Teeth may become loose and unstable due to several factors, including severe bone loss and gum recession as a result of periodontal disease. Comprehensive periodontal treatment cannot replace missing bone, and the prognosis for these teeth is poor. Dental trauma from accidents and heavy biting forces can also cause the teeth to drift and become loose.
With some variations, there are two basic types of periodontal splinting, . Before investing in either, a patient’s periodontal situation must be under control to assure long-term success.
The first type is extra-coronal splinting in which a stabilizing wire mesh, fiber-reinforced or cast-metal appliance, or similar stabilization device is bonded to the outside surfaces of the teeth like a fixed orthodontic arch wire. This is a completely reversible procedure. It usually does not last as long as an intra-coronal splint (see below) and is subject to fracture more readily. It is usually applied in situations that are more short-term in nature.
The second type is intra-coronal splinting, where a chamber is created inside the affected teeth and the stabilizing devise is inserted into the chamber and bonded into place. These splints are used for the back teeth (molars and bicuspids). They are less visible but accomplish the same goal of immobilizing the teeth.
Two or more crowns, inlays, and onlays can be splinted together, which provides a more esthetically appealing and stronger solution. These treatment modalities can be more expensive, and if the long-term prognosis for the affected teeth is questionable, then they may also be form of treatment that is too aggressive. Dr. Best will assess your situation and make appropriate recommendations.
Advantages to Periodontal Splinting
Splinting teeth together reduces the forces that are placed on individual teeth, which can slow the damage to the already weakened ligaments that attach teeth to the jawbone. By way of comparison, think how much easier it is to push back and forth on a single fence post and loosen it than it is to loosen that same post when it is attached to other posts that are part of the same fence.
Stabilization splints can delay tooth lost indefinitely and help to spare the bone around the involved teeth
Disadvantage of Splinting
Both types of splinting have disadvantages. However, these may not be that significant when patients are faced with losing their teeth:
- Extra-coronal splinting may be cosmetically unappealing.
- It may be difficult to clean in between the teeth at a time when keeping bacterial, plaque, and food particles off the teeth is imperative for long-term success. To avoid developing cavities and exasperating the periodontal condition, the patient is required to incorporate additional home care regiments and routines.