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Splinting teeth to each other allows weakened teeth to be supported by neighbouring teeth, although the procedure
can make oral hygiene procedures difficult. Several methods for splinting teeth, both extracoronal and intracoronal,
as well as the materials commonly used for splinting, are described and illustrated. Two case reports are used to
demonstrate the situations in which splinting might be appropriate.
S
plinting teeth to each other allows weakened teeth to Farmingdale, NY), Panavia (J. Morita USA Inc., Irvine, CA) or
gain support from neighbouring ones. When used to All Bond (Bisco Inc., Schaumburg, IL). This type of splint has
connect periodontally compromised teeth, splinting can greater inherent strength than a composite-resin splint created
increase patient comfort during chewing. Connecting intraorally. Extra features such as grooves, pins and parallel
multiple teeth also increases support when the teeth are used preparations increase the retentive capacity of these splints.
as abutments for a precision attached partial denture. Newly developed laboratory-cured composite resins such as
However, splinting makes oral hygiene procedures difficult. DiamondCrown (Biodent Inc., Mont-Saint-Hilaire, QC) claim
Therefore, to ensure the longevity of the connected teeth, improved diametric tensile strength and bonding capabilities.
special attention must be given to instructing the patient These materials may be considered for use in extracoronal appli-
about enhanced measures for oral hygiene after placement of cations (Figs. 2-4). No long-term clinical data are available for
the prosthesis. these materials; however, they seem promising at this time.
Several methods, both extracoronal and intracoronal, are
available to splint teeth together. Intracoronal Splinting
Intracoronal methods are also available. Composite-resin
Extracoronal Splinting restorations can be placed in adjoining teeth and cured to
The simplest way to connect teeth to each other is the classic eliminate any interproximal separation. These restorations can
bonding method. The enamel surface of the tooth is etched, be further reinforced with metal wires, glass-reinforced fibres
most commonly with a 37% solution of phosphoric acid. or pins (Fig. 5). If restoration of the mouth includes crowns,
Composite resin can then be bonded to the etched surface and the crowns can be splinted to each other by solder joints or
used to rigidly connect the teeth to each other. The composite-
precision attachments. The use of attachments affords the
resin splint can be strengthened by adding fibres to the splint or
practitioner the ease of preparing nonparallel abutments yet
by using a fibre meshwork (e.g., Ribbond, Ribbond Inc.,
achieves a splinted result.
Seattle, WA) to reinforce the material.
Extracoronal resin-bonded retainers, which can be fabricated Case Reports
in the dental laboratory, serve to strengthen the overall bonded This paper presents two clinical cases in which splinting
situation. The splints are usually cast from metals, usually non- was needed after crowns had already been placed.
noble alloys that can be electrolytically or chemically etched
(Fig. 1). Recent innovations in materials allow these frameworks Case 1
to be air abraded and then cemented in place with an adhesive A 60-year-old woman was involved in a motor vehicle
resin cement, such as Metabond C&B (Parkell Inc., accident. Prosthetic reconstruction involved placing crowns on
440 September 2000, Vol. 66, No. 8 Journal of the Canadian Dental Association
Splinting Teeth A Review of Methodology and Clinical Case Reports
Figure 1: Metal splint created from non-noble metal has been bonded Figure 2: Mobile teeth have been prepared with cingulum rests to
with Metabond C&B cement and is being used to secure mobile teeth. help support an extracoronal composite-resin-based splint.
Figure 3: A composite-resin-based splint has been fabricated from Figure 4: DiamondCrown splint has been cemented (bonded) under
DiamondCrown material. Once polished, it will be ready for rubber dam isolation. This material exhibits superior flexural strength
cementation. and may be useful in extracoronal splints.
Journal of the Canadian Dental Association September 2000, Vol. 66, No. 8 441
Barzilay
Figure 6: Inlay made from non-noble metal has a handle and has been Figure 7: The inlay has been cemented with Metabond C&B. The
cast, fit to the master cast and etched; once the inlay is cemented in inlay remained secure after 4 years of service.
place, the handle is sectioned and removed.
442 September 2000, Vol. 66, No. 8 Journal of the Canadian Dental Association
Splinting Teeth A Review of Methodology and Clinical Case Reports
Figure 9: Inlay restoration is fabricated with a handle for easy intraoral Figure 10: Teeth 36 and 37 have been isolated and treated on the
manipulation. The handle will be sectioned once the restoration is basis of their respective materials. The metal surface (tooth 37) has
bonded in position. been air abraded (microetching), and the porcelain surface (tooth 36)
has been etched with hydrofluoric acid. The crowns are now ready for
bonding.
Journal of the Canadian Dental Association September 2000, Vol. 66, No. 8 443