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Teeth loosening are caused by insufficient supporting tissue, inflammation of periodontal tissue, or occlusal trauma, which is one of the main clinical symptoms of periodontitis. A digital technique for fabricating resin-bonded splinting fixed partial dentures (S-FPDs) is presented. It restores the missing mandible anterior teeth and splints the adjacent periodontally mobile teeth of the patient at the same time. The S-FPDs is designed and fabricated by computer-aided design and computer-aided manufacturing (CAD/CAM) technology with flexible PMMA material. The workflow is straightforward, convenient, and accurate. Meanwhile, the restoration can meet the esthetic requirements and help with the stability of adjacent loosening natural teeth spontaneously. It could be considered a medium-term provisional restorative treatment option, but further controlled investigations still be needed.

Dental traumatic injuries are common in children during the mixed dentition stage. These injuries usually require splinting for stabilization, which is complicated by the various stages of the permanent tooth development and primary tooth exfoliation. The aim of this study was to evaluate the effect on mobility of splint materials and extensions for an avulsed central incisor, stabilized with and without the adjacent incisor under intrusive and extrusive loading with different periodontal ligament (PDL) conditions.Seventeen 3D model variations were created from a CBCT scan of a 7-year-old patient without erupted permanent upper lateral incisors. A 1000 N palatal load on the right central incisor simulated the avulsion injury and created an increased alveolus and bone deformation, resulting in an increased PDL thickness of 0.45 mm. Wire-resin composite splints with 0.9 mm cross-section (WCS) or 1.0 mm diameter nylon-resin composite splints (NCS) were created. The models simulated conditions with and without the adjacent upper central incisor. Two PDL conditions were investigated, simulating detached PDL or PDL with polyether impression material-like properties. Mobility was calculated under simulated biting loads in horizontal and vertical (intrusive and extrusive) directions.The NCS allowed greater tooth mobility of the avulsed incisor than the WCS, irrespective of splint extension, PDL condition, or load application. During horizontal loading, polyether-like properties for the PDL allowed around 0.2 mm mobility of the avulsed tooth with the WCS, similar to the intact tooth, whereas a simulated detached PDL allowed 25% more mobility with a WCS than with a NCS.Based on the FEA analysis, a 1.0 mm NCS may be suitable for splinting avulsion injuries during the mixed dentition stage compared to the considerably more rigid WCS. The NCS models provided flexibility for PDL healing while maintaining stability, even when missing adjacent teeth increased span widths. Extensions beyond directly adjacent teeth did not alter the mobility with the NCS but should still be considered an extra protection in case of bond failure or exfoliation.

The purpose of this study was to clinically evaluate the efficacies of three treatment methods and to compare their outcomes in patients with painful disc displacement. The study group comprised 45 patients with unilateral temporomandibular disorders who fell into Axis I group II (with limited mouth opening) of the Research Diagnostic Criteria for Temporomandibular Disorders. Magnetic resonance imaging was used for definitive diagnosis. The patients were divided randomly into three groups according to the treatment method: splint therapy, splint therapy with ultrasound-guided arthrocentesis, and splint therapy with low-level laser therapy. Patients were followed up after treatment for 6 months. The groups were compared in terms of pain and functional jaw movements (unassisted mouth opening without pain, maximum unassisted mouth opening, and contralateral movements). At the end of treatment, functional jaw movements were significantly increased while pain values were significantly decreased in all groups (P

Background: Progressive attachment loss around the teeth because of periodontal disease can result in increased tooth mobility. This adversely affects patient's comfort, function, and esthetics. Periodontal splinting helps in accomplishing stability by redistributing the functional and parafunctional forces. There are various materials that have been used for periodontal splinting. Fiber-reinforced composite, composite resin, and metal-reinforced composite are often used as splinting materials for periodontally compromised teeth. In our study, a comparison was done among these materials for their ability to distribute the stresses at different bone levels in mobile lower incisors splinted together with canines. Materials and Methods: Five patients of age group 25–50 years with Grade 2 and 3 mobile incisors having 40% or more bone loss and firm canines with optimal bone support were selected. From the computed tomography scan of each patient, three models were developed demonstrating splinting of mandibular incisors and canines with metal-reinforced composite, fiber-reinforced composite, and composite resin. So in total, 15 models were developed and each one of them was subjected to vertical and transverse loads of 150 N. Pattern of stress distribution was observed in these models using three-dimensional finite element analysis. Results: After splinting, the stress on the canine increased when bone levels around incisors decreased while stress on incisors reduced. Conclusion: Tested splinting materials were successful in stress distribution, and metal-reinforced composite was found to be better than the other splinting materials.

Chitosan and tannic acid are known for their antibacterial properties. In the present in-situ study, their antibacterial and anti-adherent effects on biofilm formation on enamel were investigated. Six subjects carried upper jaw splints with bovine enamel specimens, allowing in-situ biofilm formation. During the two-day trial, subjects rinsed with experimental solutions that contained either chitosan, tannic acid (pH = 2.5), tannic acid (pH = 7) or hydrochloric acid. Water served as the negative and chlorhexidine as the positive control. Rinsing occurred four or five times following two different rinsing protocols to investigate both the immediate and long-lasting effects. After 48 h of intraoral exposure, the dental plaque was stained with LIVE/DEAD&reg, BacLight, and fluorescence micrographs were evaluated by using the software ImageJ. The results were verified by scanning electron microscopy. Rinsing with chitosan resulted in little immediate antibacterial and anti-adherent effects but failed to show any long-lasting effect, while rinsing with tannic acid resulted in strong immediate and long-lasting effects. Except for a slightly lower antibacterial effect, the neutral solution of tannic acid was as good as the acidic solution. Hydrochloric acid showed neither an antibacterial nor an anti-adherent effect on dental biofilm formation. Experimental solutions containing tannic acid are promising anti-biofilm agents, irrespective of the pH values of the solutions. Chitosan, on the other hand, was not able to prevent biofilm formation.

The impact of implant dentistry is such that, today, very few dentists think about saving grade III mobile teeth with recurrent periodontal abscess. This case report presents the management of grade III mobile lower anterior teeth with recurrent periodontal abscess. Treatment included SRP, splinting of the lower anterior teeth using wire and composite, RCT of the lower anterior teeth, periodontal flap surgery, and placement of bone graft and PRF. A patient was evaluated at one week and then every three months up to one year. Clinical examination showed reduction in mobility, resolution of inflammation, and abscess; radiographic examination showed bone fill.

