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Abstract Objectives This clinical report aims to highlight the factors affecting the clinical success of alveolar ridge mini-implants used for orthodontic anchorage and provide an overview of the biomechanical versatility of this miniscrew and steps involving the proper technique of its placement. Methods For this clinical report, charts for 295 patients who had temporary anchorage devices (TADs) were screened. Twenty patients [15 females and 5 males: mean age = 38.15 ± 15.10 years] with 50 alveolar ridge mini-screws were assessed. A descriptive summary of the main factors affecting their clinical success and the technique employed for their placement was comprehensively discussed and illustrated, in addition to the presentation of some clinical cases illustrating their potential clinical uses. Results The survival duration (7.32 ± 9.01 months) and clinical success of the alveolar ridge mini-implants that failed (19/50) seem to be affected primarily by 2 factors: splinting; none of the splinted mini-implants failed (0/10) compared to (19/40) of the single mini-implants that failed, and the length of the used mini-implant; the average length of the mini-implants that did not fail was 9.23 mm. Additionally, it appears that these mini-implants are biomechanically robust and durable, those that did not fail had an average survival duration of 35.97 ± 19.79 months. Conclusion Ridge mini-implants offer significant biomechanical versatility in patients with partially edentulous ridges needing complex pre-prosthetic orthodontic movements. The presence of splinting and the length of the used mini-implants are factors that might affect the clinical success of the alveolar ridge mini-implants.

Aim: The aim of this study was to evaluate and compare the accuracy of hexed and nonhexed pickup impression copings with and without splinting using polyether (PE) and polyvinyl siloxane (PVS) impression materials in open-tray technique in recording multiple straight and angulated implant positions. Settings and Design: An accurate impression results in an accurate definitive cast, thus minimizing the incidence of prosthesis misfit. The critical aspect is to record the three-dimensional location of the implant in bone rather than reproducing fine surface details. Precise fit of a fixed implant-supported prosthesis depends on the accuracy of the implant analog location within the definitive cast. Factors which affect impression accuracy include implant angulation, impression material, impression copings, technique, and splinting. Materials and Methods: A sample size of 80 study models fabricated from the impression of different groups was included. A reference master model based on All-on-4 implant concept with two parallel (implants 1 and 2) and two angulated (implant 3 at 17° and implant 4 at 30°) was fabricated using implant angulation guide. All impressions were recorded using open-tray impression technique. The groups were divided into two main groups of 40 samples each. Group A used hexed open-tray impression copings and Group B used nonhexed open-tray impression copings. Both the groups involved impression recording using splinted (Subgroup I) and nonsplinted impression copings (Subgroup II). Further, impressions in each subgroup were made using PE (Subsubgroups a) and PVS (Subsubgroup b). A total of eight subsubgroups with ten samples each were included. Impressions were recorded for each group and poured into Type IV die stone for fabrication of study models. After 24 h, the study models and reference master model were fitted with implant abutments for measurement with coordinate measuring machine. Statistical Analysis Used: The mean differences of the interimplant distance R1 (1–2), R2 (1–3), R3 (2–4), and R4 (3–4) between the reference model and sample models in different subsubgroups were calculated and three-way analysis of variance test was applied with Tukey's post hoc tests. Results: No significant difference was found in mean coronal deviations for distance R1, R2, and R3 (P > 0.05) between different study groups. P = 0.02 for R4 (distance between 17° and 30° implants) between impression materials subsubgroups suggested that significantly less distortion was created in location of highly angulated implants (>30°) using PVS impression material. Splinting and type of coping did not have a significant influence on impression accuracy. Increasing angulation decreased the accuracy. Conclusion: PVS was found equivalent in accuracy to rigid PE for recording parallel or angulated implants. Impressions of implants with higher angulations were recorded more accurately with PVS. The study found no difference in accuracy with or without splinting. Furthermore, nonhexed impression copings facilitate easier and accurate recording of multiple angulated implant location in bone.

Background. Various materials are used for splinting impression copings, the most common of which are auto-polymerizing resins. In this study, a new light-curing pattern resin (Jig-Gel) was investigated and compared with auto-polymerizing resins using two different splinting methods. Methods. After taking impressions with two different materials, a digital caliper with an accuracy of 0.01 mm was used for splinting and measuring the distances between the external parts of the analogs inside the plaster cast. The accuracy was also compared in five groups as follows; group 1: splinting of impression copings by auto-polymerizing acrylic resin, group 2: cutting the splinting of impres­sion copings with self-polymerizing acrylic resin, group 3: splinting of impression copings with a light-cured resin pattern (Jig-Gel), group 4: splinting of impression copings cut by a light-cured resin pattern, and group 5: impression with no splint. All statistical analyses were performed with SPSS 17. Statistical significance was set at P

A digital technique for planning and manufacturing a periodontal splint from composite material reinforced with glass fibers is presented. The lingual surface of the permanent mandibular anterior teeth is scanned intraorally. An accurate periodontal splint of the mandibular anterior teeth with increased mobility is fabricated. Digital planning and fabrication of an immobilizing splint minimize the human factor that affects the accuracy of the restoration.

