma of how to manage periodontally compromised teeth, splinting of mobile teeth to stronger adjacent teeth is a viable option. This prolongs the life expectancy of loose teeth, gives stability for the periodontium to reattach, and improves comfort, function and aesthetics.
The document provides information on atraumatic restorative treatment (ART). Some key points:
- ART was developed in the 1980s in Tanzania as a minimally invasive approach to dental caries that aims to preserve tooth structure. It uses manual excavation and glass ionomer restoration to avoid anesthesia and expensive equipment.
- ART has several advantages, including being non-invasive and painless, making it highly acceptable to patients. It also releases fluoride and bonds to tooth structure.
- The principles of ART are removing carious lesions using hand instruments only and restoring the cavity with glass ionomer, which bonds to the tooth. This simplifies infection control compared to traditional rotary drills.
-
This document discusses various pulp therapies for primary teeth including indirect pulp capping, direct pulp capping, pulpotomy, and apexogenesis. It provides details on the procedures, indications, contraindications, and materials used for each therapy. Indirect pulp capping involves carious dentin removal while avoiding pulp exposure and using calcium hydroxide or MTA to protect the pulp. Direct pulp capping is used when a small exposure occurs, using calcium hydroxide or MTA directly on the exposure. Pulpotomy involves removing the coronal pulp and using formocresol or other medications to preserve the remaining vital pulp.
Restoration of endodontically treated teethNivedha Tina
This document discusses various methods for restoring endodontically treated teeth. It covers the history of restoring pulpless teeth dating back to 1747. Key factors in selecting a restorative approach include the amount of residual root and crown structure remaining as well as the tooth's function and position. Methods discussed include direct composite restorations, indirect restorations, fiber posts, cast posts, and full crowns. The document also addresses the vulnerability of root filled teeth to fracture and emphasizes the importance of preserving tooth structure.
Biodentin is a calcium silicate-based dental cement that forms reactionary dentin when used for pulp capping and other endodontic procedures. It has a short setting time of 9-12 minutes and excellent biocompatibility properties. Biodentin bonds mechanically and through ionic exchange with dentin, has superior mechanical properties to other cements, and provides a good seal with antibacterial effects due to the alkaline pH released during setting. Its main advantages are its biocompatibility, short setting time, and versatility for uses such as pulpotomy, apexification, and pulp capping.
Splinting is one of the oldest forms of aids to periodontal therapy. By redistribution of forces on the affected teeth the splint minimizes the effects caused by loss of support. Splinting teeth to each other allows weakened teeth to be supported by neighbouring teeth. This presentation reviews the rationale, techniques, advantages and ill effects of stabilization of teeth by splinting as an aid to periodontal therapy. With the acceptance and clinical predictability of adhesive procedures, the use of conservative bonding techniques to splint teeth offers a useful alternative to more invasive restorative procedures. Loss of tooth-supporting structures results in tooth mobility. Increased tooth mobility adversely affects function, aesthetics, and the patient’s comfort. Splints are used to overcome all these problems. When faced with the dilemma of how to manage periodontally compromised teeth, splinting of mobile teeth to stronger adjacent teeth is a viable option. This prolongs the life expectancy of loose teeth, gives stability for the periodontium to reattach, and improves comfort, function and aesthetics.
The document provides information on atraumatic restorative treatment (ART). Some key points:
- ART was developed in the 1980s in Tanzania as a minimally invasive approach to dental caries that aims to preserve tooth structure. It uses manual excavation and glass ionomer restoration to avoid anesthesia and expensive equipment.
- ART has several advantages, including being non-invasive and painless, making it highly acceptable to patients. It also releases fluoride and bonds to tooth structure.
- The principles of ART are removing carious lesions using hand instruments only and restoring the cavity with glass ionomer, which bonds to the tooth. This simplifies infection control compared to traditional rotary drills.
-
This document discusses various pulp therapies for primary teeth including indirect pulp capping, direct pulp capping, pulpotomy, and apexogenesis. It provides details on the procedures, indications, contraindications, and materials used for each therapy. Indirect pulp capping involves carious dentin removal while avoiding pulp exposure and using calcium hydroxide or MTA to protect the pulp. Direct pulp capping is used when a small exposure occurs, using calcium hydroxide or MTA directly on the exposure. Pulpotomy involves removing the coronal pulp and using formocresol or other medications to preserve the remaining vital pulp.
Restoration of endodontically treated teethNivedha Tina
This document discusses various methods for restoring endodontically treated teeth. It covers the history of restoring pulpless teeth dating back to 1747. Key factors in selecting a restorative approach include the amount of residual root and crown structure remaining as well as the tooth's function and position. Methods discussed include direct composite restorations, indirect restorations, fiber posts, cast posts, and full crowns. The document also addresses the vulnerability of root filled teeth to fracture and emphasizes the importance of preserving tooth structure.
This document discusses glass ionomer cement and resin-modified glass ionomer cement in restorative dentistry. It describes the composition and setting reactions of glass ionomer cement, as well as its advantages like adhesion to tooth structure, fluoride release, and low shrinkage. However, it also notes disadvantages like poorer wear resistance and physical properties compared to resin composites, as well as ongoing moisture sensitivity issues. The document then discusses how resin-modified glass ionomer cements were developed to improve properties like strength and reduce moisture sensitivity issues. It concludes by describing clinical applications of resin-modified glass ionomer cements, such as for class V restorations, root caries treatment, and the sandwich technique.
This document discusses splinting of traumatized teeth. It defines splints and their requirements, and describes how splinting influences dental tissues. Different types of splints are described, including composite and wire splints, fibre splints, and titanium trauma splints. Guidelines are provided for splint indications, contraindications, application steps, and recommendations for splint type and duration depending on the specific dental trauma. Factors such as injury classification, healing timeframes, and risk of ankylosis are considered for splint removal timing.
This document discusses revascularization procedures for immature permanent teeth with necrotic pulps. It begins by introducing the challenges of treating such teeth and the potential for revascularization to encourage continued root development. The history of revascularization is then reviewed, from early case studies in the 1960s demonstrating new tissue formation in root canals, to more recent definitions and understanding of the process. Key aspects of revascularization techniques using calcium hydroxide, triple antibiotic paste, and their two-step protocols are then outlined. Considerations for instrumentation, irrigation, and medication of the root canal are also presented.
This document provides an overview of glass ionomer cement (GIC), including:
1. The history and development of GIC from its invention in 1972 to current modifications.
2. Classifications of GIC based on various criteria such as type, clinical use, and curing method.
3. The composition of GIC including glass powder, polyacrylic acid liquid, and their roles in the setting reaction.
4. Key properties of GIC such as working time, strength, fluoride release, biocompatibility, and indications/contraindications for use.
5. Modifications to traditional GIC including water-hardening and metal-modified versions.
Abutment & Its Selection In Fixed Partial DentureSelf employed
This document discusses factors to consider when selecting abutment teeth for fixed partial dentures (FPDs). It defines an abutment tooth and outlines how to assess potential abutments, including taking radiographs and evaluating crown morphology, root configuration, crown-to-root ratio, and other anatomical features. Good abutment teeth are vital with adequate bone and root support and crown structure to withstand forces from the FPD. Location, occlusion, tooth structure and root health must be optimized for successful force distribution from the prosthesis.
GLASS IONOMER CEMENT AND ITS RECENT ADVANCES- by Dr. JAGADEESH KODITYALAJagadeesh Kodityala
This document provides an overview of glass ionomer cement, including its definition, history, composition, classification, setting reaction, properties, and recent advances. Key points include:
- Glass ionomer cement was invented in 1969 and first reported in 1971, consisting of a glass powder and aqueous solution of polyacrylic acid.
- It is classified based on its intended use, such as luting cement, restorative cement, or liner/base material.
- The setting reaction involves an acid-base reaction between the glass powder and polyacrylic acid, forming bonds through a calcium polyacrylate matrix that continues to harden over time.