Background/aims Traumatic dental injuries are highly prevalent and are considered an important health problem. The aim of this study was to evaluate the in vitro stress distribution around simulated traumatized teeth subjected to different types of splints by photoelastic analysis. Materials and methods For each group, five models of maxillary and mandibular arches were made in photoelastic resin using prefabricated teeth models, which were fixed and adjusted in a semi-adjustable articulator. All splints were bonded with composite resin on the labial surfaces of the maxillary central incisors, the lateral incisors and the canine teeth, simulating trauma to the 11. The groups were divided according to the type of splint: control-without splint; rigid-brackets and 0.021 × 0.025 inch stainless steel wire; semi-rigid-brackets and 0.016 × 0.016 inch cobalt-chromium wire; fiber-fiberglass ribbon; and flexible-nylon thread. The groups were submitted to an occlusal force in a special device attached to a universal test machine in balanced, protrusive, and lateral occlusions. Then, the incisal edge of the 11 was ground to simulate infra-occlusion, and the tests were performed again. Five points were analyzed around tooth 11 with a polariscope, and the data were submitted to ANOVA and Tukey tests at a 5% level of significance. Results When centric occlusion was analyzed by comparing normal occlusion to infra-occlusion, all groups showed high stress values in infra-occlusion with statistical differences-except for the control group. When lateral occlusion was analyzed, the nylon splint showed lower statistical differences compared with the control, fiberglass, and rigid splint groups, which did not differ between each other. The semi-rigid splint did not differ from any group. Conclusions Fiberglass and semi-rigid splints showed better stress distribution around the traumatized tooth under occlusal loads. The nylon splint showed characteristics of non-stress distribution.

A digital technique for fabricating a periodontal splint is presented. The lingual surface of periodontally compromised mandibular anterior teeth is captured and registered to form the emergence profile of the periodontal splint. An accurate periodontal splint is fabricated for mandibular anterior teeth with increased mobility after scaling and root planing.

To explore the aesthetic effect of orthodontics treatment combined with periodontal splint in the treatment of fan-shaped displacement of anterior teeth caused by periodontitis.Fifty patients with fan-shaped displacement of anterior teeth caused by periodontitis in PLA air force hospital from January 2013 to October 2018 were selected and randomly divided into the control group (n=25) and the experimental group (n=25). Patients in the control group were treated with conventional periodontal splint, while patients in the experimental group were treated with combined orthodontic treatment on the basis of the control group. Florida periodontal probe exploration depth (PD), gingival index (GI), attachment loss (AL), sulcus bleeding index (SBI), plaque index (PLI) and mobility were observed and compared before and 1 month after treatment between both groups. The levels of serum inflammatory factors interleukin-4 (IL-4), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and osteocalcin (OC) were measured and compared by ELISA before treatment and 1 month after treatment in both 2 groups. The data were analyzed with SPSS 21.0 software package.Compared with before treatment, PD and GI in both groups decreased significantly after treatment, and significantly lower in the experimental group than that in the control group (P0.05); the levels of AL, SBI, PLI and tooth looseness in both 2 groups were significantly lower after treatment, and significantly lower in the experimental than in the control group (P0.05); compared with before treatment, the levels of IL-4, IL-6, TNF-a and serum CRP in both 2 groups were significantly lower after treatment, and the experimental group was much lower than that in the control group (P0.05). The level of osteocalcin in the experimental group was significantly higher than that in the control group at different time points after treatment (P0.05). The level of osteocalcin in the experimental group reached its peak one day after treatment, and then gradually declined, the preoperative level was basically restored 7 days after treatment.Using orthodontics combined with periodontal splint in the treatment of fan-shaped displacement of anterior teeth caused by periodontitis has a remarkable effect. The symptoms of periodontitis can be effectively improved, the teeth can be effectively corrected and facial profiles of the patients can be improved.

To present an in-depth review on splinting versus nonsplinting the restorations of adjacent dental implants, in addition to discussing biological and technical complications associated with either choice; and to provide the clinician with a decision tree that serves in everyday judgments when it comes to addressing this issue.A comprehensive literature review was performed for articles comparing success of splinted versus nonsplinted dental implants.There is no evidence to suggest that implementing either prosthetic design results in higher implant survival. Both designs tend to have their own set of complications, but there is compelling evidence to suggest that splinted restorations generally have less technical complications.Either splinting or nonsplinting are valid options for restoring adjacent implants, but each tend to face different biological and technical complications. Knowing which patients are more likely to face particular complications is strategic to provide patients with successful restorations.

The aim of the study was to retrospectively assess the survival rate and stability of periodontally compromised and mobile anterior mandibular teeth after splinting in patients under supportive periodontal therapy (SPT).Thirty-nine patients with splinted anterior mandibular teeth and SPT (≥1 visit/year) for 3-15 years were re-examined. Periodontal status, patient and tooth-related factors were assessed retrospectively before (baseline) and 3 years after splinting (n = 39 patients, 162 splinted teeth). For patients with splints inserted for more than 3 years, retrospective data after 5 (n = 30), 7 (n = 24), 10 (n = 16), 12 (n = 8) and 15 years (n = 4) was included, if available. At baseline, splinted teeth included at least one tooth with increased mobility combined with clinical attachment loss (CAL) ≥ 5 mm and ≥50% relative bone loss (RBL). Baseline RBL of splinted teeth was assessed for all patients. Change in RBL was assessed after 10 years, if available.No splinted tooth was lost within the first 3 years after splinting. One splinted tooth was lost 7 years after baseline and one 12 years after baseline. After 3 years mean(SD) periodontal probing depth of splinted teeth decreased from 3.39(1.41) mm to 2.12(0.37) mm and mean(SD) CAL from 5.61(1.66) mm to 5.09(1.67) mm and remained stable over the observation period. No change in RBL was observed over a 10-year period (p = .213). The survival rate of the splints until fracture or debonding was 74.4% after 3 years.Periodontally compromised splinted teeth show a high survival-rate and periodontal stability during SPT.

