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CP 5

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7 views19 pages

CP 5

Uploaded by

nirmalshetty127
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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Management of

subluxation by
splinting

Presented by : Aishwarya Sinha


CASE REPORT

Name: Komal Sutar


Age: 13 years
Gender : Female
Address : Belagavi

Chief Complain: patient complained of fracture of upper front


teeth due to fall.

HOPI: patient gives history of trauma that occurred on the


same day while swimming.
ON EXAMINATION:

EXTRA-ORAL:

 Symmetry: Bilaterally symmetrical


 Lymph nodes: (NAD)
 Lips: incompetent
 TMJ: (NAD)
INTRA-ORAL:
 Lips: (NAD)
 Buccal mucosa: (NAD)
 Tongue: (NAD)
 Soft palate: (NAD)
 Hard palate: (NAD)
 Gingiva:
 Colour: Pink with melanin pigmentation
 Bleeding: bleeding present with 21
 Pockets: NONE
Hard tissues:
 No. of teeth: 20
 Colour of teeth: generalised yellowish
white
 Missing teeth: none
 Carious teeth: none
 Restored : none
 Attrition: absent
 Mobility: Grade II mobility with 11 and
21
CLINICAL TESTS

 Percussion : tenderness on vertical percussion

 Vitality tests: with 11, 21{baseline}


 Hot: delayed response
 Cold : delayed response
 Provisional Diagnosis:
Elli’s Class 2 fracture with 11 and 21

 Final diagnosis:
Elli’s Class 2 fracture with 11 and 21and
Subluxation
Treatment plan:

• Splinting for 2 weeks using flexible splint


(as per IADT guidelines)
• Vitality test upon follow up after 3 weeks
• Composite build up with 11 and 21
Pre operative Etching

Frosted appearance of Application of


enamel after Etching bonding agent
Ligature wire Post splint removal
splinting

Composite build up
Discussion
Discussion
Discussion

 How to fabricate ligature wire splint?


The composite wire-splint was constructed using a ligature stainless
steel round wire. The wire was cut to the desired length and three
strands of ligature wire were tightly held with one needle holder at
one end and other end held with another needle holder which was
moved clockwise multiple time until desired twisted intertwined
multistrand structure obtained and then placed on the labial surfaces
without bending, so as to provide neutrality.
The aims of splinting are:
 To stabilise the tooth/teeth that have been loosened,
repositioned, replanted or fractured and maintain its/their
position throughout the splinting period
 To optimise healing outcomes for the pulp and/or the
periodontal ligament
 To improve function and provide comfort.

 Wires up to 0.016(inches) i.e. 0.4mm diameter are


significantly more flexible than direct composite (rigid)
splints and are thus better suited for the splinting
traumatised teeth
Post splinting instructions-
 The analgesic was given to reduce pain and decrease
inflammation for improving healing with 0.2%
chlorhexidine gluconate rinse every 12 hours for 14 days
as an antiplaque mouth rinse.
 Postoperative written instructions for the consumption of
soft diet, maintenance of regular oral hygiene, avoidance
of direct trauma by mastication, oral habits and immature
contact were given.

International Association of Dental Traumatology guidelines for the management of traumatic


dental injuries: 1. Fractures and luxations Cecilia Bourguignon
 Current evidence supports short-term, passive, and flexible
splints for splinting of luxated, avulsed, and root-fractured
teeth.
 When using wire-composite splints, physiological
stabilization can be obtained with stainless steel wire up to
0.4 mm in diameter.
 Splinting is considered best practice in order to maintain
the repositioned tooth in its correct position and to favor
initial healing while providing comfort and controlled
function.

International Association of Dental Traumatology guidelines for the management of traumatic


dental injuries: 1. Fractures and luxations Cecilia Bourguignon
Conclusion
The IADT guidelines support the use of flexible splints
whenever possible.
This has often been achieved with the use of composite
resin or orthodontic brackets and light wire.
Both of these techniques have been shown to cause
iatrogenic damage to the enamel, therefore care must be
taken during removal of splint.
References

 Elumalai D, Kumar A, Tewari RK, Mishra SK, Andrabi SM, Iftekhar H, et al. Management of C-
shaped root canal configuration with three different obturation systems. Eur J Gen Dent
2015;4:25-8.

 Roy A, Astekar M, Bansal R, Gurtu A, Kumar M, Agarwal LK. Racial predilection of C-shaped
canal configuration in the mandibular second molar. J Conserv Dent 2019;22:133-8.

 Ashraf H, Grayeli M. Determine frequency and anatomic form of the C‑shaped canals in
mandibular second molars. J Dent Sch 2003;21:441‑6.

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