- Properties include adhesion to tooth structure, biocompatibility, fluoride
An inlay is a restoration that is constructed from materials like gold or porcelain outside of the mouth and then cemented into a prepared cavity. An onlay covers one or more cusps and adjoining occlusal surface of a tooth. Indirect restorations can be made from cast metals, composites, or porcelain. They are indicated for large restorations, endodontically treated teeth, dental rehabilitation with metals, and as removable prosthodontic abutments. Precise tooth preparation is needed with beveled margins and no undercuts to ensure proper fit.
This document provides an overview of minimally invasive dentistry (MID), including:
1. MID aims to conserve healthy tooth structure using prevention, remineralization, and minimal intervention. It focuses on performing only necessary dentistry using long-lasting materials.
2. Key principles of MID include disease control, remineralization of early lesions, avoiding removal of excess tooth structure, and using strong, long-lasting materials.
3. Techniques discussed include caries diagnosis/risk assessment, various caries removal methods like air abrasion and lasers, fissure sealants, preventive resin restorations, ART, and chemo-mechanical caries removal.
This document discusses apexification and apexogenesis procedures for immature teeth with open apices. It defines open apices as teeth with arrested root development resulting in a large apical opening. For teeth with vital pulp but pulp exposure, the goal is apexogenesis to allow continued root development through calcium hydroxide pulpotomy. For teeth with non-vital pulp, apexification is used to induce apical closure with materials like calcium hydroxide or MTA to create an apical plug for filling. Successful outcomes depend on follow up over 1-2 years to monitor continued root development or closure of the apex.
Difference between pulpotomy and pulpectomyOwais92
Pulpotomy involves removing the coronal portion of the pulp and placing a medicament, indicated for large carious lesions involving the marginal ridge in a vital tooth with no pain or infection. Pulpectomy removes all pulp tissue from the chamber and root canals, indicated for teeth with irreversible pulpitis throughout the pulp or abscessed primary teeth. Contraindications for both procedures include the presence of infection, bone loss, or non-restorable teeth.
This document discusses apexogenesis and apexification procedures for teeth with open apices or immature roots. Apexogenesis refers to inducing continued root development in a tooth with a vital pulp, while apexification aims to induce apical closure in a tooth with a non-vital pulp. For apexogenesis, calcium hydroxide is used to maintain pulp viability and allow root maturation. For apexification, multiple visits using calcium hydroxide or single-visit techniques with mineral trioxide aggregate are described to create an artificial apical barrier for obturation. The document outlines treatment approaches, materials, and expected outcomes for apexification and apexogenesis procedures.
1. The document discusses electronic apex locators (EALs), which are devices used to determine the working length of a root canal without radiography.
2. It describes the six generations of EALs, from first-generation resistance-based devices to sixth-generation adaptive apex locators. Key EAL models are provided for each generation.
3. The mechanisms of EALs are explained, noting they measure changes in resistance or impedance as a file tip approaches the apex. Accuracy and limitations of each generation are summarized.
The document discusses the use of magnification in endodontics. It begins with a brief history of magnification tools used in dentistry, from early microscopes to modern dental operating microscopes (DOM). It then defines various optical terms and describes different magnification tools including loupes, DOM, and rod lens endoscopes. The bulk of the document focuses on DOM, outlining its components, how it works, proper positioning and use. It concludes that DOM provides significant benefits for endodontic procedures by enabling preservation of tooth structure, localization of anatomy, and detection of fractures or separated instruments.
Protaper means progressively taper.
•NiTi
Protaper means progressively taper.
•NiTi
Increased flexibility
• Each instrument produces its own 'crown down effect' as larger tapers make way for smaller tapers.
• Protaper files engage a smaller area of dentine reducing torsional loads and file fatigue
This presentation is all about restoration of endodontically treated teeth, prefabricated post and core, cast post and core, direct and indirect technique.
This document discusses provisional restorations, including their definition, purpose, requirements, and fabrication methods. Provisional restorations are interim prostheses used for a limited time after tooth preparation until a permanent restoration can be placed. They protect the prepared tooth, maintain function and aesthetics, and allow the dentist to assess treatment. Ideal provisionals have biologic requirements like pulp protection and positional stability, mechanical requirements like strength and retention, and aesthetic requirements like color matching. They can be custom-made using various resin or metal materials or prefabricated. Direct, indirect, and combined fabrication techniques are described.
Biodentine is a new tricalcium silicate-based restorative cement that can be used as a dentin substitute with superior physical and biological properties compared to MTA. It sets faster than MTA due to the addition of calcium chloride as an accelerator. Upon setting, Biodentine releases calcium ions that stimulate reparative dentin formation and pulp healing. Studies show Biodentine forms a stronger bond to dentin and achieves higher mechanical strengths than MTA, making it suitable for various restorative, endodontic and pulp capping procedures.
This document provides information on root canal obturation materials. It defines obturation as the three dimensional filling of the entire root canal system as close to the cementodentinal junction as possible. The objectives and ideal requirements of root canal filling materials are described. Materials are classified and various materials used for filling root canals are discussed, including gutta percha, resilon, silver points, and various cements. The properties, advantages, and disadvantages of gutta percha are summarized. Recent advances in materials like medicated gutta percha and resilon are also outlined.
A detailed description about endo perio interrelationship, including introduction, development and etiology, historical aspects, definition, classification, diagnosis, differential diagnosis, management, special consideration in management,controversies prognosis, conclusion.
Splinting involves joining two or more teeth together to provide support and stabilization. It has been used in dentistry for thousands of years to treat injuries and mobility. Modern splinting uses various materials like wires, resins, and fibers placed intracoronally or extracoronally. Splints are indicated to stabilize mobile teeth from trauma, reduce forces during healing, or maintain arch integrity. They come in many forms like direct bonding splints, wire splints, night guards, and occlusal splints. The goal is to evenly distribute forces across multiple teeth while allowing function and hygiene.
This document provides an overview of dental splinting. It begins with definitions and a history of splinting. It describes the biologic and clinical rationales for splinting teeth, including redistributing forces and preserving arch integrity. The document outlines indications and contraindications for splinting. It classifies splints as temporary, provisional, or permanent. Examples of different splint types are described, including extracoronal, intracoronal, and fiber-reinforced splints.
This document discusses glass ionomer cement and resin-modified glass ionomer cement in restorative dentistry. It describes the composition and setting reactions of glass ionomer cement, as well as its advantages like adhesion to tooth structure, fluoride release, and low shrinkage. However, it also notes disadvantages like poorer wear resistance and physical properties compared to resin composites, as well as ongoing moisture sensitivity issues. The document then discusses how resin-modified glass ionomer cements were developed to improve properties like strength and reduce moisture sensitivity issues. It concludes by describing clinical applications of resin-modified glass ionomer cements, such as for class V restorations, root caries treatment, and the sandwich technique.
This document discusses splinting of traumatized teeth. It defines splints and their requirements, and describes how splinting influences dental tissues. Different types of splints are described, including composite and wire splints, fibre splints, and titanium trauma splints. Guidelines are provided for splint indications, contraindications, application steps, and recommendations for splint type and duration depending on the specific dental trauma. Factors such as injury classification, healing timeframes, and risk of ankylosis are considered for splint removal timing.
This document discusses revascularization procedures for immature permanent teeth with necrotic pulps. It begins by introducing the challenges of treating such teeth and the potential for revascularization to encourage continued root development. The history of revascularization is then reviewed, from early case studies in the 1960s demonstrating new tissue formation in root canals, to more recent definitions and understanding of the process. Key aspects of revascularization techniques using calcium hydroxide, triple antibiotic paste, and their two-step protocols are then outlined. Considerations for instrumentation, irrigation, and medication of the root canal are also presented.
This document provides an overview of glass ionomer cement (GIC), including:
1. The history and development of GIC from its invention in 1972 to current modifications.
2. Classifications of GIC based on various criteria such as type, clinical use, and curing method.
3. The composition of GIC including glass powder, polyacrylic acid liquid, and their roles in the setting reaction.
4. Key properties of GIC such as working time, strength, fluoride release, biocompatibility, and indications/contraindications for use.
