What is splinting and how to use it to save teeth

Dear readers, we have prepared an interesting article for you - a review about teeth splinting and answers to related questions. From this material you will learn:

Teeth splinting - what is it? Indications for using the splinting technique; splinting of mobile teeth; what techniques are used; what materials are used; how much does the procedure cost?

WHY ARE TEETH SPLINTED?

We collected the main indications for this procedure and came up with five points:

1. With a non-standard direction of tooth growth.
2. In case of displacement of teeth in a row.
3. For chronic periodontal diseases that cause bleeding.
4. In cases where a large amount of deposits accumulate around the tooth root, which can lead to its destruction and tooth loss.
5. The presence of deep gum pockets, the appearance of which has led to significant exposure of the roots of the teeth.

Advantages of technology

You should agree to the splinting procedure because it:

• reliable prevention of tooth loss;
• painlessness and efficiency;
• no likelihood of developing caries;
• aesthetics;
• stopping the process of deformation of the bones of the jaw apparatus;
• eliminating changes in the location of teeth and the distance between them;
• minimal trauma (no turning, depulpation);
• safety, harmlessness of materials;
• easy oral care after treatment.

SPLINTING FOR PERIODONTITIS, PERIODONTOSIS, DENTAL INJURIES

Periodontal disease is one of the most common problems dentists encounter. Therefore, among the “top” reasons is splinting teeth for periodontitis – an inflammatory disease of periodontal tissue. This disease causes the roots to become exposed. Teeth begin to become loose, which can ultimately lead to tooth loss.

The main task is to strengthen teeth that are starting to become loose. Moreover, it is important to do this at the initial stage. There are several solution options - high-strength fiberglass threads, prostheses, etc.

Often, patients consult a doctor only when the disease is chronic and reaches a moderate or even severe stage. This is expressed not only in unpleasant sensations, but also in the exposure of the subgingival part of the tooth by a quarter or more. Mobility directly depends on how much bone tissue is atrophied in a particular area.

You can check the condition of the bone tissue using a regular x-ray of the jaw area.

Separately, splinting of teeth for periodontal disease, which is not an infectious disease, is considered. There is still no consensus regarding the causes of this pathology. Among the main options:

• Hereditary factor;
• VSD;
• Diabetes;
• Atherosclerosis;
• Hypertonic disease.

The symptoms of periodontal disease and periodontitis are largely similar, although the diseases themselves have very little in common. Tooth mobility occurs only in severe cases of the disease, when the root is exposed by 50% or more.

The materials used include silk, fiberglass and polyethylene threads.

Specialists select them by color so that there is no obvious difference in shade from the tissue of the tooth itself. The choice of technique depends on many nuances: the stage at which the disease occurs, bleeding, general hygiene, the presence of hard deposits on the teeth, tooth mobility, violation of the position of the teeth in the row, the depth of the formed gum pockets.

Another area of ​​work is splinting teeth for injuries. This may include bruises and fractures of the jaw, or other injuries leading to tooth dislocation. The splint allows you to fix it and secure it in such a way as to avoid loosening and subsequent falling out.

Patients often exhibit a symptom such as fan-shaped discrepancy of teeth. To eliminate it, thread-like materials are also used, placed in the sawn furrow and fixed with a filling. The advantage of this method is that the load is evenly distributed between the teeth.

HOW IS THE PROCEDURE FOR INSTALLING A SPRINT THREAD?

If a patient requires splinting of the upper jaw teeth, the doctor performs the procedure in several stages:

• An anesthetic injection is given. The drug is selected individually, taking into account sensitivity, allergies, pregnancy and various diseases for which painkillers with adrenaline cannot be used.
• A furrow of the required depth is made in the chewing surfaces.
• A tape is laid in the furrow;
• The cuts are filled with a color-matched filling material. There are now an excellent selection of options that can be cured chemically or cured using a light curing lamp.

For splinting the anterior teeth of the upper row with mobility and/or divergence, the cutting depth is usually 2 mm, the height is similar. This option allows you to eliminate too large interdental spaces.

The doctor determines the general condition of the dentition in order to make a final decision on exactly how many teeth will be in the splint.

If the lateral teeth are splinted, then the cut is made on the chewing surface. The further procedure is carried out according to the same principle.

If a patient is prescribed preventive splinting of the teeth of the lower jaw, then it is performed using a similar technology. But when laying the tape, it catches canines/other teeth that do not have mobility problems.