Introduction: The wire composite splint as a general rule is placed on the middle third of labial surface of the tooth. This is due to ease of application, better isolation, and fewer chances of contamination. However, these assumptions are opinion-based, with no scientific evidence to support them. In addition, to best of our knowledge no research has been carried out to evaluate the effect of position of wire splints on the mobility of the affected tooth and anchor teeth. Aim: The aim of this study was to evaluate the effect of the cervico-incisal position of splinting wire on the mobility of a replanted tooth and anchor teeth in a cadaveric model. Methodology: Three cadavers (one female, 45 years old and two males, each 40 years old) were included in the study. periotest S was used to assess physiologic-tooth-mobility in three cadavers at baseline and after “extraction-replantation-wire-composite” splinting-protocol. Results: Greatest splint effect for horizontal-mobility was found to be 9.33 ± 0.57 for Cadaver-I (incisal-third), whereas it was highest (3.66 ± 2.51) for vertical-mobility in Cadaver-II (cervical third). Conclusion: Middle third position of wire composite splint have lowest splint effect on both horizontal and vertical mobility of replanted teeth, thus rendering the most favorable position for the establishment of physiologic mobility.

Implant treatment should be restoratively driven, however at times, ideal implant positioning may be sacrificed for surgical convenience at the expense of restorative complexity. A prosthesis incorporating a novel design was constructed to restore two converging implants placed in close proximity utilizing standard implant impression componentry and simple clinical stages. As the use of angulated screw channel technology was not possible, a customized cast “rest” abutment and overlying telescopic crown was fabricated that facilitated access for oral hygiene and retrievability as required. The complexity of the case design was transferred to the laboratory phases of construction. The case presented a satisfactory clinical outcome for an initially challenging implant presentation and reinforced the need to work closely with the laboratory technician.

Back ground: Many different splinting techniques have been described in dental trauma articles. Wire-composite splint, Orthodontic splint, TTS splint, Resin splint, Kevlar/fiberglass splint (fiberglass), Self-etching and bonding material, Suture splint. We describe here a new technique for splinting traumatized teeth and alveolar bone. To evaluate the simplicity and reliability of cold-cured acrylic resin immediate splinting in the management of traumatized anterior teeth. Results: A total number of (46) patients with traumatized dental or dento-alveolar segment due to accident or operation were managed with immediate cold-cured acrylic resin splint without the need for anesthesia for fixation, the study carried out from January (2008–2014). Forty four dento-alveolar trauma patients, 2 patients following upper dento-alveolar osteotomy, 2 splints dropped down (2) days post-splinting, the splints removed (14-21) days. Conclusion: this new technique in the management of dento-alveolar trauma is a reliable, simple, easy, less technical, painless and less time consuming procedure.

Background: Progressive attachment loss around the teeth because of periodontal disease can result in increased tooth mobility. This adversely affects patient's comfort, function, and esthetics. Periodontal splinting helps in accomplishing stability by redistributing the functional and parafunctional forces. There are various materials that have been used for periodontal splinting. Fiber-reinforced composite, composite resin, and metal-reinforced composite are often used as splinting materials for periodontally compromised teeth. In our study, a comparison was done among these materials for their ability to distribute the stresses at different bone levels in mobile lower incisors splinted together with canines. Materials and Methods: Five patients of age group 25–50 years with Grade 2 and 3 mobile incisors having 40% or more bone loss and firm canines with optimal bone support were selected. From the computed tomography scan of each patient, three models were developed demonstrating splinting of mandibular incisors and canines with metal-reinforced composite, fiber-reinforced composite, and composite resin. So in total, 15 models were developed and each one of them was subjected to vertical and transverse loads of 150 N. Pattern of stress distribution was observed in these models using three-dimensional finite element analysis. Results: After splinting, the stress on the canine increased when bone levels around incisors decreased while stress on incisors reduced. Conclusion: Tested splinting materials were successful in stress distribution, and metal-reinforced composite was found to be better than the other splinting materials.

Horizontal root fractures are a rare emergency in a dental office. The injury involves periodontal ligament, cementum, dentine and pulp. The healing is influenced by the location of the root fracture, the displacement of the fragments and the status of the pulp. This report presents a clinical case of horizontal fractures to both maxillary central incisors due to an act of violence. The type of occlusion has avoided a severe diastasis of the coronal parts with a subsequent damage to the pulp and periodontum. The fractures were treated with an orthodontic splint without any further therapy and hard tissue healing was observed. A careful diagnosis and well-timed treatment planning usually allow a cost-efficient and biologically-oriented therapy with a favorable outcome.