5. Modifications to traditional GIC including water-hardening and metal-modified versions.
Abutment & Its Selection In Fixed Partial DentureSelf employed
This document discusses factors to consider when selecting abutment teeth for fixed partial dentures (FPDs). It defines an abutment tooth and outlines how to assess potential abutments, including taking radiographs and evaluating crown morphology, root configuration, crown-to-root ratio, and other anatomical features. Good abutment teeth are vital with adequate bone and root support and crown structure to withstand forces from the FPD. Location, occlusion, tooth structure and root health must be optimized for successful force distribution from the prosthesis.
GLASS IONOMER CEMENT AND ITS RECENT ADVANCES- by Dr. JAGADEESH KODITYALAJagadeesh Kodityala
This document provides an overview of glass ionomer cement, including its definition, history, composition, classification, setting reaction, properties, and recent advances. Key points include:
- Glass ionomer cement was invented in 1969 and first reported in 1971, consisting of a glass powder and aqueous solution of polyacrylic acid.
- It is classified based on its intended use, such as luting cement, restorative cement, or liner/base material.
- The setting reaction involves an acid-base reaction between the glass powder and polyacrylic acid, forming bonds through a calcium polyacrylate matrix that continues to harden over time.
- Properties include adhesion to tooth structure, biocompatibility, fluoride
An inlay is a restoration that is constructed from materials like gold or porcelain outside of the mouth and then cemented into a prepared cavity. An onlay covers one or more cusps and adjoining occlusal surface of a tooth. Indirect restorations can be made from cast metals, composites, or porcelain. They are indicated for large restorations, endodontically treated teeth, dental rehabilitation with metals, and as removable prosthodontic abutments. Precise tooth preparation is needed with beveled margins and no undercuts to ensure proper fit.
This document provides an overview of minimally invasive dentistry (MID), including:
1. MID aims to conserve healthy tooth structure using prevention, remineralization, and minimal intervention. It focuses on performing only necessary dentistry using long-lasting materials.
2. Key principles of MID include disease control, remineralization of early lesions, avoiding removal of excess tooth structure, and using strong, long-lasting materials.
3. Techniques discussed include caries diagnosis/risk assessment, various caries removal methods like air abrasion and lasers, fissure sealants, preventive resin restorations, ART, and chemo-mechanical caries removal.
This document discusses apexification and apexogenesis procedures for immature teeth with open apices. It defines open apices as teeth with arrested root development resulting in a large apical opening. For teeth with vital pulp but pulp exposure, the goal is apexogenesis to allow continued root development through calcium hydroxide pulpotomy. For teeth with non-vital pulp, apexification is used to induce apical closure with materials like calcium hydroxide or MTA to create an apical plug for filling. Successful outcomes depend on follow up over 1-2 years to monitor continued root development or closure of the apex.
Difference between pulpotomy and pulpectomyOwais92
Pulpotomy involves removing the coronal portion of the pulp and placing a medicament, indicated for large carious lesions involving the marginal ridge in a vital tooth with no pain or infection. Pulpectomy removes all pulp tissue from the chamber and root canals, indicated for teeth with irreversible pulpitis throughout the pulp or abscessed primary teeth. Contraindications for both procedures include the presence of infection, bone loss, or non-restorable teeth.
This document discusses apexogenesis and apexification procedures for teeth with open apices or immature roots. Apexogenesis refers to inducing continued root development in a tooth with a vital pulp, while apexification aims to induce apical closure in a tooth with a non-vital pulp. For apexogenesis, calcium hydroxide is used to maintain pulp viability and allow root maturation. For apexification, multiple visits using calcium hydroxide or single-visit techniques with mineral trioxide aggregate are described to create an artificial apical barrier for obturation. The document outlines treatment approaches, materials, and expected outcomes for apexification and apexogenesis procedures.
1. The document discusses electronic apex locators (EALs), which are devices used to determine the working length of a root canal without radiography.
2. It describes the six generations of EALs, from first-generation resistance-based devices to sixth-generation adaptive apex locators. Key EAL models are provided for each generation.
3. The mechanisms of EALs are explained, noting they measure changes in resistance or impedance as a file tip approaches the apex. Accuracy and limitations of each generation are summarized.
The document discusses the use of magnification in endodontics. It begins with a brief history of magnification tools used in dentistry, from early microscopes to modern dental operating microscopes (DOM). It then defines various optical terms and describes different magnification tools including loupes, DOM, and rod lens endoscopes. The bulk of the document focuses on DOM, outlining its components, how it works, proper positioning and use. It concludes that DOM provides significant benefits for endodontic procedures by enabling preservation of tooth structure, localization of anatomy, and detection of fractures or separated instruments.
Protaper means progressively taper.
•NiTi
Protaper means progressively taper.
•NiTi
Increased flexibility
• Each instrument produces its own 'crown down effect' as larger tapers make way for smaller tapers.
• Protaper files engage a smaller area of dentine reducing torsional loads and file fatigue
This presentation is all about restoration of endodontically treated teeth, prefabricated post and core, cast post and core, direct and indirect technique.
This document discusses provisional restorations, including their definition, purpose, requirements, and fabrication methods. Provisional restorations are interim prostheses used for a limited time after tooth preparation until a permanent restoration can be placed. They protect the prepared tooth, maintain function and aesthetics, and allow the dentist to assess treatment. Ideal provisionals have biologic requirements like pulp protection and positional stability, mechanical requirements like strength and retention, and aesthetic requirements like color matching. They can be custom-made using various resin or metal materials or prefabricated. Direct, indirect, and combined fabrication techniques are described.
Biodentine is a new tricalcium silicate-based restorative cement that can be used as a dentin substitute with superior physical and biological properties compared to MTA. It sets faster than MTA due to the addition of calcium chloride as an accelerator. Upon setting, Biodentine releases calcium ions that stimulate reparative dentin formation and pulp healing. Studies show Biodentine forms a stronger bond to dentin and achieves higher mechanical strengths than MTA, making it suitable for various restorative, endodontic and pulp capping procedures.
This document provides information on root canal obturation materials. It defines obturation as the three dimensional filling of the entire root canal system as close to the cementodentinal junction as possible. The objectives and ideal requirements of root canal filling materials are described. Materials are classified and various materials used for filling root canals are discussed, including gutta percha, resilon, silver points, and various cements. The properties, advantages, and disadvantages of gutta percha are summarized. Recent advances in materials like medicated gutta percha and resilon are also outlined.
A detailed description about endo perio interrelationship, including introduction, development and etiology, historical aspects, definition, classification, diagnosis, differential diagnosis, management, special consideration in management,controversies prognosis, conclusion.
Splinting involves joining two or more teeth together to provide support and stabilization. It has been used in dentistry for thousands of years to treat injuries and mobility. Modern splinting uses various materials like wires, resins, and fibers placed intracoronally or extracoronally. Splints are indicated to stabilize mobile teeth from trauma, reduce forces during healing, or maintain arch integrity. They come in many forms like direct bonding splints, wire splints, night guards, and occlusal splints. The goal is to evenly distribute forces across multiple teeth while allowing function and hygiene.
This document provides an overview of dental splinting. It begins with definitions and a history of splinting. It describes the biologic and clinical rationales for splinting teeth, including redistributing forces and preserving arch integrity. The document outlines indications and contraindications for splinting. It classifies splints as temporary, provisional, or permanent. Examples of different splint types are described, including extracoronal, intracoronal, and fiber-reinforced splints.
09. Splinting.pptx periodontium and healthNitika588942
The joining of two or more teeth into a rigid unit by means of fixed or removable restorations or devices”
“The joining of two or more teeth for the purpose of stabilization”
A Phoenician mandible from 500BC found in modern day Lebanon which has two carved ivory teeth attached to four natural teeth by gold wire
Findings from digging of Egyptians (3000 -2500 B.C.) show similar gold wiring
FACTORS TO BE CONSIDERED
Mobility patterns of the teeth to be splinted
Crown to root ratio of involved teeth
Status of the remaining teeth in the arch
Nature and the extent of periodontal destruction
Method of therapy that will be employed
TEMPORARY SPLINTS
Essentially a diagnostic procedure; reversible
Mechanical stabilization – hypermobility reduction
Method chosen – simplest, least expensive, least time consuming, esthetically acceptable, and should meet patient needs
Aid in determining whether teeth with a borderline prognosis will respond to therapy
EXTRACORONAL SPLINTS
1. Wire Ligation
Most common
Easy to construct; sturdy
Limitation – only where coronal form permits
Greatest use in – mandibular incisors
Hirschfield – loop tied at cervical line
Orthodontic Bands
Stabilize both anterior & posterior teeth
Attention to the contours of the bands
Contacts between teeth must be opened
Acrylic over the bands
Common path of insertion
Removable Acrylic Appliances
Dimensional instability of material may cause distortions
Imperative to check these frequently & make necessary adjustments.
