1. The article describes a simplified method for splinting teeth using resin reinforced glass fibers and composite resins. 2. A key step is using a transparent vinyl polysiloxane putty index to closely adapt the fiber splint material to the tooth surface while light curing for better stabilization. 3. Benefits of splinting periodontally weakened teeth include allowing comfortable chewing, firming mobile teeth to improve hygiene, supporting other periodontal treatments, and enhancing patient confidence.

1. Dental Practice // March-April 2014 // Vol 12 No 440
Splinting Simplified
periodontic section
MAHESH CHAUHAN
W
e consider splinting teeth mainly
in two indications. In cases of peri-
odontally weakened incisor teeth
and in case of injury to stabilize luxated ante-
rior teeth.
Although materials such as wires etc. have
been used in the past but the preferred mate-
rial has been Resin Reinforced Glass Fibers
such as Fiber-Splint™ (POLYDENTIA SA)
which I have used for the past 20 years with
success; Along with a flowable and syringe
composite combinations such as Filtek
Z350XT (3M ESPE) the combination of
composite resin and glass fibers gives a supe-
rior and esthetic splint.
It is very important for long term stability
that Fiber Splint material be adapted very
closely to the teeth surface and light cured
while maintaining position. Adapting and
holding Fiber Splint material to the teeth sur-
face with the help of fine explorers etc. some-
times can get very difficult; to solve this prob-
lem Maemosil 2 (Heraeus) which is a trans-
parent, regular body; VPS bite registration
material is used to make an index on the lin-
gual/palatal side of the incisor teeth to help
adapt the Fiber Splint material snugly to the
teeth so that it can be light cured through the
indexing material. Alternatively a similar
material Fiber-Plast can also be used.
So the simplified steps in teeth splinting
would be:
1. Making clear VPS putty index
2. Cleaning of teeth enamel surface for bond-
ing
3. Isolation
4. Measuring of length of Fiber Splint
5. Etching (one minute for enamel) Rinse
and dry
6. Applying Fiber-Bond (POLYDENTIA SA)
or Scotch Bond Multipurpose plus (3M
ESPE) Primer followed by Adhesive which
is a 4th generation bonding system to the
tooth surface
7. Do not light cure at this stage
8. Soak the Fiber Splint in bonding agent
9. Adapt the Fiber Splint to the incisor 3rd of
the lingual tooth surface which has been
etched and has received bonding agent
10. Then put clear A-silicone putty index on it
11. Light Cure through the clear putty index
while maintaining its position, light cure
from lingual as well as labial surface
12. Put flowable and syringe composite mate-
rial on the whole surface of the splinting
material
13. Adapt it to a smooth contour and light
cure
14. Adjust occlusion
15. Finish and Polish using fluted carbide
burs and/or finishing rotary diamonds
and polishing system such as Venus
(Heraeus) or Sof-Lex (3M, ESPE) discs
and strips
BENEFITS OF SPLINTING PERIODONTALLY
WEAK TEETH
1. It allows the patients to chew
comfortably.
2. Mobile teeth become firm. Therefore,
allowing the patient to maintain better
hygiene. Patient can use regular brush,
interdental brush etc. without the fear of
knocking down teeth.
3. As splinting is done in conjunction with
other periodontal therapy, such as scal-
ing/curettage/root planning/flap surgery
etc, it also is an adjunct to preservation of
soft and hard tissues.
FIG 1: Lingual view of the mandibular incisors to be
splinted
FIG 2: Making Maemosil 2 (Heraeus) index directly in
the mouth
FIG 3: Verifying the tooth detail reproduction i.e. inter-
dental flow of the A-silicone index
FIG 4: Etching the lingual surface; do not etch or bond
the cervical one third area
FIG 5: Etching the interdental area on the labial side
(additionally one cervical filling will also be done)
FIG 6: Putting the pre measured Fiber Splint material
soaked in bonding agent on the lingual surface of the
teeth

2. Dental Practice // March-April 2014 // Vol 12 No 4 41
4. Enhances patient’s self-confidence
RATIONALE OF SPLINTING IN TOOTH INJURY
Injured anterior teeth needing stabilization
such as in:
• Luxation: for 2-3 weeks
• Subluxation: for 1-2 weeks
• Extrusion: for 1-2 weeks
For stabilizing an injured mobile tooth
and to allow periodontal fibers to repair
rather than a bony healing (may lead to anky-
losis), a splinting time of less than 3 weeks is
recommended.
To stabilize a root fracture, a longer splint-
ing time is indicated such as one month to
three months, as this will allow calcified tissue
to heal.
It is for the clinician to evaluate the tooth
for vitality and RCT should be done wherev-
er indicated. RCT access can be gained
through the Fiber-Splint if it has been applied
lingually.
Many times isolation in recent tooth
injury cases is difficult to achieve, also lips
may be injured. In such cases Fiber-Splinting
can be done on the labial surface of the teeth.
MAINTENANCE
Since in case of periodontally weak teeth the
splinting is for a long indefinite period of
time, it is important and even helpful that the
patient maintains good oral hygiene by
means of soft brush and appropriately sized
interdental brush.
FIG 7: Immediately afterwards – adapt the transparent
A-silicone index to closely adapt the splinting material
to the teeth and light cure (Coltolux LED used here)
FIG 8: Thereafter without removing the index, cure
from the labial side also
FIG 9: We can see that the Fiber Splint as well as the
flowable composite used interdentally is now well
adapted to the teeth surface; additional light curing is
recommended here
FIG 10: Now, the whole Fiberglass splinting material is
covered with composite (Z350XT here) and light cured
again and finished and polished
FIG 11: Occlusion is checked to adjust any high points
FIG 12: Patient is instructed of hygiene maintenance
such as by interdental brush
>> 3 MANTRAS TO
SUCCESS
Dr Ferzana Imran
Success can be identi-
fied as achieving your
goals, through hard
work and determina-
tion. To be successful
we have to follow vari-
ous attributes that
help us during different situations in life.
For me the three key attributes for suc-
cess are:
1. SELF BELIEF
The strongest factor for success is Self
Belief. If I continue to believe in my abil-
ities, I continue to stay focused and
determined towards my work. Self Belief
helps me to identify my strengths and
how I can use those strengths in diffi-
cult phases of life. Being a strong
believer of yourself helps to not only
build your confidence but also keeps
you motivated in life.
2. COMMITMENT
For me commitment is a vital attribute
for Success. Commitment brings out the
best in oneself. It allows you to con-
stantly push yourself in order to not
only continue the loyalty and hard work
that you place in your work, but also
maintain and raise the standard of it.
3. DEVOTION
Being devoted to your work is extremely
important in achieving success. Devotion
towards work means that you are ready
to work around any challenges that you
face. Being disheartened by failure is
easy to overcome when you enjoy what
you to do, furthermore devotion towards
your work allows you to build a more
positive work environment.
Dr. Ferzana Imran has a very successful
private and government practice.
Dr Mahesh Chauhan is a Gold Medalist Graduate from
MAIDS, Delhi University, 1990. He was an Adjunct
Assistant Professor at The Ohio State University
College of Dentistry, Columbus, Ohio, USA, 1995. He
lectures extensively at national and international level
on Oral Implantology, Restorative and Aesthetic
Dentistry. He maintains his private practice at Mother
Dental Implant Clinic, New Delhi. He can be reached at
drmaheshchauhan@gmail.com
About the AUTHOR