Background: Progressive attachment loss around the teeth because of periodontal disease can result in increased tooth mobility. This adversely affects patient's comfort, function, and esthetics. Periodontal splinting helps in accomplishing stability by redistributing the functional and parafunctional forces. There are various materials that have been used for periodontal splinting. Fiber-reinforced composite, composite resin, and metal-reinforced composite are often used as splinting materials for periodontally compromised teeth. In our study, a comparison was done among these materials for their ability to distribute the stresses at different bone levels in mobile lower incisors splinted together with canines.Materials and Methods: Five patients of age group 25-50 years with Grade 2 and 3 mobile incisors having 40% or more bone loss and firm canines with optimal bone support were selected. From the computed tomography scan of each patient, three models were developed demonstrating splinting of mandibular incisors and canines with metal-reinforced composite, fiber-reinforced composite, and composite resin. So in total, 15 models were developed and each one of them was subjected to vertical and transverse loads of 150 N. Pattern of stress distribution was observed in these models using three-dimensional finite element analysis.Results: After splinting, the stress on the canine increased when bone levels around incisors decreased while stress on incisors reduced.Conclusion: Tested splinting materials were successful in stress distribution, and metal-reinforced composite was found to be better than the other splinting materials. [ABSTRACT FROM AUTHOR]

Abstract Background Fixed orthodontic retainers have numerous advantages, but it is not known whether they can exert pathological forces on supporting tissues around the splinted teeth. The purpose of this study was to investigate how the inclination of the lower anterior teeth can affect dental displacement and also change the direction of occlusal loads exerted to dental and its supporting tissues. Methods Four three-dimensional finite element models of the anterior part of the mandible were designed. All the models contained the incisors and canines, their periodontal ligament layers (PDLs), the supporting bone (both spongy and cortical), and a pentaflex splinting wire placed in the lingual side of the teeth. Teeth inclination was considered to be 80° (model 1), 90° (model 2), 100° (model 3), and 110° (model 4) to the horizontal plane. The lower incisors were loaded with a 187-N vertical force. Their displacement patterns and the stress in their PDLs were evaluated. Results In incisors with 80° of inclination, less than a 0.1-mm lingual displacement was seen on the incisal edge and a similar distance of displacement towards the labial was seen on their root apices. However, in models with 90°–110° of inclination, the incisal edge displaced labially between about 0.01 and 0.45 mm, while root apices displaced lingually instead. By increasing the angle of the teeth, the strain in the periodontal ligament increased from about 37 to 58 mJ. The von Mises stresses around the cervical and apical areas differed for each tooth and each model, without a similar pattern. Increasing the angle of the teeth resulted in much higher cervical stresses in the incisors, but not in the canines. In the lateral incisor, cervical stress increased until 100° of inclination but reduced to about half by increasing the angle to 110°. Apical stress increased rather consistently in the incisor and lateral incisors, by increasing the inclination. However, in the canines, apical stress reduced to about half, from the first to fourth models. Conclusions Increasing the labial inclination can mostly harm the central incisors, followed by the lateral incisors. This finding warns against long durations of splinting in patients with higher and/or patients with reduced labial bone thickness.

Objective: To determine the characteristics, reasons, and patterns of splinting done in the Periodontology clinic of University of Benin Teaching Hospital, Benin City, Nigeria. Materials and Methods: This retrospective review of patients treated with splints in the Periodontology clinic of University of Benin Teaching Hospital, Benin City, Nigeria, over a 3-year period (January 2013–December 2015) was done using a self-developed pro forma as the data collection tool. Results: A total of ten patients aged between 24 and 68 years with a mean age of 45.40 ± 14.19 years had composite and wire splinting. The majority of the patients were middle--aged adults and elderly (60.0%), females (60.0%), indigenous people (70.0%), and reside near the specialist clinic (60.0%). The patients were mostly the first-time dental clinic attendee (80.0%), fully dentate (80.0%), and had fair oral hygiene status (70.0%). The reasons for dental attendance among the patients were mainly due to pain (50.0%) and tooth mobility (50.0%). The main reason for the splinting was tooth mobility caused by chronic periodontitis (50.0%). The patients had 1–11 mobile teeth with a mean of 3.5 teeth. Central incisor (90.0%) was almost always the involved mobile tooth in the treated patients. The periodontal treatments involved were scaling and root planing, medications, incision, and drainage for the abscess. The most prescribed antibiotic was doxycycline. The splinting was equally divided into maxillary and mandibular arches. The majority of the splinting were done on buccal/labial surfaces of the teeth (80.0%). On recall, three cases (30.0%) had complications in form of debonding; one case was changed from lingual/palatal surfaces to buccal/labial surfaces while the other two cases were redone. Conclusion: Periodontal splinting were done mainly for older, nonprofessional, female, indigenous patients for varied reasons in the studied periodontology clinic.