Vital to check the path
of insertion of appliance
Acrylic Bite Guards (Night Guards)
Treatment of bruxism and clenching
Most common – covers occlusal surface of teeth
For additional support – palate is covered
Removable Cast Appliances
Usually a rigid casting either of gold or of chrome cobalt
Friedman’s variation – double continuous clasp casting
One end is not joined but is left open so that the casting can be sprung over the undercuts and then ligated
The posterior end is continuous from the buccal to the lingual surface
Another modification is an interlocking attachment on the distal end
The posterior end is continuous from the buccal to the lingual surface
Another modification is an interlocking attachment on the distal end
The posterior end is continuous from the buccal to the lingual surface
Another modification is an interlocking attachment on the distal end
The posterior end is continuous from the buccal to the lingual surface
Another modification is an interlocking attachment on the distal end
The posterior end is continuous from the buccal to the lingual surface
Another modification is an interlocking attachment on the distal end
The posterior end is continuous from the buccal to the lingual surface
Another modification is an interlocking attachment on the distal end
The posterior end is continuous from the buccal to the lingual surface
Another modification is an interlocking attachment on the dista
This document provides an overview of using dental implants for orthodontic anchorage. It discusses the history of implants, defines relevant terminology, and classifies implants based on position, material, size, and shape. The benefits of implants as anchorage devices and various implant designs are described. Acceptable placement sites are outlined as well as surgical procedures and bone-implant interface. Loading protocols, problems encountered, and other applications are summarized. The document concludes by referencing additional sources.
Materials used in Orthodontics _ Dr. Nabil Al-ZubairNabil Al-Zubair
This document discusses materials used in orthodontics. It begins by outlining the early history of orthodontics from ancient times through the 1800s, noting some of the first documented orthodontic materials like gold ligature wires. It then classifies orthodontic materials into two categories: by structure (such as wire alloys, brackets, cements) and by usage (such as wires, brackets, cements). Several specific orthodontic materials are described in more detail, including ceramic and self-ligating brackets, clear aligners, and different types of orthodontic wires. The document also covers topics like the properties and classifications of orthodontic forces, stresses, strains, and the stiffness of orthodontic
This document discusses post and core procedures for endodontically treated teeth. It covers objectives, indications, considerations for post length, diameter and design. Ideal post length is 1-2 mm shorter than the root and diameter should allow at least 1 mm of dentin surrounding the post. A ferrule is important to improve structural integrity. Post types discussed include custom cast metal posts, prefabricated metal posts like stainless steel and titanium, and non-metal options like carbon fiber, fiber-reinforced and zirconia posts. Fiber posts are more esthetic and flexible but have less strength than metal or zirconia posts. Proper diagnosis and treatment planning is required to select the best post and core for
Endodontically treated teeth ppt - a detailnitinsippy
This document discusses post and core procedures for endodontically treated teeth. It covers objectives, historical background, diagnosis and treatment planning considerations, indications for post and cores, methodology including post length, diameter and design. Factors like ferrule effect and different types of posts like custom cast, prefabricated metal, carbon fiber, glass fiber, and ceramic posts are described. Complications with post and core failures are also mentioned.
Advanced treatment of post & core - A presentationnitinsippy
The document discusses post and core procedures for endodontically treated teeth. It covers objectives, historical background, diagnosis and treatment planning considerations, indications for posts, post length, diameter and design factors. Types of posts discussed include custom cast posts, prefabricated metal posts, carbon fiber posts, glass fiber reinforced posts, and ceramic posts. Key factors in determining the need for and type of post include remaining tooth structure, root length and morphology. Ferrule effect and its role in improving restoration prognosis is also summarized.
The Basics of Splinting in Dentoalveolar Traumatology.pptxulster University
In order to even consider the use of a splint, it is necessary to know whether the traumatized tooth is primary or permanent and what kind of injury it has suffered.
In general, the use of a splint is not recommended for injuries to milk teeth, such as luxation or avulsion. Luxated milk teeth are most often extracted.
Repositioning is not recommended because there is a risk of infection which could endanger the tooth
Modern trends in dentoalveolar traumatology support the use of functional and flexible splints for luxation and avulsion.
The prognosis for traumatized teeth is more determined by the type of trauma than the type of splint selected.
The type of splint and the duration of immobilization, therefore, may not be considered significant variables in terms of the outcome of healing.
Rehabilitation of endodontically treated teeth : Post & CoreNaveed AnJum
These days we often come across mutilated or badly broken teeth in our practice. However various factors are involved for a better prognosis of such a teeth. This presentation mainly focuses on post and core treatment of such a teeth.
SPLINTING-MATERIALS AND TECHNIQUES final.pptxurmy1
This document provides an overview of splinting materials and techniques. It defines a splint as an apparatus used to support, protect or immobilize teeth that have been loosened or subjected to certain procedures. It discusses the objectives, indications, contraindications and principles of splinting. Various types of splints are classified, including temporary, provisional and permanent splints made from different materials. Factors like duration, influence on dental tissues, and splint removal are also outlined.
The document discusses periodontal splinting, including definitions, classifications, objectives, indications, advantages and disadvantages. It provides details on various splint types and materials. The key points are:
Periodontal splinting aims to stabilize mobile teeth affected by periodontal disease. Splints can be temporary, provisional or permanent depending on the material and duration of use. Fiber-reinforced composite splints are an advanced option that provide strength while adapting well to tooth contours. The objectives of splinting include reducing mobility, redistributing forces, and maintaining arch integrity.
Effect of ferrule and post - journal club Effect of ferrule and post placemen...Partha Sarathi Adhya
The study evaluated the effect of ferrule placement and post placement on the fracture resistance of endodontically treated teeth after fatigue loading. 40 teeth were divided into 4 groups: no ferrule-no post, no ferrule-post, 2mm ferrule-no post, 2mm ferrule-post. Teeth underwent fatigue loading and fracture testing. Results showed the highest fracture resistance in the 2mm ferrule-no post group, followed by the 2mm ferrule-post group. Only teeth with a ferrule restored without a post did not experience non-repairable root fractures. The study concludes that a 2mm ferrule can improve fracture resistance as much as adding
Restoration of endodontically treated teethAnish Amin
Restoration of endodontically treated teeth often requires posts and cores to provide adequate retention and resistance for weakened teeth. Key principles for posts and cores include preserving tooth structure, maximizing retention through post length and design, and providing resistance through features like ferrules. Posts and cores are indicated when there is significant loss of coronal tooth structure and the risk of fracture is high. The amount of remaining tooth structure, presence of a ferrule, and post length and design all influence the success of a post and core restoration.
Restoration of endodontically treated teeth.Anish Amin
provides an overview of restoring endodontically treated teeth using posts and cores. It discusses the historical background of posts and describes characteristics of teeth that have undergone endodontic treatment. Key points include that these teeth often have reduced strength and require special considerations for retention and resistance. The document outlines indications for posts and cores, principles of preservation of tooth structure and providing retention and resistance. It also describes methodologies for various steps of the post and core procedure.
This document provides information on dental splinting, including definitions, history, indications, types of splints, and splinting techniques. It defines splinting as joining two or more teeth to stabilize them. The goals of splinting include reducing tooth mobility, redistributing forces, and preserving teeth. Different types of temporary, provisional, and permanent splints are described based on materials used, location on teeth, and duration. Techniques for wire and acrylic splints are outlined. In summary, this document covers the clinical rationale and process for splinting mobile teeth.