Before installing a splint, it is important to completely remove soft and hard plaque. Stones on the visible surface of the tooth and on the root itself are one of the main reasons for the development of periodontitis, causing tooth mobility, bleeding gums and other unpleasant symptoms.

Therefore, the doctor must refer the client to hygiene procedures. To prevent problems with enamel, increased sensitivity, etc. after them, remineralization therapy can be prescribed. This includes both the application of special compounds and the use of preparations containing substances that help accelerate the recovery process and saturate the enamel with the necessary compounds.

If the reason for splinting is periodontitis, courses of anti-inflammatory therapy are carried out in parallel. It can be local or general.

In the first case we mean:

• Antiseptic rinses and baths;
• Applications;
• Physiotherapeutic procedures – electrophoresis, laser;
• Correct selection of toothpastes;

General therapy refers to drug treatment.

Usually we are talking about a course of antibiotics in the form of tablets or intramuscular injections.

Types of orthopedic devices

Based on the duration of use, temporary, semi-permanent and permanent stabilization devices can be distinguished.

Fiberglass

Splinting mobile teeth with fiberglass is a temporary and semi-permanent technique. The essence: embedding a biocompatible ligature to reliably unite a group of teeth. The advantages include

• possibility of performing the procedure in one visit;
• no need for depulpation;
• fast adaptation;
• high aesthetics.

The flexible fiber is placed in the prepared groove. A photopolymer composite is applied on top. The structure is illuminated by a polymerization device. Under the influence of the lamp, the fiberglass hardens, acquiring strength comparable to a metal beam.

Using fiberglass, you can unite your teeth and even fill in defects. In this case, a composite gap is modeled clinically on the beam. After treatment is completed, the splint is removed and the surfaces are restored with conventional fillings.

Crowns

Splinting teeth with crowns and bridges refers to fixed prosthetics. Recommended when it is necessary to restore damaged fragments of the coronal part and have a high degree of mobility.

Manipulation involves an indirect method of production. The dentist determines whether depulpation is necessary, grinds, and takes impressions. At the laboratory stage, interconnected crowns are made, which are installed with permanent cement at the next visit. The structures are made of metal-plastic, metal-ceramic, zirconium. Solid crowns can be installed on the distal chewing molars.

The technique has a number of advantages:

• the ability to correct the appearance (color, shape, eliminate interdental spaces);
• reliability and durability;
• filling missing teeth in spaces.

Disadvantages include the inability to remove the device (replacement only) and relatively high cost.

Aramid thread

The technique is similar to fiberglass splinting. It is performed directly in the chair, under local anesthesia. Does not require pulp removal, allows you to restore included defects. The aramid thread is made in the form of a flat braided tape, installation is also similar: furrow, thread laying, sealing with light polymer. The difference is increased strength, comparable to the stability indicators of steel.

In some situations, aramid fiber replaces prosthetics. This material:

• lasting;
• biocompatible;
• bioinert.

Cable-stayed (sealed, permanent) splinting does not interfere with normal hygienic procedures, is aesthetically pleasing and can last 5-7 years.

Clasp dentures

Clasp structures are devices that have a dual function. In addition to strengthening and stabilization, dentures fill gaps and end defects, evenly distributing the load on the gum and supporting units.

From the inside, the prosthesis base duplicates the architectonics of the mucous and cervical region, tightly and firmly grasping each remaining unit. The frame is made of dental metal (cobalt-chrome or nickel-chrome), on top of which a base is modeled that imitates the gingival part and crowns that replace the lost ones. The base part is made of acrylic, nylon, acry-free to match the color of the natural mucous membrane. Artificial crowns are matched to natural ones (shape, size, color).

Among the disadvantages of clasp splinting, one can note the need to remove the apparatus for cleaning and the clasp fastening system (metal hooks extending into the visible area). In addition, this device should be prescribed and installed only by an experienced, qualified specialist, otherwise the design will not be able to strengthen the periodontium, but, on the contrary, will loosen the teeth even more.

ABOUT THE MATERIALS

So, let's move on to the important point - the raw materials used when applying a splint to mobile teeth. There are many requirements for it:

• Biocompatibility with natural tissues;
• Hypoallergenic. Not all materials in this regard can be 100% safe for human health.
• Hygiene;
• Ability to withstand mechanical loads.