Aim: To evaluate the bond strength of two splinting materials (orthodontic wire and ribbond) to the tooth structure using cyanoacrylate (CA) ester, self-adhering flowable composite (Vertise flow) and conventional flowable composite as adhesives. Materials and Methods: A total of 120 human central incisors free of any carious lesions were selected for the study. To obtain the specimens, 120 human central incisors were embedded in the blocks of rapid polymerizing self-cure acrylic resin with two teeth each. The specimens were divided into six groups with ten specimens each. Group I-Orthodontic wire bonded with CA, Group II-Orthodontic wire bonded with flowable composite Group III-Orthodontic wire bonded with Vertise flow, Group IV-Ribbond bonded with CA, Group V-Ribbond bonded with flowable composite and Group VI-Ribbond bonded with Vertise flow. The adhesive force in newtons to debond the splinting material was measured in tension using universal testing machine. The force at which the splint system failed was noted. The data obtained were statistically analyzed using one-way ANOVA and significant differences were subjected to Tukey′s post-hoc test at a confidence interval of 0.05. Results: Bond strength with the orthodontic wire groups was significantly less compared with Ribbond groups p < 0.05. Among the adhesives, CA demonstrated lower bond strength value as compared to Vertise flow and flowable composite p < 0.05. Conclusion: Orthodontic wire groups demonstrated significantly lower bond strength compared to ribbond groups. Among the adhesives CAs showed significantly lower bond strength compared to Vertise flow and conventional flowable composite.

Avulsion is defined as the complete displacement of the tooth out of its socket with disruption of the fibers of periodontal ligament, remaining some of them adhered to the cementum and the rest to the alveolar bone. This condition is more frequent in young permanent teeth, because the root development is still incomplete. Splints are used to immobilize traumatized teeth that suffered damage in their structures of support, preventing their constant movement. The literature has shown that after replantation, it is necessary to use splints in order to immobilize the teeth during the initial period, which is essential for the repair of periodontal ligament; the use of semi-rigid splint is more indicated than the rigid one, and long periods of splinting showed that substitutive resorption or ankylosis is an expected complication. Thus, the aim of this review is to describe the different types of splints; their time of permanency, and its influence on the process of healing and reparation on the occurrence of substitutive resorption or ankylosis. It is very important to keep gathering knowledge about this content, since it has been proved that the approaches and the protocols keep changing over time.

Introduction After Cota et Al. gingival overgrowth in renal transplanted patients varies in accordance with the type of the immunosuppressive treatment that’s why the integration between the medical and the dental team may be an important approach in the post-transplant maintenance routine. Case report A female patient N.C., 45 years old, retired for medical reasons, with renal transplant and diabetes, was referred in March 2013 by the general dentist for a gingival overgrowth at the level of the anterior mandibular arch. The periodontal treatment plan included: super and subgingival scaling and root planning, laser assisted surgical removal of the gingival overgrowth and splinting of the teeth from tooth 3.3 to tooth 4.3. Taking into account the very special general status of the patient we decided to perform the periodontal surgery as minimally invasive as possible that’s why we used a 940 nm wavelength diode laser instead the conventional technique. Results and discussions The final result of our case was a positive one because we succeeded in surgically removing the overgrowth using a nonconventional technique and in the same time we conserved the affected teeth on the arch. Conclusions This technique may be considered as an election technique for the periodontal surgeries performed in patients with highly significant systemic diseases.

Since the inception of root form implant dentistry by P-I Branemark in the early 1980′s, so many technical advances have been put forward by several authors. However, the open tray impression technique is still performed for impressing multiple implant fixtures as it was first described in the original Branemark procedure manual. The most critical aspect for a successful implant-supported restoration is the passive and an accurate fit of superstructures to avoid preload and loading stresses. Splinting impression technique in multiple implants has gained popularity. Auto-polymerizing acrylic resin is among the most routinely practiced splinting material for multiple implant units. However, unfortunately, it exhibits shrinkage, which makes an impression quite inaccurate. This case report presents the solution to minimize the shrinkage of resin by utilizing sectional-splinting technique as advocated in the previous implant literature.

Objectives: The synthetic fiber content significantly improves some physical properties of composite materials, such as tension and flexural resistence. These materials are known as the fiber reinforced composites. They have a wide spectrum of applications in many fields, including medicine, thanks to their low weight and a plethera of other advantageous mechanical properties. They are used in dentistry to provide greater range of favourable alternatives to many standard treatment methods. The basic components of fiber reinforced composites are resin matrix and fibers (nonimpregnated or preimpregnated) and silans, that work as bonding agents between matrix and fibers. The spatial distribution of fibers is also important for the quality of the material; the internal architecture of the fiber beams can be either unidirectional, braided or woven. The glass and polyethylene fibers are usually used as the reinforcement of material. The shapes of the materials for use in dentistry are commonly either posts or ribbons. The design of the products reflects their specific applications. The fiber reinforced composites are most frequently used in prosthetic dentistry for the post and core fabrication as well as for fabrication of temporary and permanent dentures. In periodontology and dentoalveolar surgery they are used for fabrication of stabilization splints with short-term or long-term usage, and in orthodontics as retainers after completion of the active treatment period. Contraindications of their include poorly cooperating patient, wet operating field and some parafunctions, such as bruxism. The favourable mechanical as well as aesthetic properties are the main advantages of the fiber reinforced composites. Other advantages include relatively low costs, the possibility of direct fabrication without any laboratory phase during prosthetic treatments and the long-term durability of material. Practical working procedures have previously been discussed in literature that reiterate the fact that a complete knowledge of the material's properties and their indications is essential for their clinical use.