The purpose was to describe a novel simple experimental model of injured teeth for developing dental trauma splints (DTS), and to test various splints by combining use of this model and the Periotest® device. Rubber O-rings and spring washers were used to simulate and modify injured tooth mobility. Splinting effects were assessed among three kinds of DTS, including a composite splint and two wire-composite splints (1: rectangular orthodontic wire 0.533×0.635 mm, 2: cobalt-chromium alloy wire Φ0.9 mm). The Periotest values were measured three times for each tooth before and after splint insertion. The splinting effect was defined as the change in tooth mobility. Splinting effects significantly increased in the order wire-composite splint 1

Accident-related dental dislocations must be considered as part of an emergency treatment. The use of tooth-colored fixation composites makes the splint seem less noticeable in everyday life. However, this makes it more difficult to remove without damaging the tooth's enamel surface. In order to better visualize the transition between composite and the tooth , the fluorescent properties of some composites can be advantageous. This article will explain the individual steps of a rapid and minimally invasive splint removal, using the so-called Fluorescence- aided Identification Technique.

In this prospective case series, the effects of flapless intentional replantation (IR) with root surface conditioning with enamel matrix derivative (EMD) was evaluated for the treatment of periodontally-endodontally involved hopeless teeth.A total of 17 teeth (17 patients, aged 40 to 73) with ≥ 10 mm attachment loss and radiographic bone loss to the apex were included in the study. The affected teeth were atraumatically extracted using a flapless approach, then granulation tissues, calculus, and necrotic cementum on the root surfaces were removed. EMD was applied for 5 minutes to the root surfaces. The teeth were reinserted to the socket without any bone grafts and splinted.After 2 years, clinical healing was uneventful in 16 cases and the radiographs revealed no root resorption or ankylosis. IR with EMD treatment provided statistically significant reduction in probing depth (6.4 ± 2.6 mm), gain in clinical attachment level (5.9 ± 2.5 mm), and gain in radiographic bone level (48.2 ± 26.1%) compared to baseline values (P.01).Within the limitations of the study, flapless IR with EMD treatment appeared to act as an alternative strategy to extraction of severely compromised teeth with endodontic-periodontal lesions beyond the root apex.

Objectives This study assessed the survival and maintenance needs of splinted teeth in periodontitis patients. Methods Patients receiving active and supportive periodontal treatment involving teeth splinting in a university setting were retrospectively assessed. Tooth and splint survival and number of splint-repairs were recorded. Multilevel Cox and generalized-mixed linear regression analyses were performed. Results Fifty-seven patients with 227 splinted teeth (maxilla/mandible: 148/79) were followed over mean ± SD 11.0 ± 7.2 [range: 2.0–32.4]) years. Twenty-six splinted teeth were extracted during this period, the mean (95% CI) time of splint retention was 7.3 ± 5.7 (0.1–22.7). Splinted teeth did not show significantly increased risk of tooth loss compared with non-splinted teeth (HR; 95% CI: 1.30; 0.87–1.93); while age (1.07; 1.05–1.09), PPD >6 mm (4.24; 1.26–14.31), bone loss (mean HR was 5.07–15.36 depending on severity), tooth location (posterior versus anterior teeth: HR 2.08; 1.24–3.49) and the number of occlusal contact areas (mean HR was 4.38–17.34 depending on the number of antagonistic contact areas) were associated with tooth loss. 75.3% splints required repair, with a mean of 2.6 ± 1.9 [1.0–8.0] repairs per splint during the mean observation time (0.4 ± 0.6 [0.0–3.5] repairs per splint/year). Conclusion Splinting did not significantly increase the risk of tooth loss; splinted teeth showed long-term survival. To maintain splints, frequent repairs were needed. Clinical significance Splinted teeth were not at significantly higher risk of tooth loss than non-splinted teeth. While splinting does not improve the prognosis of periodontally affected teeth, it can assist their retention by reducing their mobility.

Short implants can be used as alternatives to standard implants to prevent invasive surgical procedures. However, due to concerns about complications caused by less bone-implant contact area, researchers have focused on biomechanical properties of short implants and methods to promote them. Splinting has been suggested to decrease the limitation of short implants. This study compared the pattern of stress and strain distribution in bone supporting splinted standard and short implants positioned at crestal and subcrestal levels. An edentulous posterior mandible was made using computer-aided design. Five models of different combinations of splinted short (4 × 6 mm) and standard (4 × 10 mm) implants placed at the level of crestal bone or subcrestally mesial and distal to the edentulous region with a pontic between them were designed using the CATIA software program. ANSYS software was used for finite element analysis (FEA). In each model, 100 and 300 N loads at zero (parallel to the long axis of implants) and 30° angles were applied to implants. Maximum stress and strain for each of the five models, including equivalent stress, shear stress, and strain in peri-implant cortical and cancellous bone, were calculated and stress distribution pattern in different models were recorded. The highest stress was caused by the 300 N load applied at a 30° angle, followed by the 300 N load applied axially and the 100 N load applied at 30°. This order changed in model 1, where the highest stress was noted under the 300 N load at 30°, followed by the 100 N load at 30°. Maximum stress in peri-implant bone occurred under oblique (30°) load. Maximum stress was noted when two splinted short implants were placed subcrestally. In addition, stress in bone around crestal-level splinted short implants was lower than that around standard implants. Combination of short and standard implants had no biomechanical advantage. Application of load parallel to the long axis can significantly decrease stress in peri-implant bone. Although the combination of short and standard implants has no biomechanical advantage, crestal-level placement of splinted short implants is a suitable treatment plan.

Purpose This study was designed to compare the biomechanical performance of splinted and nonsplinted short implants, in the posterior mandible, using finite element analysis. Materials and methods Three-dimensional models of short implants with 2 different diameters (4 × 6 mm or 5 × 6 mm) were scanned, and CATIA (R21) was used to simulate the model of an edentulous lower jaw. Experimental groups were designed as follows: (1) D4L6-splinted (three 4 × 6-mm splinted implants), (2) D4L6-nonsplinted, (3) D5L6-splinted, and (4) D5L6-nonsplinted. A 100 N load was applied, and stress and strain values in surrounding bone were analyzed in specific nodes using ANSYS software (16.1). Results The maximum stress values under axial load were found in D5L6-splinted model, and under oblique load, D5L6-nonsplinted model had the maximum stress values. Under axial load, D4L6-splinted model showed maximum strain values, but when oblique load was applied, D4L6-nonsplinted model had the maximum strain values. Conclusion Splinting adjacent short implants may provide less bone strain and stress, especially at the presence of lateral forces. Increasing the implant diameter may be effective in strain reduction, but does not seem to reduce the bone stress, regardless of the direction of the load applied.