There are also requirements that are independent of the choice of material. These include:

• Invisibility, allowing you to maintain aesthetics.
• No problems with diction and eating.
• Reliable fixation of mobile teeth. They should not move in any of the possible directions.
• Reliable fixation on the teeth themselves.

It is also very important that the fixing splint does not interfere with brushing teeth and gums and does not injure soft tissues.

Among the most popular options is strengthening teeth with fiberglass tape, as well as its analogues made of polyethylene and silk.

Tire production times are always individual.

In some cases, it is made right in front of you, in others it requires time and work in a dental laboratory.

After the fiberglass thread cures, it turns into a strong element - a beam that holds the teeth together. At the same time, the effect of load distribution acts in such a way that even when biting on just one tooth, the load is divided among all teeth united by the splint. This is important to ensure that the teeth maintain contact with each other.

Many people underestimate the importance of this moment. However, contact greatly influences the rate of bone atrophy, which is observed in many patients

Result

Splinting teeth using reliable materials and structures can significantly reduce the mobility of elements and restore chewing function. A rigid, but at the same time elastic tire binds the elements into one block, holding them securely and preventing them from loosening further. The more units covered by the bus, the better the result. Tire service life is 3-4 years. The biocompatible material does not irritate the mucous membrane, does not injure the gums, and does not interfere with hygiene.

Article Expert

Kopylova Lyubov Ivanovna Dentist-therapist, doctor of the highest category

Work experience: more than 12 years

USING ARAMID FIBER

Also very popular is cable splinting of teeth with aramid thread, which has enormous strength. Experts have conducted several studies, during which it turned out that aramid fiber has eight times greater strength than piano steel with similar parameters.

• This technique allows you to achieve excellent aesthetics and correction of the dentition in case of displacements caused by periodontal diseases, injuries and other reasons.
• Aramid fiber is superior in durability to any other thread.
• The material does not enter into chemical reactions with saliva and food, and has excellent biocompatibility.
• Bone tissue stops rapidly atrophying.
• Large gaps between teeth are eliminated. Consequently, the space between them is not clogged and the overall aesthetics are improved.
• The natural load on the dentition is restored.
• You can simultaneously install dentures to replace lost teeth.

How much does it cost

The cost of splinting in each region differs and depends on the material used and the length of the fixed dentition. The average cost of the procedure is presented in the table.

HOW TO STRENGTHEN MOVABLE TEETH WITH CROWNS

In modern dental practice, various types of dental splinting are offered, differing in indications and effectiveness. One of them involves the use of metal crowns, or their metal-ceramic and metal-free analogues.

The crowns are connected to each other, thereby eliminating mobility. However, in order to perform the procedure, the nerves are removed from the teeth. Therefore, doctors consider all options before settling on grinding teeth for crowns. Let’s not forget that this method is much more expensive.

REMOVABLE PROSTHETICS AS A METHOD OF SPLINTING

If, in addition to loose teeth, there are also “gaps” formed due to the loss of several teeth in a row, the use of removable dentures is effective. They are used when it is necessary to replace 1–3 teeth in a row. The doctor examines all the nuances regarding the general condition of the dentition, the number of missing teeth, and the presence of bite problems. There is also a dependence of the choice on the age and other individual characteristics of the patient.

There are many materials for making dentures. Some are universal, but expensive. Others are affordable, but are far from ideal in a number of ways, or may cause allergies in some people.

Typically, dental splinting with a removable denture is often chosen as a temporary measure necessary for injuries such as a jaw fracture. During the rehabilitation period, this design provides reliable stability.

USING CLASS DENTURES TO ELIMINATE TEETH MOBILITY

A technique such as clasp prosthetics can be recommended in cases where other options are excluded for medical reasons, or are not suitable due to anatomical and other features. Eg:

• The patient has a deep bite;
• Signs of bruxism are observed;
• Violation of the natural position of the teeth;
• Periodontal diseases causing bleeding from the gums;
• Displacement of teeth in a row;
• The appearance of periodontal pockets and significant exposure of roots;
• Loss of more than one tooth in a row where there is no supporting tooth for fixation;
• The need for effective redistribution of chewing load.

The design of the clasp prosthesis used for splinting is an arch with several types of fixing elements - clasps and processes, fixed to the teeth and holding those teeth in the row that have become mobile. Crowns are placed on the supporting teeth.