This document provides an overview of post and core restorations for endodontically treated teeth. It discusses the history and evolution of post systems from the 18th century use of metal posts to modern fiber-reinforced posts. The key components of a post and core restoration are described, including the post, core, and final crown. Guidelines for evaluating a tooth for post placement are outlined, considering endodontic, periodontal, restorative, esthetic, and radiographic factors. The rationale and indications for using posts to retain cores and provide retention, protection and marginal integrity are explained. Contraindications include abnormal root anatomy and extensive caries.
Ferrule refers to a band of metal that encircles the external surface of a tooth. It strengthens root-filled teeth by resisting various stresses. A minimum ferrule height of 1.5-2mm is recommended. Factors like ferrule height, width, location, tooth type, post type, and core material affect its functionality. Ferrule promotes better fracture resistance and allows for repairable fractures versus non-repairable fractures without it. When ferrule cannot be created, crown lengthening or forced eruption can help generate tooth structure for ferruling.
This document discusses splinting in dentistry. It defines splinting as a technique used to stabilize mobile teeth. It describes the evolution and classification of splinting, factors that influence splint use, and indications and contraindications. The key objectives of splinting are to reduce tooth mobility, distribute forces across multiple teeth, and promote periodontal healing. Ideal splints are simple, cost-effective, stable, hygienic, and non-irritating to tissues.
This document provides an overview of temporomandibular joint disorders (TMD). It begins with definitions of TMD and discusses the history of terminology used to describe TMD. The anatomy of the temporomandibular joint and surrounding structures is described. Several etiological theories for TMD are discussed, including biomechanical, hormonal, traumatic, occlusal, and joint hypermobility theories. Signs and symptoms, diagnosis, classifications, and various treatment approaches for TMD are also outlined. The document contains detailed information on TMD intended for healthcare professionals.
1. The document discusses various treatment approaches for temporomandibular disorders (TMDs) including definitive treatments that address etiological factors and supportive treatments aimed at managing symptoms.
2. Definitive treatments include occlusal appliance therapy using stabilization, anterior positioning, anterior/posterior bite planes, and pivoting/soft appliances to modify occlusion. Other definitive treatments are selective tooth grinding and restorative/orthodontic procedures.
3. Supportive treatments involve physical therapies like heat/coolant therapy, ultrasound, TENS, acupuncture and manual techniques as well as pharmacological therapies.
This document provides an overview of biocompatibility testing for dental materials. It defines biocompatibility and outlines the historical background and requirements for biocompatible materials. The document discusses various in vitro and animal biocompatibility tests, including cytotoxicity, cell function, and mutagenesis assays. It notes that in vitro tests provide initial screening but cannot fully predict in vivo response, while animal tests are more comprehensive but also have limitations. The goal of biocompatibility testing is to systematically evaluate materials before clinical use to protect patients.
The document discusses the anatomy and histology of the root apex. It describes the development of root structures including the apical constriction, cementodentinal junction, and apical foramen. Variations in root apex morphology are discussed including accessory canals, resorption, and calcifications. The clinical significance of understanding root apex anatomy for procedures like working length determination, apical resection, and apexification are summarized.
This document provides an overview of the blood supply of the head and neck region. It begins with an introduction to circulation and the functional parts including arteries, arterioles, capillaries, and veins. It then details the major arteries supplying the head and neck, including the common carotid artery, external carotid artery, and its branches like the lingual artery and facial artery. It also discusses the internal carotid artery and its branches. Finally, it briefly mentions the venous drainage and pulp vasculature before concluding.
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This document provides an overview of the structure and properties of enamel. It discusses the physical and chemical composition of enamel, including its high mineral content and hydroxyapatite crystals. It describes the microscopic structure of enamel, including enamel rods, interrod enamel, and surface features like striations of Retzius. It also summarizes the life cycle of ameloblasts and the process of amelogenesis. Bleaching effects on enamel and developmental disturbances are briefly covered.
The document discusses various aspects of wound healing, including definitions of regeneration, repair, and primary and secondary intention healing. It describes the process of regeneration as proliferation of parenchymal cells to restore original tissues, while repair involves proliferation of connective tissue elements and fibrosis. Primary intention healing occurs when a clean, surgically incised wound is approximated by sutures, resulting in re-epithelialization within 48 hours and scar formation over 4 weeks. Secondary intention healing applies to wounds with tissue defects that are left open to heal more slowly through granulation tissue formation and contraction over weeks.
This document provides information on bone structure and function. It begins with definitions of bone and its functions, which include providing shape and support, protecting organs, and storing minerals. It describes the various types of bone based on development and microscopic appearance. It discusses the anatomy of long bones and bone structure including lamellae, osteons, Haversian canals, and Volkmann's canals. It provides information on cells involved in bone remodeling including osteoblasts, osteoprogenitor cells, and osteoclasts. It covers regulators of bone formation including hormones, proteins, and vitamins. It also discusses alveolar bone development, classification, and changes that occur after tooth extraction.
it describes the bony anatomy including the femoral head , acetabulum, labrum . also discusses the capsule , ligaments . muscle that act on the hip joint and the range of motion are outlined. factors affecting hip joint stability and weight transmission through the joint are summarized.
ISO/IEC 27001, ISO/IEC 42001, and GDPR: Best Practices for Implementation and...PECB
Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
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Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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Physiology and chemistry of skin and pigmentation, hairs, scalp, lips and nail, Cleansing cream, Lotions, Face powders, Face packs, Lipsticks, Bath products, soaps and baby product,
Preparation and standardization of the following : Tonic, Bleaches, Dentifrices and Mouth washes & Tooth Pastes, Cosmetics for Nails.
हिंदी वर्णमाला पीपीटी, hindi alphabet PPT presentation, hindi varnamala PPT, Hindi Varnamala pdf, हिंदी स्वर, हिंदी व्यंजन, sikhiye hindi varnmala, dr. mulla adam ali, hindi language and literature, hindi alphabet with drawing, hindi alphabet pdf, hindi varnamala for childrens, hindi language, hindi varnamala practice for kids, https://www.drmullaadamali.com
A workshop hosted by the South African Journal of Science aimed at postgraduate students and early career researchers with little or no experience in writing and publishing journal articles.
How to Fix the Import Error in the Odoo 17Celine George
An import error occurs when a program fails to import a module or library, disrupting its execution. In languages like Python, this issue arises when the specified module cannot be found or accessed, hindering the program's functionality. Resolving import errors is crucial for maintaining smooth software operation and uninterrupted development processes.
This presentation was provided by Steph Pollock of The American Psychological Association’s Journals Program, and Damita Snow, of The American Society of Civil Engineers (ASCE), for the initial session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session One: 'Setting Expectations: a DEIA Primer,' was held June 6, 2024.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
2. CONTENTS
• Introduction
• History
• Terminologies
• Rationale of splinting
• Principles of splinting
• Indications
• Objectives of splinting
• Classification
• Various splints in detail
• Case reports
• Conclusion
• References
3. INTRODUCTION
With advances in the understanding of healing processes of
the periodontium, pulp and alveolar bone following various
injuries, the role of splinting has become relatively well
defined.
4. HISTORY
• A Phoenician mandible from 500BC discovered near the ancient
city of Sidon demonstrates anterior teeth elaborately bound
together with gold wire.
• Remains from Egyptians [3000 to 2500 BC] have shown the use
of ligature wire (gold wire).
• And in 600 A.D. the Mayans inserted shells directly into the
jawbone to replace missing teeth.
• Extensive reconstructions replacing missing teeth were placed
on broken diseased roots- “golden traps for sepsis”.
5. DEFINITIONS
• According to American Association of Endodontists. Glossary of Endodontic
Terms. 8th ed a splint has been defined as ‘an apparatus used to support,
protect or immobilize teeth that have been loosened, replanted, fractured or
subjected to certain endodontic surgical procedures’.
• According to Glossary of Periodontic Terms 1986 a splint is “an appliance
designed to stabilize mobile teeth”.
6. • According to AAP (1996), a splint has been defined “as an apparatus, appliance, or
device employed to prevent motion or displacement of fractured or removable
parts.”
• The Glossary of Prosthodontic Terms, 9th ed defines splint as “a rigid or flexible
device that maintains in position a displaced or movable part; also used to keep
in place & protect the injured part.”
• Dawson defines splinting as “the joining of two or more teeth for the purpose of
stabilization”.