The purpose of this retrospective clinical study was to assess the influence of immediate loading and lengths of splinted implants on the clinical effectiveness of 6.5-mm-long implants supporting two-implant fixed prostheses in the premolar-molar regions.A clinical database was reviewed in a private dental center to select those patients who had 6.5-mm-long implants placed to support two-implant fixed partial prostheses in the premolar-molar regions of the maxilla and the mandible. All implants were immediately loaded. The study groups were defined according to the lengths of the implants. Two groups were identified: the short-short splinted group, when both implants had 6.5 mm lengths, and the short-long splinted group, when one implant was longer than 6.5 mm. A total of 48 dental implants were placed in 16 patients to support 24 two-implant fixed prostheses. The mean follow-up time was 14 ± 5 months. The short-short splinted group included 8 patients with 16 implants; the short-long splinted group included 16 patients with 32 implants. The main variable was implant survival, and secondary outcomes were marginal bone stability and prosthesis survival.The statistical analyses indicated an absence of significant differences between the two groups in terms of implant and prosthesis survival (100% for both groups and both variables); however, distal bone loss around the splinted implants was significantly higher in the short-long splinted group. Bone loss was 0.37 ± 0.55 mm in the short-short splinted group and 0.94 ± 0.66 mm in the short-long splinted group.Immediate loading of short (6.5-mm-long) implants in the premolar-molar regions did not jeopardize their survival. Two-implant supported prostheses had the same clinical effectiveness, whether extra-short implants were splinted to another extra-short implant or to a longer one.

This article describes an impression technique for a complete-arch prosthesis supported by multiple implants where additive manufacturing technologies were used to fabricate a splinting framework and a custom tray. The technique presented uses a shim method to control the homogenous splinting acrylic resin and impression material during the procedure, thereby reducing laboratory and chairside time and the number of impression copings and laboratory analogs needed.

In the orthognathic surgery, dental splints are important and necessary to help the surgeon reposition the maxilla or mandible. However, the traditional methods of manual design of dental splints are difficult and time-consuming. The research on computer-aided design software for dental splints is rarely reported. Our purpose is to develop a novel special software named EasySplint to design the dental splints conveniently and efficiently. The design can be divided into two steps, which are the generation of initial splint base and the Boolean operation between it and the maxilla-mandibular model. The initial splint base is formed by ruled surfaces reconstructed using the manually picked points. Then, a method to accomplish Boolean operation based on the distance filed of two meshes is proposed. The interference elimination can be conducted on the basis of marching cubes algorithm and Boolean operation. The accuracy of the dental splint can be guaranteed since the original mesh is utilized to form the result surface. Using EasySplint, the dental splints can be designed in about 10 minutes and saved as a stereo lithography (STL) file for 3D printing in clinical applications. Three phantom experiments were conducted and the efficiency of our method was demonstrated., Comment: 10 pages, 10 figures, 1 table, 18 references

The purpose of this article was to compare through photoelastic analysis the stress distribution in 3 direct transfer techniques for implants with splinting. Three photoelastic resin blocks were made with 2 implants placed parallel to each other and 2 square transfer copings splinted. Both transfers were splinted with acrylic resin chemically activated in 3 different techniques: metallic sticks (T1), prefabricated acrylic bars (T2), or dental floss (T3). A circular polariscope was used, and the distortion energy (E) was calculated in 4 periods: 20 minutes and 3, 24, and 36 hours. Statistically significant differences were found among the 3 techniques (P < .05). The dental floss presented the greatest distortion energy values (T3 = 0.469 Kgf/mm2) and the metallic sticks the lowest values (T1 = 0.0 Kgf/mm2). Thus, the metallic sticks technique (T1) appears to be the most accurate protocol to be used for implant-supported prosthesis with multiple abutments.

The purpose of this study was to apply a novel method to evaluate surgical outcomes at 1 year after orthognathic surgery for Class III patients undergoing two different surgical protocols. Fifty patients divided equally into two groups (maxillary advancement only and combined with mandibular setback) had cone beam computed tomography (CBCT) scans taken pre-surgery, at splint removal, and at 1-year post-surgery. An automatic cranial base superimposition method was used to register, and shape correspondence was applied to assess, the overall changes between pre-surgery and splint removal (surgical changes) and between splint removal and 1-year post-surgery at the end of orthodontic treatment (post-surgical adaptations). Post-surgical maxillary adaptations were exactly the same for both groups, with 52% of the patients having changes >2 mm. Approximately half of the post-surgical changes in the maxilla for both groups were vertical. The two-jaw group showed significantly greater surgical and post-surgical changes in the ramus, chin, and most of the condylar surfaces (P < 0.05). Post-surgical adaptation on the anterior part of the chin was also more significant in the two-jaw group (P < 0.05). Regardless of the type of surgery, marked post-surgical adaptations were observed in the regions evaluated, which explain the adequate maxillary–mandibular relationship at 1-year post-surgery on average, with individual variability.

The benefits of the Herbst thermoformed advancement splint in the treatment of obstructive breathing disorders during sleep have been assessed in numerous studies. Unfortunately, like all other mandibular advancement devices, patients fail to wear it regularly in the long-term. Injuries, discomfort or pain caused by errors in manufacture or adjustment are generally blamed for this. After a critical review of the literature, some solutions are proposed to improve production of the orthesis and patient management.

The aim of this study was to assess the effects of bite splint (BS) treatment termination in patients treated for temporomandibular disorder (TMD) and sleep bruxism (SB).This longitudinal single-cohort study assessed 30 patients (29.5 ± 7.8 years old, 86.7% women) who were successfully treated with BS for SB and TMD for 30 days to 6 months prior to termination of the use of BS. The Research Diagnostic Criteria for TMD Axes I and II, Sleep Assessment Questionnaire, Beck Depression Inventory, and BiteStrip were used to assess TMD signs and symptoms, sleep disorders, depression, and SB at baseline and after 15 days of BS disuse.TMD symptoms, including the disability points, characteristic pain intensity, and present pain at rest, increased significantly (P0.05). After 15 days of BS termination, there were no significant differences in SB and depression levels, sleep quality, and TMD signs.In patients with TMD and SB, BS treatment cessation is not recommended.

