Splinting In Periodontal Therapy

A periodontal splint is an appliance used for maintaining or stabilizing mobile teeth in their functional position.

Principles of Periodontal Splinting

Before proceeding for the splinting, following principles should be considered:
Only after the completion of elimination of all local factors which contribute to inflammation, the splinting should be considered.
Occlusal adjustment should be done before splinting except when the remaining teeth are so mobile that they have to be stabilized to facilitate occlusal correction.
There should be sufficient number of non mobile teeth should be included in a splint.
Support of posterior teeth is necessary when anterior segments are mobile.
If in case of occlusal trauma associated with severe bone loss, all the teeth demonstrate hypermobility, cross arch splinting is beneficial as the pattern of mobility of some teeth is in a buccolingual direction and others in a mesiodistal direction. With splinting, a group of single rooted teeth in effect becomes multirooted teeth.
Splinting should not impede normal functions like phonetics, mastication or oral hygiene maintenance of the patient.
Splinting should not irritate the gingival tissues.
Splinting should be aesthetically acceptable.

Procedure of Periodontal Splinting

The most common splint and simple to fabricate are the wire and acrylic splint.
Take a soft stainless steel wire of around 0.24 mm diameter, loop the wire around all the teeth to be included in splint, and its ends are loosely twisted. Loop should be positioned just apical to the contact points.
Inter – dental wires of around 0.2 mm diameter should be cut to about 2 inches in length. Insert the wire between the teeth from lingual side and twist the ends until tight around the loop wire.
As all of the inter dental wires have been placed, tighten the loop wire finally making sure that it should be just below the contact points. Cut ends of the wires leaving 2 to 3 mm which should be tucked between the teeth.
Dry the area and a thin mix of quick set acrylic runs over the wire. Take care to ensure that the wire is evenly covered. Provide the acrylic a half round contour as it is run on.
As acrylic become set, it should be trimmed so that the embrasures become free from acrylic at cervical margins, check the bite. Polish the acrylic so that it is easy to keep clean