7. RATIONALE OF SPLINTING
• Stabilization of mobile teeth for masticatory comfort.
• Control of forces of para- functional habits.
• Stabilization of mobile teeth during surgical, especially regenerative therapy.
• Stabilization of severely periodontally compromised tooth when more definitive
treatment is possible.
• Preservation of arch integrity and Cross arch stabilization
• Restoration of vertical dimension of occlusion
• Redistribution of forces along the long axis of tooth
8. PRINCIPLES OF SPLINTING
• The main objective of splinting is to decrease movement three dimensionally.
• This objective can be met with the proper placement of a cross arch splint.
• Conversely, unilateral splints that do not cross the midline tend to permit the
affected tooth to rotate in a faciolingual direction about a mesiodistal linear axis.
9. INDICATIONS OF SPLINTING
• According to Smukler and Lemmer; spinting is indicated only when the mobility
of teeth is sufficient to hinder function or cause discomfort.
• EXTRUSION
• LATERAL LUXATION
• INTRUSION
• AVULSION
• AUTO TRANSPLANTATION
• ROOT FRACTURE
• ALVEOLAR BONE FRACTURES
11. REQUIREMENTS OF IDEAL SPLINT
• Be simple and easy to construct
• Economic, Stable and efficient
• Hygienic and Nonirritating
• Not interfere with treatment
• Esthetically acceptable
• Not provoke iatrogenic disease.
• Allows pulp testing and endodontic treatment
• Easy to remove
12. OBJECTIVES OF SPLINTING
• Rest is created for the supporting tissues giving them a favorable climate for
repair of trauma.
• Reduction of mobility immediately and hopefully permanently. In particular
jiggling movements are reduced or eliminated.
• Redirection of forces - redirected in a more axial direction over all the teeth
included in the splint.
• Redistribution of forces - ensures that forces do not exceed the adaptive capacity.
Forces/received by one tooth are distributed to a number of teeth.
• Restoration of functional stability - functional occlusion stabilizes mobile
abutment teeth.
13. A) ACCORDING TO THE PERIOD OF STABILIZATION
a) Temporary Stabilization: worn for less than 6 months.
• REMOVABLE -Occlusal Splint with wire
-Hawley appliance with arch wire
• FIXED
• INTRACORONAL- Amalgam
-Amalgam & Wire
-Amalgam , Wire & Resin
-Composite Resin & Wire
14. • EXTRACORONAL -Stainless steel wire with resins
-Wire & Resin with acid etching
-Enamel etching & composite resin
-Orthodontic soldered bands, Brackets & Wire
b) Provisional splinting: to be used for months up to several years.
- Acrylic splints, Metal band etc.
c) Permanent Splints: used indefinitely
-Removable/Fixed
-Extra/Intracoronal
-Full/Partial veneer crowns soldered together.
-Inlay/Onlay soldered together.
15. B) ACCORDING TO TYPE OF MATERIAL:
- Bonded composite resin splint
- Braided wire splint
- A- splints
C) ACCORDING TO LOCATION ON THE TOOTH:
• Intracoronal - composite resin with wire
- inlays
- onlays
• Extracoronal - Night guard
- tooth bonded plastic and welded bands
16. According To Goldman, Cohen And Chacker:
a)Temporary splints
• A. Extra coronal type -Wire ligation
-Orthodontic bands
-Removable acrylic appliances
-Removable cast appliances
-Ultraviolet-light-polymerizing bonding materials
17. B. Intracoronal type -Wire and acrylic
-Wire and amalgam
-Wire, amalgam, and acrylic
-Cast chrome-cobalt alloy bars with acrylic, or both.
b) Provisional splints
-All acrylic
-Adapted metal band and acrylic
18. According To Ross, Weisgold And Wright:
A) TEMPORARY STABILIZATION: -Removable extra coronal splints
-Fixed extra coronal splints
-Intracoronal splints
-Etched metal resin-bonded splints
B) PROVISIONAL STABILIZATION: -Acrylic splints
-Metal band and acrylic splints
C) LONG- TERM STABILIZATION: -Removable splints
-Fixed splints
-Combination removable and fixed splints
19. SUTURE SPLINTING
• Simplest type
• Suture placed over incisal edge from
palatal gingiva to buccal gingiva.
• Preventing repositioned incisors from
extruding.
• Auto transplantation- premolars sutures
palced over occlusal surface.
• Suture splints have been found to improve
prognosis when compared to rigid splints.
Gharechahi, Maryam & Shojaeian, Shiva. (2016). Management of Traumatized Permanent Incisors
Revascularization and Delayed Replantation. The New York state dental journal. 82. 40-44.
20. ARCH BAR SPLINTING
• Rigid splint
• Cause considerable damage to the injured
teeth.
• There may also be physical damage from
the ligature wires to the gingival tissues
and the integrity of the cemento-enamel
junction.
DeAngelis AF, Barrowman RA, Harrod R, Nastri AL. Review article: Maxillofacial emergencies: dentoalveolar and
temporomandibular joint trauma. Emerg Med Australas 2014;26:439– 445.
21. COMPOSITE AND WIRE SPLINT
• Composite and wire splints are perhaps the most commonly used in clinical
practice and are flexible splints when the wire has a diameter of no greater than
0.3–0.4 mm. (26- 28 gauge wire).
Functional splinting with an orthodontic
0.016inch stainless steel wire and composite
resin.
Biagi, Roberto & Cardarelli, Filippo & Storti, Ennio & Majorana, Alessandra & Farronato, Giampietro. (2013). Multiple traumatic injury to
maxillary incisors in an adolescent female: treatment outcome with two years follow-up. Annali di stomatologia. 4. 212-7.
22.
23. Following an avulsion and subluxation injury to the central incisors.
In this case the left central incisor was not replanted as the tooth was lost. An aesthetic
splint was provided.
Oikarinen K. Comparison of the flexibility of various splinting methods for tooth fixation. Int J Oral Maxillofac Surg
1988;17:249–252.
24. COMPOSITE AND FISHING LINE SPLINTS
• An alternative to wire is, where fishing line replaces wire and the line is secured
with composite resin.
25. An interesting alternative at St Vincent’s Hospital, Sydney, utilizes nylon attached to
the teeth with coloured composite resin (Ultradent; flowable purple).
The coloured composite provides a guide for the removal of the splint to minimize
damage to enamel.
26. ORTHODONTIC WIRE AND BRACKET SPLINT
• This splint, which is extensively employed by paedodontists.
• Involves orthodontic brackets bonded to the teeth with a resin-based cement and
connected with a light 0.014 NiTi flexible wire.
patient has sustained traumatic injuries to the maxillary
right central and lateral incisors and the maxillary right
central incisor.
Dawoodbhoy I, Valiathan A, Lalani ZS, Cariappa KM. Splinting of avulsed central incisors with orthodontic wires: a case report. Endod Dent
Traumatol 1994;10:149–152.
27. • Orthodontic bracket splints allow teeth that have been intruded or not repositioned
correctly to have the occlusal relationships modified at a later date.
• However, care must be taken that orthodontic forces do not develop stress that
disturbs the healing phase of an injured tooth.
• While this type of splint was found to be irritating to the lips when compared to
composite and wire splints, and titanium trauma splints, this is generally not considered
to be a clinical problem as any lip irritation can be avoided with the application of wax.
Filippi A, von arx T, Lussi A. Comfort and discomfort of dental trauma splints–a comparison of a new device (TTS) with three commonly used
splinting techniques. Dent Traumatol 2002;18:275–280.
28. FIBRE SPLINTS
• Fibre splints use a polyethylene or Kevlar fibre mesh and are attached either with an
unfilled resin such as OptibondTM FL (Kerr, USA) and/or with composite resin.
• Materials such as Fiber-Splint, RibbondTM (Ribbond Inc., Seattle, USA) or EverStick
(Stick Tech Ltd, Turku, Finland), which is a silinated E-type glass fibre, are commercially
available.
An example of a Fibre-Splint following an avulsion
injury of the maxillary left central and lateral incisor
teeth.
29. In a study of 400 root-fractured teeth by Andreasen et al., fibre splints were associated with the
highest frequency of favourable healing outcomes.