Purpose: The purpose of this study was to investigate and compare the accuracy of two procedures: open tray with splinting technique and closed tray impression techniques, in innovative in vitro experiments. Materials and Methods: One master cast was fabricated with 4 abutment replica implants with almost parallel position in an anterior region of an edentuloys mandibular plaster cast. The working cast was taken impessions with open tray splinting technique (group 1) and closed tray technique (group 2) using polyvinyl siloxane impression material. The Type III dental stone ws poured into around the impressions. The accuracy of impression procedured were measured 24 hours long after pouring dental stone to each impression. Four sited were marked to measured on every platform of implant analogs. The analyzing stylus was positioned to each site and the heights, horizontal inclination and saggital incliniation were measured using the Laser displacement transducer (LK G115; Keyence, Osaka, Japan). Measurements of these 16 points of four implants per a model was repeated 7 times under the same condition. The gap between the abutment and superstructure at one screw test was evaluated with a digital microscope system (VH-Z100 & VH-5000; Keyence, Osaka, Japan). The mean and standard deviation estimated from the samples of each subgroup were statistically analyzed by ANOVA test (PResults: The relative differences of implant heights, horizontal inclination and saggital inclination of each implant on closed tray technique was statistically different to master cast and open tray with splinting (PConclusion: The open tray technique was more accurate comparing to the closed tray technique. The gap between the abutment and superstructure in the open tray with splinting technique was smaller comparing to closed tray technique.DOI: 10.14693/jdi.v17i1.111

Spacing in dentition negatively interferes with harmony of the smile. A lot of literature has been devoted to prosthetic closure of such space(s) in the dentition; however, the only option for maintaining space(s) in tooth-supported fixed dental prosthesis (FDP) is with the aid of loop connectors. Eleven patients (seven males and four females) with mean age of 45.18 years (range 22-70 years), previously treated with porcelain fused to metal full coverage restorations joined with loop connectors, were evaluated clinically to assess the clinical status and longevity of treatment provided. All the patients were asked to fill a simple close-ended questionnaire to provide their perspective on the limitations and outcome of the treatment and rate their satisfaction level on the scale of 1-10. The cumulative survival of the FDPs with the aid of loop connectors was 90.9%. There was no reported esthetic failure and, at the time of responding to the questionnaire, none of the patients had active complaint with respect to the prosthesis and all but one of the patients were satisfied with the treatment provided. Clinical survivability and the patient feedback suggests that customized designing of loop connectors for each patient is an excellent treatment modality to successfully maintain excessive (single/generalized) spacing between teeth and effectively splint pathologically migrated and mobile teeth. The reported problems with this treatment option are all transient in nature.

Introduction: In patients with hopeless prognosis of the anterior teeth there is still a strong desire to save them for the sake of esthetics. If not grossly carious, broken down or discolored the extracted tooth after suitable modifications can be placed back in its original site by splinting it to the adjacent stable teeth. Materials and Methods: Fifteen patients (10 males, 5 females) in the age range of 40-65 years with pathologically migrated, unsalvageable teeth were treated by splinting the extracted teeth immediately with the stable adjacent teeth. After 12 weeks, all the patients were explained various treatment options available for replacement of the lost teeth. The patients were asked to fill out a simple closed ended questionnaire citing the various difficulties encountered during this transitional period, selection of further treatment modalities and the reasons for their choice. The feedback obtained was then analyzed statistically. Results: Hundred percent of patients were happy with the esthetics; however, 60% of them were dissatisfied with the function that it provided. The primary problem being apprehension of splint fracture and difficulty while incising and the data was found to be statistically significant (P=0.01FNx08). All patients demanded a permanent treatment option following this with a fixed prosthesis. None of the patients were interested in the implant supported prosthesis due to cost, treatment time involved, and need for surgery. Conclusion: The concept of immediate pontic placement is surely a viable treatment option and promises an excellent transient esthetic solution for a lost tooth as well as enables good preparation of the extraction site for future prosthetic replacement.