The aim of this systematic review was to compare the crestal bone loss around splinted and nonsplinted adjacent implants.To address the focused question, "Is crestal bone loss around adjacent implants different with splinted from that with nonsplinted restorations?," indexed databases were searched from 1965 up to and including May 2016 using various combinations of the following keywords: "implant," "splinted," "nonsplinted," "unsplinted," "connected," "unconnected," "nonconnected," and "bone loss." Letters to the editor, commentaries, historic reviews, case reports, case series, animal studies, and studies on full-arch rehabilitation were excluded.Six studies were included with titanium implants ranging from 114 to 1187 implants. All studies had nonsplinted and splinted restorations that ranged from 20 to 234 restorations and from 60 to 970 restorations, respectively. In all the studies, the follow-up period after the restoration placement ranged between 1 and 22 years, with a mean follow-up ranging between 3 and 10.18 ± 3.18 years. In all studies, the mean crestal bone loss for implants restored with nonsplinted restorations ranged between 0.30 ± 0.65 and 1.3 ± 0.2 mm, whereas the mean crestal bone loss for implants restored with splinted restorations ranged between 0.50 ± 0.8 and 1.22 ± 0.95 mm.Within the limitations of this review it is concluded that adjacent implants restored with splinted and nonsplinted fixed restorations did not exhibit a difference in crestal bone loss. The evidence from this systematic review suggests further investigation.

Purpose The aim of this study was to evaluate the clinical performance of glass fiber-reinforced composite-based resin-bonded fixed partial dentures (GFRC-RBFPDs) as periodontal splints for periodontal support-reduced anterior partially edentulous dentition and for replacing lost teeth. Materials and methods A total of 39 subjects were enrolled who required fixed restorations for lost mandibular anterior teeth where the adjacent teeth offered severely reduced periodontal support. GFRC-RBFPDs were cemented to replace the lost teeth and to stabilize the adjacent teeth. The survival rates were recorded, and the periodontal condition (bone height, bleeding index, and probing depth) was evaluated at 1, 2, 3, and 4 years after the restorations. The results were statistically analyzed with single-factor variance analysis and chi-square tests (α = .05). Results The complete survival rate was 89.7%, and the functional survival rate was 92.3% at the fourth year. The main reason for failure was fracture of the connector of the GFRC-RBFPDs. In 21.7% of adjacent teeth, the bone height decreased; in the other 78.3%, it increased from 1 year after the restoration to the end of the observation period and the heights were statistically different from the initial values. The periodontal condition of the adjacent teeth was improved after the restoration. Conclusions This 4-year clinical evaluation indicated that GFRC-RBFPDs may be useful as fixed prostheses to replace one to three lost anterior teeth with damaged periodontal support in adjacent teeth.

To evaluate the clinical performance of glass fiber reinforced resin-bonded fixed partial denture(GFR-RBFPD) as a periodontal splint on abutment teeth with reduced periodontal support.Thirty fixed-fixed GFR-RBFPD were delivered to restore anterior partial edentulous dentitions. The adjacent abutment teeth had severely reduced periodontal support and were not indicated for full crown retained FPD. The success rate and functional survival rate had been recorded and the periodontal condition had been evaluated for 4 years. The results were statistically analyzed with single factor variance analysis and chi square test(α=0.05).In the first, second, and third year following restoration, one connector fractured in each year and they were repaired with adhesive resin and the pontics were kept in place for function. In the third and fourth years after restoration, there was one pontic displacement with fracture of connectors. The total survive rate was 83%(25/30) and the functional survival rate was 93% (28/30) at the end of the fourth year. The main reason of failure was fracture of connector. About 22%(13/60) of the adjacent teeth showed marginal bone height decrease, while the other 78% (47/60) increased with statistic significant difference from one year after the restoration to the end of the observation term(P0.05). The periodontal condition of the adjacent teeth was improved after the restoration.The four years clinical evaluation indicates that the GFR-RBFPD may be used as fixed prostheses to replace lost one to three anterior teeth with reduced periodontal support of abutment teeth.

Evaluates the clinical performance of of a fiber-reinforced, composite-resin bonded splint; a bridge; a fiber post; and/or a resin veneer for the restoration of periodontally-involved anterior teeth. Shows that a combination of approaches is a good choice for minimally invasive prosthodontic treatment in the aesthetic zone in periodontal patients., Aims This retrospective study evaluated the clinical performance of combining a fiber-reinforced, composite-resin (FRC) bonded splint; bridge; fiber post; and/or resin veneer for the restoration of periodontally-involved anterior teeth. Methods Sixty-three patients with periodontally-involved anterior teeth each received one of the following splinting restorations: FRC-bonded splint-bridges (SB), a combination of an FRC-bonded splint and resin veneer (SV), or FRC-bonded splints (S). Six patients with healthy periodontal teeth received orthodontic retainers with FRC-bonded splints (OS) as a control. Modified USPHS criteria were used to evaluate the effects of rehabilitation, and the periodontal pocket depth (PPD) and clinical attachment level (CAL) of the natural teeth were measured. Results All restorations resulted in good aesthetic outcomes. SV, S in combination with fiber posts and OS all resulted in 100% acceptable ratings for each category that was directly evaluated at each follow-up. The mean PPD was 3.5 ± 1.0 mm at baseline, decreased to 3.3 ± 1.0 mm after one year (p 0.05). These changes were similar to those in the mean CAL. Conclusion A combination of a FRC-bonded splint, bridge, fiber post and/or resin veneer for minimally invasive prosthodontic treatment in the aesthetic zone is a good choice for periodontal patients.

Root fractures are uncommon following dental trauma but are mostly diagnosed shortly after the injury, although occasionally at routine dental appointments. This paper presents the management of the different types of root fractures and the types of healing response suggesting the appropriate follow-up of these injuries. Clinical Relevance: A thorough clinical examination supplemented with radiographs, vitality tests, appropriate treatment planning and subsequent follow-up of root fractured teeth can improve the prognosis for these teeth and also minimize the need for subsequent extractions. Immature teeth with root fractures have a better chance of healing compared to teeth with fully formed roots.

Aim To report the intentional replantation of a maxillary central incisor with a crown-root fracture. Summary An 11-year-old girl was referred to a paediatric clinic with an extensive crown-root fracture of the maxillary right central incisor (tooth 11) with pulp exposure. Radiographs revealed that tooth 11 had a periapical radiolucent lesion, which suggested pulpal necrosis. The treatment option chosen was planned extraction and immediate intentional replantation of tooth 11 in a more coronal position. Sixteen years after treatment, tooth 11 was aesthetically and functionally sound, suggesting that the treatment was successful. Key learning point Intentional replantation may be considered as a treatment option for teeth with crown-root fractures.

