Dental splints are essential tools in management of TDI in children, used to stabilize mobile teeth, manage trauma, or provide temporary support during healing and treatment. In children, the choice of splint depends on the type of dentition, type of injury, the stage of dental development, and the specific clinical circumstances.
Types of Dental Splints in Children
1. Fixed Splints
Fixed splints are cemented or bonded directly onto the teeth and remain in place until healing is satisfactory. Common types include:
A. Wire and Composite Resin Splints
These consist of a stainless steel pre-curved wire (0.12”) or even ligature wire (0.09” / 0.10”) bonded to the adjacent teeth using composite resin. They are often used in cases of laxative injuries as (Intrusion, lateral laxation, Extrusion or avulsion where stabilizing the traumatized teeth is necessary.
Advantages: Strong, reliable, and minimally invasive.
Application: Usually preferred in permanent teeth but sometimes used for primary teeth with careful consideration due to eruption concerns.
B. Fiber-Reinforced Composite Splints
These involve placing a fiber material (like polyethylene or fiberglass) bonded with composite resin across the mobile teeth. They are flexible, esthetically pleasing, and less invasive.
C. Wire and Orthodontic brackets splints
These consist of a stainless steel precurved wire (0.12”) or even ligature wire (0.09” / 0.10”) attached to brackets using orthodontic O-Ties.
Same uses as wire and composite splints
D. Orthodontic Powerchain splint
Recent studies have shown the use of super flexible powerchains used in space closure in ortho treatment in adults is as effective as other splints
E. Titanium Trauma Splint
The TTS is just 0.2 mm thick and can therefore be readily adapted to the patient’s dentition and is easily inserted and removed by a clinician working alone with highest success rates and minimal risk factors as external inflammatory resorption and replacement resorption
https://cda-adc.ca/JCDA/vol-72/issue-8/721.pdf
2. Removable Splints
Removable splints are fabricated outside the mouth and placed during treatment sessions. They provide stabilization while allowing for easier hygiene and inspection.
A. Acrylic or Thermoplastic Splints
Custom-made acrylic appliances that fit over the teeth, often used in managing multiple or significant trauma. They can be adjusted or removed by the patient and caregiver.
Advantages: Easier hygiene management and modification.
B. Occlusal Splints (Night Guards)
Although more common in adult bruxism, similar devices can be used in children to protect teeth from injury or during orthodontic treatment.
Special Considerations in Pediatric Patients
Primary vs. Permanent Teeth:
The splinting techniques vary due to differences in tooth anatomy and periodontal ligament maturity. Primary teeth are often managed conservatively to avoid damage to the developing permanent tooth buds.
In primary teeth, minimal intervention is preferred, and splints are typically used temporarily for traumatic injuries like luxations.
In permanent teeth, more durable splints are employed to promote healing and stability.
Growth and Development:
The splinting method must accommodate ongoing facial growth and dental development, minimizing risks of interference.
Patient Cooperation:
Young children may require shorter procedures and simpler appliances to facilitate compliance.
Conclusion
Various types of dental splints are employed in pediatric dentistry, each tailored to the child’s age, stage of dental development, and type of trauma or mobility. Proper selection and application of the appropriate splint are vital for the successful management of dental injuries in children, ensuring both functional stabilization and esthetic outcomes while minimizing long-term complications.