Retention after orthodontic treatment is still an important part of the treatment. Splints are considered as an alternative for removable retainers. The main goal of this study was to assess splinting biomechanically.Three dimensional finite element models (3D) were designed of a mandibular anterior segment which included six anterior teeth with their supporting tissues (model 1 as control) and with a bonded lingual fixed retainer in the two other models. The wire cross section was round (0.016") in model 2 and rectangular (0.016" × 0.022") in model 3. The models were designed in Solid Works 2006 and analyzed in ANSYS Workbench Ver. 11.0 SolidWorks Incisors were loaded with a vertical force of 187 N. PDL stress and tooth displacements were evaluated.The numeric findings showed an increase after splinting in the central incisors [2.42 MPa to 4.57 MPa (round) and 16.66 (rectangular) MPa] in biting with four incisors. Biting with two incisors decreased the stress after splinting [2.42 MPa to 1.7 MPa (round wire) and 1.77 MPa (rectangular wire)]. In lateral movement, all teeth showed an increased stress except for the working side canine.Splinted cases (with round or rectangular wires) can benefit from stress redistribution when biting small food particles and in lateral movement.

Objectives: The synthetic fiber content significantly improves some physical properties of composite materials, such as tension and flexural resistence. These materials are known as the fiber reinforced composites. They have a wide spectrum of applications in many fields, including medicine, thanks to their low weight and a plethera of other advantageous mechanical properties. They are used in dentistry to provide greater range of favourable alternatives to many standard treatment methods. The basic components of fiber reinforced composites are resin matrix and fibers (nonimpregnated or preimpregnated) and silans, that work as bonding agents between matrix and fibers. The spatial distribution of fibers is also important for the quality of the material; the internal architecture of the fiber beams can be either unidirectional, braided or woven. The glass and polyethylene fibers are usually used as the reinforcement of material. The shapes of the materials for use in dentistry are commonly either posts or ribbons. The design of the products reflects their specific applications. The fiber reinforced composites are most frequently used in prosthetic dentistry for the post and core fabrication as well as for fabrication of temporary and permanent dentures. In periodontology and dentoalveolar surgery they are used for fabrication of stabilization splints with short-term or long-term usage, and in orthodontics as retainers after completion of the active treatment period. Contraindications of their include poorly cooperating patient, wet operating field and some parafunctions, such as bruxism. The favourable mechanical as well as aesthetic properties are the main advantages of the fiber reinforced composites. Other advantages include relatively low costs, the possibility of direct fabrication without any laboratory phase during prosthetic treatments and the longterm durability of material. Practical working procedures have previously been discussed in literature that reiterate the fact that a complete knowledge of the material's properties and their indications is essential for their clinical use. [ABSTRACT FROM AUTHOR]

Background: Controversy regarding tooth-implant connection in implant dentistry has emerged due to the differences in the mobility pattern of tooth and implant causing increased stress on the implant leading to implant failure. Purpose: The purpose of this review is to critically analyze the technical complications, the biological impact of tooth-implant connection and the treatment modalities that may be helpful in preventing intrusion. Materials and Methods: A detailed search was carried out in the dental literature available in English language from 1989 to 2012 which included review articles and case reports. The search was carried out in PubMed database, Google search engine, Medline and Science Direct as well as manual search of peer reviewed literature using relevant key words. Results: Literature search revealed studies involving complications and biomechanical interactions of tooth-implant connection and the survival rates of tooth-implant supported fixed prosthesis (TISP). Conclusion: Thus tooth-implant connection has its own advantages, disadvantages, risks and complications, but what justifies its application is the risk-benefit evaluation with a special attention on patient requirements. Thus many longitudinal studies are necessary before this method is declared as the treatment of choice. [ABSTRACT FROM AUTHOR]

Spacing in dentition negatively interferes with harmony of the smile. A lot of literature has been devoted to prosthetic closure of such space(s) in the dentition; however, the only option for maintaining space(s) in tooth-supported fixed dental prosthesis (FDP) is with the aid of loop connectors. Eleven patients (seven males and four females) with mean age of 45.18 years (range 22-70 years), previously treated with porcelain fused to metal full coverage restorations joined with loop connectors, were evaluated clinically to assess the clinical status and longevity of treatment provided. All the patients were asked to fill a simple close-ended questionnaire to provide their perspective on the limitations and outcome of the treatment and rate their satisfaction level on the scale of 1-10. The cumulative survival of the FDPs with the aid of loop connectors was 90.9%. There was no reported esthetic failure and, at the time of responding to the questionnaire, none of the patients had active complaint with respect to the prosthesis and all but one of the patients were satisfied with the treatment provided. Clinical survivability and the patient feedback suggests that customized designing of loop connectors for each patient is an excellent treatment modality to successfully maintain excessive (single/generalized) spacing between teeth and effectively splint pathologically migrated and mobile teeth. The reported problems with this treatment option are all transient in nature. [ABSTRACT FROM AUTHOR]