Samantha S, Mondal D, Maiti A, Mukherjee S. MANAGEMENT OF FRACTURED TEETH WITH FIBER-REINFORCED COMPOSITE SPLINT. 2013.
30. TITANIUM TRAUMA SPLINTS
• The titanium trauma splint developed by von Arx is a flexible splint made of
titanium, 0.2 mm thick and 2.8 mm wide (Medartis AG, Basel, Switzerland).
• It has a rhomboid mesh structure which is secured to the tooth with flowable
composite resin. A disadvantage of this splint type is its relatively high cost.
Von Arx T, Filippi A, Buser D. Splinting of traumatized teeth with a new device: TTS (titanium trauma splint). Dent Traumatol 2001;17:180–184.
31. (a) Radiograph of an arch bar secured by wire ligatures.
(b) The arch bar and ligature splint has been replaced with
a titanium trauma splint. Gross gingival irritation caused
by the arch bar splint is evident
(courtesy of Dr Rob Hazlewood).
32. WIRE LIGATURE SPLINTS
• Wire ligature splints are sometimes used
by oral surgeons in clinics where dental
splinting materials may not be available.
• These splint types are generally rigid and
impinge on the gingival tissues with
resulting inflammation.
33. COMPOSITE SPLINTS
• Resin composite applied to the surfaces of teeth is a rigid
splint and accordingly is not recommended in the IADT
guidelines.
• An example of a composite resin splint applied to the labial
surfaces of the maxillary right central incisor and adjacent
teeth.
• Composite splints that are bonded interproximally to
adjacent teeth are also reported to be prone to fracture.
• Furthermore, composite splints resulted in greater gingival
irritation when compared with wire and composite, an
orthodontic bracket splint or the titanium trauma splint.Oikarinen K. Tooth splinting: a review of the literature and consideration of the versatility of a wire-composite splint. Endod Dent
Traumatol 1990;6:237–250.
34. • A splint for medical emergency departments, An innovative
approach in splinting developed by Dr Peter Foltyn is the use
of Stomahesive (ConvaTec Inc.), a skin barrier adhesive material
used for superficial skin trauma.
• This material can crudely hold teeth in the socket and cover
coronal fractures to reduce sensitivity when patients are seen
in emergency medical departments out of hours of routine
dental practice.
• However, this approach could require further repositioning
with subsequent splinting in a dental office. A Stomahesive splint placed at the Royal Brisbane
Hospital Emergency Department. (b) The Stomahesive
splint
removed to reveal a crown-root fracture of the maxillary
right central incisor and uncomplicated crown fractures of
the left central and lateral incisors.
35. FLEXIBLE SPLINTS
• Berthold et al. reported in an in vitro study that composite and wire splints where
the wire was 0.41 rectangular orthodontic wire or 0.45 multistranded flexible
orthodontic wire and the titanium trauma splint were flexible splints.
• A wire composite splint consisting of three stranded wires measuring 0.8 mm x
1.8 mm was found to be rigid.
• Four resin composite splints were also tested and found to be rigid. It was also
reported that composite splints may break during the immobilization period and
were difficult to remove.
• In a further study Berthold et al. found that the wire length influences rigidity and
these authors recommended splinting only one uninjured tooth bilaterally.
Berthold C, Auer FJ, Potapov S, Petschelt A. Influence of wire extension and type on splint rigidity–evaluation
by a dynamic and a static measuring method. Dent Traumatol 2011;27:422– 431.
36. •
• In the study by Berthold et al. teeth were set in an acrylic resin model and periodontal
mobility was mimicked with a soft silicon impression material.
• To avoid this limitation, Kwan et al used a human cadaveric model.
• The results of this study also found composite splints and composite and wire splints
where the wire diameter was greater than 0.4 mm were deemed to be rigid splints.
• These authors considered a wire thickness of 0.4 mm as the clinical threshold for flexible
and rigid splints.
• The use of nylon fishing line with a 20-pound test strength also allowed for physiologic
movement and provided the advantage of a more aesthetic appearance than a metal
wire bonded across the anterior teeth.
• These authors also found that there was no benefit from extending the splint to more
than one adjacent firm tooth.
Kwan SC, Johnson JD, Cohenca N. The effect of splint material and thickness on tooth mobility after extraction
and replantation using a human cadaveric model. Dent Traumatol 2012;28:277–281.
37. LUXATION INJURIES
• A study of 172 luxation injuries immobilized with rigid splints
consisting of cap splints, ligature wires +/- acrylic coverage
reported that the fixation period was a significant variable for
loss of alveolar bone. The mean duration of immobilization in
this study was 52 days. longer periods of immobilization
resulted in bone loss from periodontitis associated with oral
hygiene difficulties.
• In a study of 140 intruded teeth, the type of splint (i.e. flexible,
semi-rigid or rigid) and the length of splinting time (shorter or
longer than 6 weeks) were not significant in healing outcomes
on teeth that were surgically repositioned.Andreasen JO, Bakland LK, Andreasen FM. Traumatic intrusion of permanent teeth. Part 3. A clinical study of the effect of treatment
variables such as treatment delay, method of repositioning, type of splint, length of splinting and antibiotics on 140 teeth. Dental
Traumatology. 2006 Apr;22(2):99-111.
38. CONCUSSION AND SUBLUXATION
• Importantly, where multiple teeth have had more severe injuries, adjacent teeth
with either subluxation or concussion injuries can be splinted without damage to
the periodontal ligament.
• In a study of 637 luxated teeth, teeth with concussion or subluxation injuries were
splinted only if there were other injured teeth.
39. EXTRUSION
(a) Photograph of the extruded maxillary right
central incisor.
(b) Photograph of the composite splint and
gingival laceration.
(c) A radiograph showing open apices of the
maxillary central incisors at the time of splint
placement.
(d) A 12-month review radiograph showing
continued maturation of the traumatized
tooth (courtesy of Dr Jeremy Jansz).
a c
b d
40. LATERAL LUXATION AND INTRUSION
(a) An intruded maxillary left central incisor where the tooth has also been rotated to show
the palatal surface. An extensive gingival laceration has occurred as a result of the trauma.
(b) (b) The intruded tooth has been repositioned and splinted with composite resin and
fishing line.
The gingival laceration has been sutured (courtesy of Dr Derek Lewis).
41. AVULSION
• The type of splint and fixation periods were not significant variables in a multivariate analysis
for pulp and periodontal healing outcomes in a study of 400 replanted teeth.
a) Splint on avulsed tooth using
composite and 0.014" or 0.4 mm hard
stainless steel wire
b) Replanted tooth after 16 months
Ize-Iyamu I N, Saheeb B. Reimplantation of avulsed dry permanent teeth after three days: A report of
two cases. Niger J Clin Pract 2013;16:119-22
42. • In another study of 128 replanted teeth, the fixation period was not a significant variable
on healing outcomes. The type of fixation was not disclosed.
• In an experimental study on the effect of splinting upon periodontal healing after
replantation of permanent incisors in monkeys, the authors reported that in teeth
replanted after 18 minutes, the frequency and extent of replacement resorption was
significantly lower in non-splinted teeth compared to the splinted teeth. A limitation of this
study is that the teeth were splinted with an orthodontic band-acrylic splint and the rigid
nature of this splint may have also accounted for the extent of the resorption.
Andreasen JO, Borum MK, Jacobsen MK, Andreasen FM. Replantation of 400 avulsed permanent incisors. 2. Factors related to pulpal
healing. Endod Dent Traumatol 1995; 11: 59– 68.
43. ROOT FRACTURES
(a) Radiograph of a root-fractured maxillary left central incisor where no displacement was noted at
the time of fracture so no splint was placed.
(b) Radiograph taken at an 8-week review showing internal resorption remodelling in both the
coronal and apical fragments.
(c) Radiograph taken at a 7-year review showing extensive calcific reorganization at the fracture site
and intracanal calcification in both the coronal and apical fragments.
a b c
44. (a) Radiograph showing a cervically located root fracture in the
maxillary left central incisor of a 9-year-old female. (b) Panoramic
image taken 5
years later at age 14 showing the previously root fractured left central
incisor and wire/composite splint in position. (c) Proximal view of the
tooth following
extraction. (d) Radiographs taken from the proximal and labial surfaces.