To determine the influence of number and location of implants loaded on the stress to the bone in an edentulous maxilla using a three-dimensional finite element model (3D FEM).Computed tomographic data with the bone density of a dry skull were used to construct a 3D FEM. Titanium implants were simulated in the configuration as 14 unsplinted implants (US14), 14 splinted implants (S14), 6 splinted implants (canine, premolar, and molar regions, S6), 4 splinted implants (S4), and 6 anterior implants (incisors and canines, A6). Distributed loads of 200 N were applied on the occlusal table of the superstructures.The S6 model was subjected to a similar amount of stress and deformation to the US14 and the S14. The S4 and A6 models were subjected to approximately three times of stress under the vertical load, and approximately five times of stress under the inclined load, respectively, compared with the S6 model.The 3D FEM analyses suggest that the six splinted implants configuration has a similar stress and deformation pattern as compared with naturally positioned splinted 14 implants in the edentulous maxilla.

There are several benefits in using adhesive technique in removable prosthodontics as well as fixed prosthodontics. Previous studies have examined denture-base surface treatments that improve bond strength between a denture base resin and autopolymerizing repair resin. Dichloromethane and ethyl acetate are organic solvents that swell the denture base surface, thereby permitting diffusion of the acrylic resin. The optimal treatment duration is 5-10 s for dichloromethane and 120 s for ethyl acetate. It was reported that the bond durability of dichloromethane was superiorto that of ethyl acetate. Bonding between metal components and the denture base resin has an important role in the longevity of removable prostheses. The combination of metal conditioners and alumina air-abrasion is effective in fabricating and repairing removable dentures. Acidic monomers (4-META and MDP) are appropriate for base metal alloys, including Co-Cr alloy and titanium alloy, while thione monomers (MTU-6 and VBATDT) are suitable for noble metal alloys such as gold alloy and silver-palladium-copper-gold (Ag-Pd-Cu-Au) alloy. As an alternative to conventional restorations, resin-bonded restorations can provide precisely parallel guide planes with well-made rest seats. Careful consideration should be paid to stabilizing loosened teeth by fixing them with resin-bonded splints or fixed partial dentures.

AIM: To audit key demographic and clinical factors relating to treatment of trauma to the permanent dentition at the Paediatric Dental Department, Cork University Dental School and Hospital, Ireland and to compare clinical management with guideline recommendations. STUDY DESIGN: Clinical audit. METHODS: Consecutive clinical records for children attending for treatment of dental trauma were audited with regard to age, gender and distance travelled. The number of teeth per patient, the cause, type and prevalence of injury were examined. Splinting of mobilisation injuries and the prevalence of pulp extirpation were compared with published guidelines. RESULTS: Records were available for 94 children (65 male, 29 female) with a mean age at time of injury of 10.1 (SD±2.64) years. There were 82% of children living within 50 km of the Hospital. A total of 168 teeth were involved. Dental injuries comprised 39 uncomplicated crown fractures, 18 complicated crown fractures, 37 subluxations, 9 root fractures, 10 extrusions, 14 lateral luxations, 7 intrusions, 30 avulsions and 4 were unclassified. Sport injuries accounted for 23.2% of injuries to teeth, falls for 22.6%, bicycles were involved in 15.5%, other domestic accidents 6.5%, assault 4.2%, vehicles 3.0%, swimming 0.6%. and the remaining 24.4% were unclassified. In some instances of avulsion, lateral luxation, subluxation and extrusion injuries, a tendency to splint for durations longer than that recommended in guidelines was observed. Prevalence of pulpal extirpation for replanted teeth was in keeping with recommendations. CONCLUSION: General adherence to guidelines in respect of splinting and prevalence of pulp extirpation was demonstrated. Utilising a standardised recording system would facilitate the clinical audit process.

WOS: 000291363900013, PubMed ID: 21196840, Objective: Different fixation techniques have been used for stabilization of autotransplanted teeth. Because rigid or extended fixation periods can cause complications such as ankylosis and disturbances of pulpal revascularization, our aim was to evaluate an alternative technique, a removable splint, for improving the success rate of autotransplanted molar teeth. Study Design: In 44 patients, (20 male and 24 female patients), 45 transplanted teeth were analyzed. These cases were followed for 31 to 47 months after operation. Transplanted teeth were evaluated after use of a thermoplastic retainer for 1 month, in terms of success rate and dissatisfaction with this apparatus. The primary stability, ankylosis, and root resorption were also analyzed. Results: To date, 1 transplant was extracted after 6 months due to unpreventable periapical root inflammation, and 2 transplants were extracted after one year due to external root resorption. Although 2 ankylosed transplants were still functional after an average follow-up period of three years, with no dissatisfaction by the patients, these cases were treated as failures because of the probable risk for external root resorption. The remaining 40 (88.8 % success rate) transplants remained asymptomatic and functioning for a mean follow-up period of 37 months. In the assessment of dissatisfaction with the thermoplastic retainer, 36 (81.8 %) patients had no or little dissatisfaction, 4 (9 %) patients had very appreciable or excessive dissatisfaction, and 4 (9 %) patients had moderate dissatisfaction. Conclusions: A thermoplastic retainer for use after autotransplantation of third molar teeth is a reasonable and useful method and a good alternative to conventional rigid or semi-rigid splints. This technique was especially useful in autotransplanted teeth that had poor stability, i.e., in cases in which it is conventionally advised to use long-term rigid or semi-rigid splints.

Background Avulsion or exarticulation accounts for up to 16% of all traumatic injuries. It is most common in age group of 7 to 14 years. Following the loss of anterior teeth, the replacement is necessary to maintain esthetics, phonetics and avoid arch length discrepancy. Following replantation, postoperative care and management is done in several ways. Case report This article reports replantation and use of laser for endodontic sterilization and healing in a 12-year-old boy. Conclusion It is suggested that replantation of an avulsed tooth as soon as possible using appropriate splint and regular followup will show good prognosis. Clinical significance Laser offers itself as a good alternative to Ca(OH)2 for root canal sterilization and improved periapical healing. How to cite this article Gupta I, Gupta S, Sonwane K, Damankar D. Management of Maxillary Avulsed Teeth: Using Lasers for Canal Sterilization. J Contemp Dent Pract 2011;12(4):322-326.