Complete crown fracture is a dental injury affecting enamel, dentin, and pulp and unfortunately crown is lost usually due to loss of tooth structure. Root-crown lengthening can be performed if an acceptable root-crown ratio is preserved for the retention of root. This paper presents a case report of a mandibular canine incisor tooth having complete crown fracture. Root-crown lengthening is performed by surgical extrusion of the root coronally, splintted using a semi-rigid splint and prognosis was successful after one year later. Treatment of complete crown fracture by surgical extrusion and splintting may be a good alternative for general practitioners since it is an easy and short time requiring technique necessiating less equipments. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate the biomechanical interactions in tooth–implant-supported fixed partial dentures (FPDs) under several loading conditions with different numbers of splinted teeth and connector types (rigid and non-rigid) by adopting the three-dimensional (3D) non-linear finite element (FE) approach. Material and methods: A 3D FE FPD model was constructed containing one Frialit-2 implant in the mandibular second-molar region splinted to the first and second premolars. Frictional contact elements were used to simulate realistic interface conditions within the implant system and the non-rigid connector function. The main effects for each level of the three investigated factors (loading condition, number of splinted teeth and connector type) in terms of the stress values and dissimilar mobility of the natural teeth and implant were computed for all models. Results: The results indicated that load condition was the main factor affecting the stress developed in the implant, bone and prosthesis when comparing the type of connector and the number of splinted teeth. The stress values were significantly reduced in centric or lateral contact situations once the occlusal forces on the pontic were decreased. However, the prosthesis stress for the non-rigid connections was increased more than 3.4-fold relative to the rigid connections. Moreover, the average tooth-to-implant displacement ratios ( RTID) with a non-rigid connection were obviously larger than those for rigid connections under axial loading forces. Adding an extra tooth to support a three-unit tooth–implant FPD only exploited its function when the prosthesis withstood lateral occlusal forces. Conclusions: The load condition is the main factor affecting stress distribution in different components (bone, prosthesis and implant) of tooth–implant-supported FPDs. Minimizing the occlusal loading force on the pontic area through selective grinding procedures could reduce the stress values obviously. A non-rigid connector may more efficiently compensate for the dissimilar mobility between the implant and natural teeth under axial loading forces but with the risk of increasing unfavorable stresses in the prosthesis. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: This study investigated the mechanical interactions of implant-teeth splinting systems under different periodontal supports and number of splinted teeth with rigid and non-rigid connectors using non-linear finite element (FE) approach. Methods: Two FE models with normal and compromised periodontal supports containing a Frialit-2 implant splinted to the first and second premolars were constructed. Non-linear contact elements were used to simulate a realistic interface fixation within the implant system and the sliding function of the non-rigid connector. ANOVA was used to test for relative importance of the investigated factors and main effects for each level of the three investigated factors (periodontal supports, teeth splinting and connector designs) in terms of the stress values were performed. Results: The simulated results indicated that the cross-interaction of the periodontal support and the splinting situation was a major factor affecting the stress value in alveolar bone. An additional splinting decreased the stress values of bone significantly for a compromised periodontal support. The individual factor of periodontal support also influenced the stress found in the alveolar bone (28%) and implant (72%), and the stress values increased when the periodontal support was reduced. Using different connectors affected the stresses found in bone (15%), implant (21%) and prosthesis (99%). The stress values of the implant and prosthesis increased, but were decreased in bone when the splinting system used non-rigid connectors. The mobility of natural teeth and the implant system between non-rigid and rigid connections showed only small differences. Conclusions: A non-rigid connector should be used with caution since it breaks the stress transfer and increases the unfavorable stress values in the implant system and prosthesis. The tooth/implant-supported system with an additional splinting is more efficient in compromised periodontal supports. [Copyright &y& Elsevier]

Interdisciplinary cooperation between periodontics and prosthodontics is currently a hot issue in dentistry. However, permanent splinting of the teeth with compromised periodontal support that is mostly provided by cement-fixed prostheses or by a dental implant system and the application of a removable device, i.e., telescopic designs, has not been widely reported. In this article, we present 3 periodontal-prosthetic cases in which teeth of periodontally questionable or hopeless prognoses were included in removable but tooth-supported telescopic splint units. All cases were followed-up for 3-4 years, and none showed any further periodontal breakdown. [ABSTRACT FROM AUTHOR]

A prospective study of 140 intruded permanent teeth was examined for the following healing complications: pulp necrosis (PN), root resorption (RR; surface, inflammatory and replacement resorption), and defects in marginal periodontal bone healing (MA). The occurrence of these healing complications was related to various treatment factors such as treatment delay, method of repositioning (i.e. expecting re-eruption, orthodontic reposition and surgical reposition), type of splint (rigid, semirigid and flexible), length of splinting (days) and the use of antibiotics. Treatment delay, i.e. before and after 24 h, had no effect upon healing. Active repositioning in individuals with incomplete root formation (surgical or orthodontic) had a negative effect upon the three healing parameters compared with spontaneous eruption. In teeth with complete root formation and an age of 12–17 no repositioning was still the best treatment in regard to MA. In individuals older than 17 years of age, cases were not anticipated to spontaneously erupt and in these cases, the general choice of treatment was either active orthodontic or surgical repositioning. The former procedure appeared in this treatment scenario to slightly reduce the risk of MA complications. However, this treatment procedure was also found to be more time demanding (an average of 22 consultations for orthodontic repositioning compared with 17 consultations for surgical repositioning). If a surgical repositioning was performed, the type of splint (i.e. flexible, semirigid or rigid) appeared to have no significant effect on the type of healing. The same applied to the length of splinting time (shorter or longer than 6 weeks). No effect of dentin covering procedures for associated crown fractures (enamel–dentin fractures) could be demonstrated. Likewise, antibiotics had no apparent effect upon healing. In conclusion, in patients with intruded teeth with incomplete root formation, spontaneous eruption should be expected. In patients with completed root formation and with an age of 12–17 spontaneous eruption can still occur, but must be monitored very carefully. In older patients (i.e. >17 years) with completed root formation, either surgical or orthodontic extrusion should be attempted. The latter procedure appeared to lead to a slight reduction (not significant) in the risk of MA complications. The extent and direction of the intrusion may however favour surgical repositioning. [ABSTRACT FROM AUTHOR]

