Dento-alveolar Splint Fabrication

Image: Splinting of tooth.

Splinting guidelines for tooth/bone fractures and luxated/avulsed teeth recommend flexible, non-rigid splinting except in root fractures in the cervical third of the tooth and alveolar fractures when rigid splinting is recommended.

Fabrication Technique:

Materials

Non rigid (flexible) splint:

  • .017 X .025 stainless steel wire, composite
  • 018 round stainless steel wire, composite
  • Monofilament nylon (20-30 lb test) with composite

Rigid splint:

  • 030 stainless steel wire, composite

Procedure

  1. Adjust the length of the wire so it extends one to two teeth on either side of repositioned tooth.

  2. Reposition the tooth.

  3. Prophy the enamel with pumice.

  4. Apply etchant and bonding solution.

  5. Place a dab of composite in the center of the facial surface of the tooth to be bonded.

  6. Position the wire on to the composite.

  7. Set the composite.

  8. Add additional composite so the wire is covered, especially at the distal terminal ends.

  9. Smooth the composite to insure that there are no rough surfaces that might irritate the soft tissue.

  10. Rx chlorhexidine rinse for one week.

Table 1. Recommended Splinting Times
Type of injury Splinting time Splint type
Subluxation 2 weeks Flexible
Extrusive luxation 2 weeks Flexible
Avulsion 2-4 weeks Flexible
Lateral luxation 4 weeks Flexible
Root fracture (middle third) 4 weeks Rigid
Alveolar fracture* 4 weeks Rigid
Root fracture (cervical third) 4 months Rigid
* In cases when teeth are not present (avulsion), fixation may be obtained by using firm pressure to realign the bone fragments and stabilizing the area by suturing the gingival tissues.