Features and advantages of a splinting clasp prosthesis:

• Does not cause discomfort when wearing;
• Significantly slows down the process of loss of bone and periodontal tissue;
• Does not require long-term adaptation;
• Has compact dimensions;
• Doesn't interfere with eating or talking;
• Does not change the taste of food;
• Has a reliable design

The procedure for manufacturing and installing a tire based on a clasp design is carried out in several stages.

First of all, the doctor examines the condition of the oral cavity, periodontium, jawbone, and takes photographs.

After this, the specialist has data on his hands, on the basis of which a preliminary prosthetic scheme can be determined.

Next, it is necessary to make impressions of both jaws and create a model, with the help of which the frame will subsequently be made. Then they try it on and make an exact adjustment. It is important that the patient does not experience discomfort while wearing the prosthesis.

POSSIBLE COMPLICATIONS AFTER THE SPLINTING PROCEDURE

Unfortunately, sometimes unpleasant situations arise in which the patient develops complications. There are several options for negative developments:

• In some cases, the groove for the tire is too deep. This leads to opening or damage to the pulp chamber. After some time, the patient develops pulpitis - inflammation of the dental nerve. Typically, in this case, the nerve tissue has to be removed and the tooth filled.
• Because Before the procedure, doctors perform professional cleaning, the thickness of the enamel decreases. This leads to the fact that the patient's teeth may begin to react to cold and hot.
• If the tire becomes deformed during polymerization or overheats, it may break.
• If bacteria remain under the structure, caries may develop, which remains undetected for a long time. Often, patients seek help from a dentist already at the stage of pulpitis development.
• Inflammatory processes and other complications caused by irritation of the mucous membrane, as well as allergic reactions to the material used.

What are the disadvantages

The procedure has its consequences, which are not always positive and convenient for the patient. So, for example, the presence of a splinting structure leads to a more intense accumulation of plaque and deposits, which can provoke inflammation in periodontal tissues, as well as the appearance of carious cavities

Therefore, after splinting, it is important to maintain a high level of hygiene and carefully monitor the cleanliness of the enamel and cervical area. Experts recommend additionally using a monotuft brush and irrigator, and rinsing your mouth with water or an antiseptic after each meal.

Splints made of aramid fiber do not look very aesthetically pleasing, so they are fixed either on the back side of the row or to unite the chewing molars. To guarantee an aesthetic result, it is better to use translucent fiberglass. In rare cases, splinting structures can provoke irritation of the mucous membrane and cause discomfort, but these are only temporary phenomena that will pass after getting used to it.

Aramid fiber tires do not look very aesthetically pleasing

If the product was not installed correctly or the doctor created a groove that was too deep, the patient may experience increasing pain after the procedure. In such a situation, you should urgently contact a specialist, otherwise the pulp chamber may be damaged, which risks leading to pulpitis and the need to remove the nerve. Sometimes during operation the tire becomes unstuck or breaks off. The cause may be bruxism, malocclusion, or simply excessive chewing loads. To correct the damage, you should contact your orthodontist.

Important to remember! Splinting alone for periodontitis is extremely insufficient - it is important to regularly remove deposits and maintain therapy, otherwise the teeth will continue to loosen and simply fall out along with the splint group

PATIENTS' REVIEWS ABOUT THE TEETH SPLITTING PROCEDURE

Before praising or criticizing one type of dental splinting, you need to understand the features of the procedure.

For example, when using fiberglass material, the service life does not exceed three years from the date of installation of the tire.

And even then, only with full compliance with all the rules by the doctor and the patient. A polishing procedure is carried out annually.

It is also important to know that in the absence of molars, the load on the front teeth becomes excessive. Therefore, preventive prosthetics of chewing teeth is recommended to restore the natural bite.

As for crowns, they last a long time, and in this regard they are more effective than fiberglass. But to install them, the doctor has to grind the teeth. Cavities can develop under the crown. And if it is necessary to splint a large number of teeth, this is simply impractical and not profitable.

The most reliable and durable option, which allows not only to strengthen existing teeth, but also to replace missing teeth, is the clasp system. However, this method has one significant disadvantage - the price. Not every patient can afford such expenses.

Negative reviews from patients are often associated not with the unprofessionalism of dentists, but with a banal failure to comply with a number of care requirements. In addition, as we wrote above, it is important that when splinting the anterior row you have strong lateral and posterior teeth.