The present clinical study was undertaken to determine the effects of splinting overunsplinted mobile teeth following periodontal surgery and compared the efficacy of two splinting materials, i.e. Ribbond ribbon + Composite with Stainless steel wire + Composite. Materials and methods Total of 30 patients (20 experimental and 10 control) formed the study group. Entire study was extended over a period of 12 weeks for each patient and treatment plan was divided into 8 phases. Healing response was monitored and application, durability, biocompatibility of splint material was assessed. Results Splint had a promising and beneficial effects on anterior teeth exhibiting Grade I to Grade II degrees of mobility. Experimental group showed a greater reduction in tooth mobility compared to control group. There was no significant difference in plaque index and Ribbond Ribbon reinforced with composite resin was an excellent material for application, patient comfort, resistance to fracture, biocompatable and esthetic acceptability. Clinical significance Splinting is recommended as an adjunct to periodontal surgery in the treatment of hypermobile teeth, especially in cases where patient discomfort is a prominent factor. How to cite this article Chandra Sekhar L, Koganti VP, Ravi Shankar B, Gopinath A. A Comparative Study of Temporary Splints: Bonded Polyethylene Fiber Reinforcement Ribbon and Stainless Steel Wire + Composite Resin Splint in the Treatment of Chronic Periodontitis. J Contemp Dent Pract 2011;12(5): 343-349.

Masticatory efficiency is altered by mobile teeth resulting from periodontal disease. The goal of our study was to investigate changes before and after fixation of mobile teeth with a Quartz Splint Woven high-strength quartz fiber splint and evaluate the fixation effect. Forty-two patients with chronic severe periodontal disease and 2 to 3 degree tooth mobility underwent fixation with Quartz Splint Woven quartz fiber splints. Masticatory efficiency was determined before and 1 month after periodontal treatment, and 1 month after fixation. Changes in periodontal probing depth (PD) and periodontal attachment level (AL) were measured and clinical efficacy was evaluated. Masticatory efficiency significantly increased from 39.32% to 50.95% after treatment (P

Purpose To evaluate the survival rate of implants placed in the maxillary tuberosity region using the fixed prosthesis in partially edentulous cases. Materials and Methods Of implant-treated patients who visited Kyung Pook National University Hospital, 7 partially edentulous patients (2 male and 5 female; mean age, 52.3 years; range, approximately 43 to 65) were selected according to the following criteria: 1 ) less than 3-mm thickness alveolar bone reaming at the first molar area and 2 ) 1 to 2 fixture premolars, with the additional implant at the maxillary tuberosity region. For the control group, patients who had nontuberosity areas were selected. After 1 to 7 years, marginal bone level, fixture mobility, and radiolucency of tuberosity fixtures of the fixed prostheses were evaluated by digital panorama (Starpacs, Infinitt, Seoul, Korea). Results None of the fixtures of the tuberosity-installed implants for 1 to 7 years failed. The marginal bone level around the implants of the maxillary tuberosity 1 to 6 years (average 3.4 years) after the final prostheses was approximately 0.6 to 1.3 mm, with an average of 0.94 mm. Conclusion The fixture installation at the maxillary tuberosity using the unilateral partially edentulous implant-fixed prosthesis would be a clinically acceptable treatment module.

– Background/aim: The Periotest® method is a technique for the objective assessment of tooth mobility. The aims of this study were to determine normal Periotest® values in the vertical and horizontal dimensions of periodontally healthy teeth in individuals aged 20–35 years and investigate the reliability of Periotest® in terms of intra-series and inter-series reproducibility before and after applying a dental trauma splint in vivo. Materials and methods: Periotest® values were measured in periodontally healthy dental students (n = 33; mean age 24.7 years) at reproducible measuring points in the vertical and horizontal dimensions, before and after splint insertion. Three readings were taken per series to observe the intra-series reproducibility; three series were measured to test inter-series reproducibility (Friedman-test; P ≤ 0.001). Two different wire-composite splints, 0.45 mm Dentaflex and 0.8 × 1.8 Strengtheners, were inserted and the Periotest® values were measured. Results: The median Periotest® values before splinting were: canines -2.5, lateral incisors -0.9, and central incisors 0.0 for the vertical dimension, and canines 1.1, lateral incisors 3.2, and central incisors 3.6 for the horizontal dimension. The intra-series and inter-series Periotest® values were highly reproducible. Conclusion: The Periotest® method provides highly reproducible results. Focused on dental trauma, the method can be applied diagnostically during the splint and follow-up period and for evaluating splint rigidity.

This paper describes the resolution of an extensive complicated crown-root fracture of an endodontically treated maxillary central incisor. Initially, the fractured crown was splinted to the adjacent teeth with orthodontic wire and composite resin. Subsequently, the crown fragment was reattached by means of a fiber post using a hybrid composite resin. Early stage success was achieved with the observance of normality in function, esthetics, and health of the tooth and surrounding periodontal structures. An athletic mouthguard was fabricated to prevent further trauma. Advantages, disadvantages, and prognosis of the treatment presented are discussed.

The following case studies provide insight into the integration of the principles set forward in the preceding article. Each case is evaluated first on the endorestorative principles that form the basis of the modern endo-endorestorative-prosthodontic continuum. Case 1 is provided by Dr Clark, and cases 2 to 6 are provided by Dr Khademi.

– Conservative solutions for the restoration of a single edentulous space in the anterior maxilla present an esthetic challenge to the clinician. A 45-year-old male patient whose right upper central tooth was planned to be extracted was referred to our clinic for a conservative, rapid, and economic treatment. After radiographic and clinical examinations, it was decided that the tooth which was to be extracted should be used for the restoration of its own extracted area. The extracted tooth was splinted to adjacent teeth with the aid of the grooves and fiber-reinforced composite (everStick®, StickTech Ltd., Turku, Finland). Following an early and unexpected failure of the restoration, the fiber layer was thickened twice with a flowable composite resin (Stick Flow, Stick Tech Ltd.) which fit better to the grooves. The restoration satisfied the patient with a good mechanical behavior, esthetics, and long-term durability after 12 months while. Restoring the missing tooth area with the patient’s own tooth is advantageous when combined with modern adhesive techniques. The clinician must pay attention to the mechanical adaptation of the restoration and the technique sensitivity of the applied adhesive system.

