DENTAL SPLINTS: TYPES AND TIME OF IMMOBILIZATION POST TOOTH AVULSION

Abstract

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.

Keywords

• Tooth replantation,Tooth avulsion; ankylosis; substitutive resorption; splinting

References

1. Caldas AF, Jr., Burgos ME. A retrospective study of traumatic dental injuries in a brazilian dental trauma clinic. Dent Traumatol 2001;17(6):250-253.
2. Andreasen JO, Andreasen FM. Texto e atlas colorido de traumatismo dental. São Paulo: Artmed, 2001, p.383-453.
3. International Association of Dental Traumatology – IADT. Dental trauma guide. International Association of Dental Traumatology 2012. Available from: http://www.dentaltraumaguide.org
4. Viegas CM, Scarpelli AC, Carvalho AC, Ferreira FM, Pordeus IA, Paiva SM. Predisposing factors for traumatic dental injuries in brazilian preschool children. Eur J Paediatr Dent 2010;11(2):59-65.
5. Wendt FP, Torriani DD, Assuncao MC, Romano AR, Bonow ML, da Costa CT, Goettems ML, Hallal PC. Traumatic dental injuries in primary dentition: Epidemiological study among preschool children in South Brazil. Dent Traumatol 2010;26(2):168-173.
6. Vasconcellos RJDH, Marzola C, Genu PR. Trauma dental aspectos clínicos e cirúrgicos. ATO 2006;6(12):774-796.
7. Prokopowitsh I. Condutas endodônticas em dentes reimplantados. Espelho Clínico:São Caetano do Sul 2001;4(24):8-9.
8. Busato ALS, González PAH, Camilo EM, De Deus MN. Alternative treatment for teeth with substitutive root resorption. ROBRAC 2000;9(27):18-23.

