Splinting vs. Orthodontic Repositioning: Favorable Results Despite Significant Trauma

This article describes five cases of dental trauma and subsequent orthodontic treatment. Treatment was rendered in order to optimize healing by splinting and/or repositioning traumatized teeth. Splinting or repositioning may be required following trauma, and sometimes a combination of the two may be required.

The objective of describing the cases and the associated background of dental trauma is to elucidate the distinctions and overlap between splinting and orthodontic repositioning. For instance, when a tooth is luxated into an unfavorable position such as a cross-bite with or without traumatic occlusion, the ideal treatment may include stabilization with careful repositioning. A clinician’s choice to use orthodontic appliances may be advantageous since a combination of methods of treating trauma, splinting and repositioning, are more easily effectuated with orthodontic appliances than with standard splinting methods alone. There is literature that describes orthodontic management of traumatized teeth, however, there is a lack of description and study of the interface between splinting and orthodontic repositioning.

The epidemiology of dental trauma has been well evaluated. Previously described risk factors include gender, age, race/ethnicity and previous dental trauma. Specifically, males may experience dental injuries twice as often as females. Children over the age of 10 are also at higher risk than younger children. Additionally, socio-economic status may have a predictive value for the prevalence of trauma. Excessive overjet may also be a risk factor for trauma, especially an overjet greater than 9mm.3

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Gary Schulman

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