Purpose: The objective of this study was to evaluate the stress on the cortical bone around single body dental implants supporting mandibular complete fixed denture with rigid (Neopronto System-Neodent) or semirigid splinting system (Barra Distal System-Neodent). Methods and Materials: Stress levels on several system components were analyzed through finite element analysis. Focusing on stress concentration at cortical bone around single body dental implants supporting mandibular complete fixed dentures with rigid (Neopronto System-Neodent) or semirigid splinting system (Barra Distal System-Neodent), after axial and oblique occlusal loading simulation, applied in the last cantilever element. Results: The results showed that semirigid implant splinting generated lower von Mises stress in the cortical bone under axial loading. Rigid implant splinting generated higher von Mises stress in the cortical bone under oblique loading. Conclusion: It was concluded that the use of a semirigid system for rehabilitation of edentulous mandibles by means of immediate implant-supported fixed complete denture is recommended, because it reduces stress concentration in the cortical bone. As a consequence, bone level is better preserved, and implant survival is improved. Nevertheless, for both situations the cortical bone integrity was protected, because the maximum stress level findings were lower than those pointed in the literature as being harmful. The maximum stress limit for cortical bone (167 MPa) represents the threshold between plastic and elastic state for a given material. Because any force is applied to an object, and there is no deformation, we can conclude that the elastic threshold was not surpassed, keeping its structural integrity. If the force is higher than the plastic threshold, the object will suffer permanent deformation. In cortical bone, this represents the beginning of bone resorption and/or remodeling processes, which, according to our simulated loading, would not occur.

– Background/Aim: This investigation assessed the effects of dental trauma on the perception of pain and quality of life (QoL) of patient-parent pairs for a year following severe injuries. Sample: A visual analogue scale (VAS) was used to assess the pain of injury and treatment for 27 individuals 8–20 years and their parents. The Child Oral Health Quality of Life (COHQoL) survey was used to assess the effects of dental injuries on the QoL of 23 children aged 8–14 and their parents. Results: Mean VAS scores revealed that all patients and parents perceived the pain of initial injury to be significantly greater than pain of splint removal (P ≤ 0.05) and that pain decreased in a stepwise manner from injury through emergency treatment to splint removal. The COHQoL questionnaire demonstrated a profound and continuing effect on children and their parent's QoL following severe dental injury. The initial parental COHQoL score was significantly greater than the 12-month score (P ≤ 0.05) in both 8–10 and 11-14- year-olds. The COHQoL results indicated a measurable reduction in the QoL of patients and parents was still present 12-months after the injuries. At the end of one-year children were still affected by the social and well-being aspects of the injury yet parents exclusively reported that one-year effects were limited to their children's oral symptoms and functional limitations. Conclusions: Severe dental injuries produce initial and ongoing pain. Detrimental effects on the QoL of both children and parents are still present at one-year and these long-term effects are different for children and parents.

Clinical guidelines are now available for the management of avulsed teeth. The principles of evidence-based dentistry can be used to assess whether these guidelines are based on currently-available evidence. A qualitative systematic review was conducted of relevant clinical literature to examine the evidence on splinting duration and periodontal healing outcomes. The review was constrained markedly by small sample sizes, retrospective nature of clinical audits, dissimilarities of selected studies in their design, methodology and observation periods, and lack of uniformity in terminology for outcomes. A total of 138 replanted avulsed permanent teeth pooled from four papers each reporting both short-term splinting (14 days or less) and long-term splinting (over 14 days) in accord with current clinical guidelines, were studied. The evidence for an association between short-term splinting and an increased likelihood of functional periodontal healing, acceptable healing, or decreased development of replacement resorption, appears inconclusive. The study found no evidence to contraindicate the current guidelines and suggests that the likelihood of successful periodontal healing after replantation is unaffected by splinting duration. Pending future research to the contrary, it is recommended that dentists continue to use the currently-recommended splinting periods when replanting avulsed permanent teeth.

The presence of mesiodens often results in complications including retention of primary teeth and delayed eruption of permanent teeth, closure of eruption path, rotations, retention, root resorption, pulp necrosis, and diastema as well as nasal eruption and formation of dentigerous and primordial cysts. Less common complications involving the permanent incisors include dilaceration of the developing roots and loss of tooth vitality. Therefore, early diagnosis of mesiodens has particular importance in terms of preventing such complications. However, with respect to surgical removal of mesiodens, ideal timing of intervention - immediate or delayed intervention - remains to be a highly controversial issue. While predisposing factors of dental trauma such as open bite, increasing overjet with protrusion of upper incisors, and insufficient lip closure have been well documented in the literature, there is limited evidence indicating mesiodens as a risk factor in trauma. In this report of two cases, it is aimed to emphasize mesiodens as a risk factor in the treatment of dental trauma besides its effect on prognosis.

The aim of this study was to evaluate the tensile strength of orthodontic wires bonded onto the enamel with cyanoacrylate ester. To obtain the specimens, 120 human premolars (extracted for orthodontic or periodontal reasons) were included in acrylic blocks of rapid polymerization with three teeth each. Four groups were formed with ten specimens each. In the specimens, a dental splint model was made with cyanoacrylate ester and round stainless steel wire. In groups I, II and III, cyanoacrylate ester was used with round steel wires, with variation in diameter: 0.014 inches; 0.016 inches and 0.018 inches, respectively. In group IV, round steel wire 0.018 inches was used with photo polymerizing resin composite with previous acid etching. The adhesive force of the materials was measured in two points under the action of the tensiometer (ETM-USA). The number of loose wires was counted along with those that remained fixed according to the different levels of force applied because of the direction of the tensile force (vertical or horizontal) and the diameter of the wire used. The data obtained were first submitted to a descriptive analysis and then submitted to a statistical analysis (Friedman's Test and Dunn's Test of Multiple Comparison - Epi-info 3.2). Within the limitations of the experimental conditions presented, the cyanoacrylate ester or 'Super Bonder' maintained bonded to enamel and steel wires (0.016 and 0.018 inches) during the tensile strength tests under different levels of applied forces.

This paper describes the case of a 12-year-old male patient who presented a severe lateral luxation of the maxillary central incisors due to a bicycle fall. Treatment involved suture of the soft tissues lacerations, and repositioning and splinting of the injured teeth, followed by endodontic treatment and periodontal surgery. After a 2-year follow-up, clinical and radiographic evaluation revealed that the incisors presented satisfactory esthetic and functional demands. Este artigo apresenta o caso de um paciente de 12 anos de idade que apresentou uma luxação lateral severa dos incisivos centrais superiores decorrente de uma queda de bicicleta. O tratamento envolveu a sutura dos tecidos moles dilacerados e reposicionamento e fixação dos dentes traumatizados, seguidos por tratamento endodôntico e cirurgia periodontal. Após um acompanhamento de 2 anos, a avaliação clinica e radiográfica revelou que os incisivos apresentavam exigências estéticas e funcionais satisfatórias.