9. Ceschin JR. Reimplante dental na época atual. São Paulo: Panamed, 1984, p.131-138.
10. Vasconcelos BCE, Fernandes BC, Aguiar ERB. Reimplante dental. Rev. Cir. Traumat Buco-Maxilo-Facial 2001;1(2):45-51.
11. Chelotti A, Valentim C. Lesões traumáticas em dentes anteriores. Odontopediatria. São Paulo: Editora Santos 1990, p.771-797.
12. Álvares S, Álvares S. Tratamento do traumatismo dentário e de suas seqüelas. São Paulo: Livraria Editora Santos, 1993, p.59-70.
13. Trope M, Chivian N, Sigurdsson A. Traumatismo dentário. Rio de Janeiro: 2000, p.520-564.
14. Pereira NRS, Júnior JPF, Ribeiro BL, Silva PG, Fukada MY. Replantation of avulsed permanent tooth. RGO 2001;49(4):230-234.
15. Castro JCMD, Poi WR, Lucas LVMD, Ângelo LT. Correcting the consequences of tooth replantation. RGO 2002;50(4):213-216.
16. Filippi A, Pohl Y, Kirschner H. Replantation of avulsed primary anterior teeth: Treatment and limitations. ASDC J Dent Child 1997;64(4):272-275.
17. Flores MT, Andreasen JO, Bakland LK, Feiglin B, Gutmann JL, Oikarinen K, Pitt Ford TR, Sigurdsson A, Trope M, Vann WF, Jr., Andreasen FM, International Association of Dental T. Guidelines for the evaluation and management of traumatic dental injuries. Dent Traumatol 2001;17(5):193-198.
18. Oliveira FAM, Oliveira MGD, Orso VDA, Oliveira VRD. Dentoalveolar trauma: Literature review. Rev. Cir. Traumat. Buco-Maxilo-Facial 2004;4(1):15-21.
19. Cobankara FK, Ungor M. Replantation after extended dry storage of avulsed permanent incisors: Report of a case. Dent Traumatol 2007;23(4):251-256.
20. Gomes MCB, Westphalen VPD, Westphalen FH, Silva Neto UX, Fariniuk LF, Carneiro E. Study of storage media for avulsed teeth. Brazilian Journal of Dental Traumatology 2009;1(2):69-76.
21. Westphalen VP, Martins WD, Deonizio MD, da Silva Neto UX, da Cunha CB, Fariniuk LF. Knowledge of general practitioners dentists about the emergency management of dental avulsion in Curitiba, Brazil. Dent Traumatol 2007;23(1):6-8.
22. Granville-Garcia AF, de Menezes VA, de Lira PI. Dental trauma and associated factors in Brazilian preschoolers. Dent Traumatol 2006;22(6):318-322.
23. Granville-Garcia AF FJ, Menezes VA, Cavalcanti SDB, Leonel MT, Cavalcanti AL. Dental avulsion: Experience, attitudes, and perception of dental practitioners of Caruaru, Pernambuco, Brazil. Rev. odonto ciência 2009;24(3):244-248.
24. de Jesus Soares A, do Prado M, Farias Rocha Lima T, Gomes BP, Augusto Zaia A, Jose de Souza-Filho F. The multidisciplinary management of avulsed teeth: A case report. Iran Endod J 2012;7(4):203-206.
25. Andreasen JO, Andersson L, Tsukiboshi M. Autotransplantation of teeth to the anterior region. Oxford, United Kingdom: Blackwell Munksgaard, 2007, p.740-760.
26. Czochrowska EM, Stenvik A, Zachrisson BU. The esthetic outcome of autotransplanted premolars replacing maxillary incisors. Dent Traumatol 2002;18(5):237-245.
27. Tsukiboshi M. Autotransplantation of teeth. Chicago: Quintessence, 2001.
28. Steiner DR. Avulsed maxillary central incisors: The case for replantation. Am J Orthod Dentofacial Orthop 2012;142(1):8, 10, 12, 14, 16.
29. Zachrisson BU, Stenvik A, Haanaes HR. Management of missing maxillary anterior teeth with emphasis on autotransplantation. Am J Orthod Dentofacial Orthop 2004;126(3):284-288.
30. Sardana D, Goyal A, Gauba K. Delayed replantation of avulsed tooth with 15-hours extra-oral time: 3-year follow-up. Singapore Dent J 2014;35:71-76.
31. Nagata JY, Rocha-Lima TF, Gomes BP, Ferraz CC, Zaia AA, Souza-Filho FJ, De Jesus-Soares A. Pulp revascularization for immature replanted teeth: A case report. Aust Dent J 2015;60(3):416-420.
32. Lucisano MP, Nelson-Filho P, Silva LA, Silva RA, de Carvalho FK, de Queiroz AM. Apical revascularization after delayed tooth replantation: An unusual case. Case Rep Dent 2016;2016:2651643.
33. Kim SG, Kahler B, Lin LM. Current developments in regenerative endodontics. Current Oral Health Reports 2016;3(4):293-301.
34. Priya MH, Tambakad PB, Naidu J. Pulp and periodontal regeneration of an avulsed permanent mature incisor using platelet-rich plasma after delayed replantation: A 12-month clinical case study. J Endod 2016;42(1):66-71.
35. Saoud TMA, Ricucci D, Lin LM, Gaengler P. Regeneration and repair in endodontics—a special issue of the regenerative endodontics—a new era in clinical endodontics. Dentistry Journal 2016;4(1):3.
36. Bezerra SRS, Braz R, Arruda IMS, Requejo LSL, Carneiro SCDAS. Reimplante dental: Estágio atual. Rev. Fac. Odont. Pernambuco 1992;12(12):29-33.
37. Andreasen JO, Andreasen FM, Bakland LK, Flores MT. Manual de traumatismo dental. São Paulo: Artmed 2000, p.64.
38. Baldissera Ede F, Fontanella VR, Ito W, Pomar F. Use of hydroxyapatite in tooth replantation radiographically followed up for 14 years: A case report. Dent Traumatol 2007;23(1):47-50.
39. Côrtes MIDS, Bastos J. Tratamento das urgências em traumatismo dentário. São Paulo: Artes Médicas 2002, p. 391-408.
40. Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, Bourguignon C, DiAngelis A, Hicks L, Sigurdsson A, Trope M, Tsukiboshi M, von Arx T, International Association of Dental T. Guidelines for the management of traumatic dental injuries II. Avulsion of permanent teeth. Dent Traumatol 2007;23(3):130-136.
41. Manfrin TM, Boaventura RS, Poi WR, Panzarini SR, Sonoda CK, Massa Sundefeld ML. Analysis of procedures used in tooth avulsion by 100 dental surgeons. Dent Traumatol 2007;23(4):203-210.
42. Mcdonald RE, Avery DR. Odontopediatria. Rio de Janeiro: Guanabara Koogan, 2001, p.353-395.
43. Panzarini SR, Pedrini D, Brandini DA, Poi WR, Santos MF, Correa JP, Silva FF. Physical education undergraduates and dental trauma knowledge. Dent Traumatol 2005;21(6):324-328.
44. Ruellas RMDO, Ruellas ACDO, Ruellas CVDO, Oliveira MMD, Oliveira AMD. Reimplante de dentes permanentes avulsionados - relato de caso. R. Un. Alfenas 1998;4:179-181.
45. Soares IJ, Goldenberg F. Endodontia: Técnica e fundamentos. Porto Alegre: Artmed 2001, p. 277-338.
46. Souza Neto MDD, Pécora JD, Saquy PC. Traumatismo alvéolo- dentário. Endodontia princípios biológicos e mecânicos. São Paulo: Artes Médicas 2001, p.763-819.
47. Filippi A, Pohl Y, von Arx T. Treatment of replacement resorption by intentional replantation, resection of the ankylosed sites, and emdogain--results of a 6-year survey. Dent Traumatol 2006;22(6):307-311.
48. Petti S. Over two hundred million injuries to anterior teeth attributable to large overjet: A meta-analysis. Dent Traumatol 2015;31(1):1-8.
49. Uchoa AKM, Lins CCSA, Travassos RMC. Presença de reabsorção radicular externa após reimplante dental: Relato de caso. Rev. Cir. Traumatol. Buco-Maxilo-Fac. 2009;9(4):49-54.
50. Isolan TMP, Borges CB, Renon MA, Pesce AL, Moro M.Tooth replantation. RGO 1994;42(5):271-284.
51. Ferreira EL, Filho FB, Correr GM, Leonardi DP, Fariniuk LF, Campos EA, Valença PC. Dental avulsion, from dental replantation to dental implant: A case report with a 20-year follow-up. Brazilian Journal of Dental Traumatology 2009;1(1):13-19.