(e) Sagittal histological section in a labio-palatal plane showing pulp
and hard
tissue deposition between the fractured segments, Van Giessen stain.
Heithersay GS, Kahler B. Healing responses following transverse root fracture: a historical review and case reports
showing healing with (a) calcified tissue and (b) dense fibrous connective tissue. Dent Traumatol 2013;29:253–265.
ed
cba
45. a) A high cervical root-fracture of the maxillary
central incisor.
b) A functional composite resin and light wire
splint placed on the day of injury
following a high cervical root fracture of the
maxillary left central incisor.
(c) At the 6-week follow-up, a hygienic rigid
splint was placed on the palatal
surfaces of the incisor teeth.
(d) Radiograph taken at a 4-year review.
(e) Photograph of the hygienic splint taken at the
4-year review
a b c
ed
46. a b c
d
e
f
g
(a) A root-fractured maxillary right
central incisor where the coronal
fragment was also avulsed.
(b) Radiograph of the replanted
coronal fragment where the coronal
fragment was splinted with
interproximal composite resin to the
adjacent teeth.
(c) The splint described in Fig. 16b
debonded within hours and was
replaced with a composite and wire
splint on the same day.
(d) A fibre splint was the third splint
placed in a 24-hour period.
(e) At 6 weeks, a gingival swelling
was evident as well as extrusion of
the tooth and stretching of the fibre
splint.
(f) The coronal fragment was
endodontically treated and the
coronal fragment was root filled with
mineral trioxide aggregate.(g) Radiograph taken at the 10-year review. A calcific barrier at the apex of the coronal fragment as
a response to the placement of the mineral trioxide aggregate as well as intracanal calcification of
the apical fragment is evident.
47. (a–i) Showing the clinical
procedures involved in the
application and removal of a
nylon fishing line/GC Fuji Ortho
LC splint.
a
d
cb
hg
fe
i
48. REMOVAL OF SPLINT
• Removing a splint in which composite resin has been used is not
only time consuming, but iatrogenic injury to the enamel is an
inevitable outcome.
• Techniques of composite removal may involve debonding pliers,
handscalers, ultrasonic scalers, tungsten carbide burs, diamond
burs, Soflex disks (3M ESPE, St Paul, MN, USA), rubber wheels
and cups.
• Debonding pliers generate shearing forces that result in
irreversible damage to the enamel.
• Hand and ultrasonic scalers caused distinctive patterns of
enamel detachment.
49. CASE REPORTS
The development of a new and simplified splinting
Regimen:
The principal researcher of the study, Jun-Yi Hu,
developed an experimental model designed to
simulate the dentoalveolar complex which then
allowed standardized, reproducible evaluations of
splinting techniques using several test bonding
adhesives.
Hu J‐Y, Heithersay GS. An evaluation of alternate splinting adhesives in the management of dental trauma. Aust Dent
J 2011; 56: S16.
50. The results of this study identified GC Fuji Ortho
as fulfilling the requirements of an ideal
splinting adhesive material.
Hu J‐Y, Heithersay GS. An evaluation of alternate splinting adhesives in the management of dental trauma. Aust Dent
J 2011; 56: S16.
While GC Fuji Ortho LC has been shown to fulfil the
requirements of an ideal splinting adhesive materia
a practical alternative is GC Fuji 2 which has similar
physical characteristics and handling properties, and
is more commonly used in dental practices.
51. Mazzoleni S, Meschia G, Cortesi R, Bressan E, Tomasi C, Ferro R, Stellini E. In vitro comparison of the flexibility of
different splint systems used in dental traumatology. Dental Traumatology. 2010 Feb;26(1):30-6.
• The aim of the study was to evaluate the flexibility of five different splint systems
[polyethylene fibre-reinforced splint (Ribbond THM, Ribbond Inc., Seattle, WA, USA),
resin splint (RS), wire-composite splint (WCS), button-bracket splint (BS) and titanium
trauma splint (TTS)] commonly used in clinical practice for the treatment of dental
traumatic injuries involving the periodontal supporting tissues.
• Devices with the highest flexibility are the TTS and the Ribbond THM as they exhibit a
lower energy variation needed for splint deformation compared with the other materials
that were examined.
52. CONCLUSION
• Understanding the favourable healing outcomes, always Flexible splint is
preferred over the rigid splint.
• New materials must be tried to splint which do not damage the enamel on splint
removal.
• IADT guidelines must be followed for the time period of splinting.
53. REFERENCES
• Andersen’s dental traumatology 2nd ed, chapter 32 ,pages 842-3.
• Louis Berman, Stephen cohen. A Clinical Guide to Dental Traumatology. 1st edition.
• Oikarinen K. Tooth splinting: a review of the literature and consideration of the versatility of a wire-
composite splint. Endod Dent Traumatol 1990;6:237–250.
• DeAngelis AF, Barrowman RA, Harrod R, Nastri AL. Review article: Maxillofacial emergencies:
dentoalveolar and temporomandibular joint trauma. Emerg Med Australas 2014;26:439– 445.
• Lin S, Emodi O, El-Naaj IA. Splinting of an injured tooth as part of emergency treatment. Dent
Traumatol 2008;24:370–372
• Kahler B, Hu JY, Marriot‐Smith CS, Heithersay GS. Splinting of teeth following trauma: a review and a
new splinting recommendation. Australian dental journal. 2016 Mar;61:59-73.
54. • Berthold C, Thaler A, Petschelt A. Rigidity of commonly used dental trauma splints. Dent Traumatol
2009;25:248–255.
• Berthold C, Auer FJ, Potapov S, Petschelt A. Influence of wire extension and type on splint rigidity–
evaluation by a dynamic and a static measuring method. Dent Traumatol 2011;27:422– 431.
• Kwan SC, Johnson JD, Cohenca N. The effect of splint material and thickness on tooth mobility after
extraction and replantation using a human cadaveric model. Dent Traumatol 2012;28:277–281.
• Mazzoleni S, Meschia G, Cortesi R, Bressan E, Tomasi C, Ferro R, Stellini E. In vitro comparison of the
flexibility of different splint systems used in dental traumatology. Dental Traumatology. 2010
Feb;26(1):30-6.
• Heithersay GS, Kahler B. Healing responses following transverse root fracture: a historical review and
case reports showing healing with (a) calcified tissue and (b) dense fibrous connective tissue. Dent
Traumatol 2013;29:253–265.
• Ize-Iyamu I N, Saheeb B. Reimplantation of avulsed dry permanent teeth after three days: A report
of two cases. Niger J Clin Pract 2013;16:119-22
55. • Andreasen JO, Bakland LK, Andreasen FM. Traumatic intrusion of permanent teeth. Part 3. A
clinical study of the effect of treatment variables such as treatment delay, method of repositioning,
type of splint, length of splinting and antibiotics on 140 teeth. Dental Traumatology. 2006
Apr;22(2):99-111.
• Von Arx T, Filippi2 A, Buser3 D. Splinting of traumatized teeth with a new device: TTS (Titanium
Trauma Splint). Dental Traumatology. 2001 Feb;17(4):180-4.
• Hu J‐Y, Heithersay GS. An evaluation of alternate splinting adhesives in the management of dental
trauma. Aust Dent J 2011; 56: S16.
• Andreasen JO, Borum MK, Jacobsen MK, Andreasen FM. Replantation of 400 avulsed permanent
incisors. 2. Factors related to pulpal healing. Endod Dent Traumatol 1995; 11: 59– 68.
• Dawoodbhoy I, Valiathan A, Lalani ZS, Cariappa KM. Splinting of avulsed central incisors with
orthodontic wires: a case report. Endod Dent Traumatol 1994;10:149–152.
• Samantha S, Mondal D, Maiti A, Mukherjee S. Management of fractured teeth with fiber-reinforced
composite splint. 2013.
Editor's Notes
its ease of application without the need for enamel etching,
ability to withstand physical forces during the splinting period, and
ease of removal with minimal
No damage to the enamel surface.