A 30-month follow-up study was conducted on 36 patients to evaluate the effects of the lingual plate as a major connector in distally extended removable partial dentures (RPDs) on tooth stabilization. At the same time, the study evaluated the effects of lingual plate-type RPDs and lingual bar-type RPDs on periodontal health. The most striking finding of the study was that, with the exception of gingival recession (GR), periodontal conditions improved with both types of RPDs. At the end of 30 months, there were significant differences in plaque index, GR and tooth mobility (TM) values between treatment groups ( P < 0·05). Plaque accumulation was greater in the lingual plate treatment group; however, this did not result in periodontal breakdown. There were no statistically significant differences between treatment groups with respect to pocket depth, gingival index or attachment loss ( P > 0·05). Moreover, patients treated with lingual plate-type RPDs demonstrated less TM when compared with patients treated with lingual bar-type RPDs at the end of 30 months follow-up. Overall study findings established that with adequate checks on oral and denture hygiene at regular intervals, patients with RPDs may even experience improved periodontal health. Moreover, the clinical interpretation of decreased TM observed in patients treated with lingual plate-type RPDs may be questionable as the plaque accumulation was greater in the lingual plate treatment group inspite of periodic recalls. [ABSTRACT FROM AUTHOR]

The purpose of this study was to evaluate the effect of splinting teeth on the results of periodontal reconstructive surgery using a specific carbonate bone replacement graft (BRG) material. Forty-five patients were randomly treated with a periodontal surgery approach. Natural coral calcium BRG was utilised in 33 patients. This 33-patient group was divided into three equal groups. In the presplint group, teeth were splinted to at least two rigid teeth before surgery, in the postsplint group, teeth were splinted at suture removal, and in the nonsplint group, the treated teeth were not splinted at all. In 12 patients, teeth were treated with surgical debridement (DEBR) alone and not splinted. Periodontal probing depth (PPD), clinical probing attachment level (CPAL), and tooth mobility were measured using desmodontometry (DDM) and periotest (PTV) with reproducible methods before surgery and at various periods up to 1 year afterwards . A decrease in PPD (5.4 mm, SD 1.4 mm) and tooth mobility (DDM-horizontal 257 µm, SD 60 µm) and a gain of CPAL (5.1 mm, SD 1.4 mm) were seen following the use of BRG in presplint teeth. In the same group, PPD and tooth mobility were significantly reduced compared to nonsplint teeth. DEBR alone showed reductions in tooth mobility and PPD and a significantly smaller gain in CPAL than in presplint teeth treated with BRG. The less favourable improvement in periodontal function of postsplint or nonsplint teeth seemed to be due to the loss of BRG material caused by tooth mobility. These results indicate that an undisturbed wound healing process using BRG together with tooth stability is beneficial to overall clinical success. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine if fixed splinting of teeth with intraoral wire and acrylic splints had advantages with respect to tooth mobility, bone level and attachment level over unsplinted teeth following osseous surgery. Ten patients were chosen who exhibited bilaterally similar chronic destructive periodontitis and mobile teeth. One maxillary sextant was splinted, while the other was unsplinted. Both sextants functioned against an unsplinted mandibular arch. Following initial therapy, osseous surgery was performed in both maxillary sextants on the same day. Tooth mobility data was collected 1 week before and at 3, 6, 12, and 24 weeks following surgery. Levels of gingival attachment and bone were recorded before and 24 weeks after surgery. Splints were removed before measurements, then replaced, and the occlusion refined. Prophylaxes and oral hygiene instruction were repeated every 3 weeks throughout the study. For all categories of teeth and mobility examined, tooth mobility increased initially after surgery and subsequently decreased by 24 weeks to about presurgical values. The splinted and unsplinted segments reacted similarly throughout the study; splinting did not significantly reduce the mobility of individual teeth. Pre- and postsurgical bone and gingival attachment Levels were also similar for the splinted and unsplinted segments. [ABSTRACT FROM AUTHOR]