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Tooth splinting: a review of the literature and consideration of the versatility of a wirecomposite 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. .,, Abstract -T'he principles of tooth luxation splinting have been changed since the animal and human tests conducted in the early 1970s showed that masticatory stimulus promotes healing of luxated teeth and normally exerted occlusal forces arc able to prevent and eliminate small resorption cavities on the root surface. It has also been shown that iixation of only one week is enough to achieve the clinical healing of repositioned teeth. Apart fi-om esthetic and hygienic cotnponents, present-day demands on tooth fixation techniques also include ease of construction and removal and the use of devices which allow slight movement of the fixed teeth. This paper presents the history of tooth splinting, our present-day knowledge ofthe subject, and introduces various splinting techniques. T^he wide range of indications for a flexible wire-composite splint are analyzed more thoroughly.

A total of 1152 patients under 20 yr of age with 1611 accidentally traumatized teeth treated at the Helsinki Health Center oral surgery clinic in 1979 and 1980 were studied with respect to the etiology, type, extent and severity of their injuries. The mean age of the patients was 11 yr and the male: female ratio was 2.7:1. The prevalence was highest in the age group 7‐10 yr for girls and in the age group 11–15 yr for boys. More injuries were recorded as having taken place outside school or kindergarten and in the fall and winter months. Most of the injuries were exclusively hard tissue traumas; 81% were estimated as mild, 15% as moderate, and only 4% as serious and needing specialized treatment. Typical causes were accidents at school (28%) or at home (27%), while only 11% were traffic accidents, 21% were due to sports and 11 % due to acts of violence. These last three etiologies were more common among the boys (p< 0.001). Violence was the main etiology for tooth injuries among patients aged 16–20 yr (p<0.001), resembling the findings regarding causes of facial bone injuries. The proportion of home or school accidents seemed to be decreasing in relation to traffic and sports accidents, which were more numerous in 1980 than in 1979. Most accidents were single‐tooth injuries, but the youngest and oldest age groups involved more cases of 3 or more simultaneous tooth traumas than did the other age groups.

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It has been shown that the shape of the mandible correlates with occlusal condition and the function of the masticatory muscles. Edentulous subjects have a wider gonial angle than dentate subjects, and a gender difference has also been shown. However, some studies have reported differing results. Less is known about the effect of dental status and gender on the ramus and condylar height. The aim of this study was to evaluate the association of tooth loss on the shape of mandible (i.e., gonial angle, ramus height and condylar height) in subjects aged 60 years and older. A total of 1036 subjects (667 dentate, 389 edentulous; 554 women and 482 men) were included in the study. Interviews and clinical and panoramic radiographic examinations were carried out. The gonial angle of the mandible and the mandibular and condylar height were measured using panoramic radiographs. In edentulous subjects, the gonial angle was significantly larger, while the ramus and condylar height was significantly smaller on both sides compared with dentate subjects. Women had a significantly larger gonial angle and smaller ramus and condylar height on both sides compared with men. In conclusion, the morphology of the mandible changes as a consequence of tooth loss, which can be expressed as a widening of the gonial angle and shortening of the ramus and condylar height. These findings highlight the importance of rehabilitation of the masticatory system to maintain good functioning of the masticatory muscles for as long as possible.

Horizontal and vertical rigidity of teeth fixed with seven types of dental splints were evaluated by two tooth mobility measuring devices. Altogether 21 dissected sheep mandibles including soft tissues were used for the experiments in which Fermit, flexible wire-composite, Kevlar, Fiber, Protemp, rigid wire-composite and Triad Gel splints were applied to four incisors. The mean rigidity of the central incisors within the splint was measured by means of Mühlemann periodontometer (horizontal mobility) and Periotest (horizontal and vertical mobilities). Mobility values of teeth before splinting were used as covariants and the values with the splints were illustrated as adjusted mobility. Statistical significance between the rigidity of various splints was analyzed by an unpaired t-test. It was shown that the most rigid splints both in horizontal and vertical directions were Triad Gel, rigid wire-composite and Fermit splints. Kevlar and Fiber splint allowed more horizontal movement than other splints. Protemp and flexible wire-composite splints proved to produce adequate lateral support for the fixed teeth and allowed vertical flexibility which is experimentally known to improve periodontal healing of luxated teeth.