Periodontal splinting in a dog
(15.05.2006) Lisa is a 11 year old female spayed that has an advanced periodontal disease due to the presence of advanced periodontal disease, with increased mobility of the frontal superior incisor teeth. We decided to apply a periodontal splint.
Fig. 1
Upper and lower incisors, in groups or as a single tooth, may require stabilization because of bone loss from periodontal disease, particularly in toy-breed dogs.
This stabilization is performed in conjunction with periodontal treatment. Mobile teeth interfere with post-surgical healing, often making it impossible to ensure remission of the periodontal disease.
Mobile teeth are stabilized by splinting or ligating the involved tooth or teeth to stable abutment teeth, provided there are no missing teeth in the incisor segment.
This can be accomplished in two ways: with the use of dental acrylics or composite filling material alone or with dental acrylic/composite and interdental ligation. After periodontal therapy the mobile teeth are placed in proper arch alignment.
Method I. Dental acrylic is applied to the contact areas between teeth and over the labial and lingual surfaces, making sure to prevent subgingival seeping of the acrylic.
The acrylic is best applied by dipping a camel's hair brush into the liquid, then dipping the brush into a small reservoir of powder. This small amount of mixed acrylic is then carried to the contact area. This is repeated until sufficient material has been applied and allowed to cure.
Fig. 3
Method II. The crowns and roots are thoroughly scaled and polished with a nonfluoride dental polish. The teeth are acid-etched (Fig. 1), and a band of transparent fiberglass material is glued to the equator area of the vestibular side of incisor teeth by using either a transparent light curing composite or alternatively by use of a cyanoacrylate glue.
It is essential to leave sufficient space between the splint and the soft tissues to allow for proper oral hygiene. Finishing disks and burs are used to shape and smooth the surface of the teeth (Fig. 2 and 3).
After stabilization, the mouth is closed to check for occlusal contact. If the splinted teeth or tooth is found to strike the opposing incisors, the incisal edge of each affected tooth or maloccluding bulge of the splint is reduced and the bite rechecked until the occlusion is normal.
Composite resins are somewhat more rigid than are acrylic splints; this may be a problem for the lower jaw because the symphysis is fibrous. The result is that a rigid splint joining the right and left lower incisors may break.
Dental splints, depending on the severity of the disease or bone loss, may be retained for a short period or for several years. Composite resins provide a more esthetic splint than does pink acrylic material; they will slowly wear down and require periodic reinforcement.