Switch to Dark theme

References

Djemal S, Singh P, Tomson R, Kelleher M. Dental trauma Part 1: acute management of luxation/displacement injuries. Dent Update. 2016; 43:812-824
Dental Trauma Guide. http://www.dentaltraumaguide.org (Accessed 15 December 2016)
Diangelis A, Andreasen JO, Ebeleseder KA, Kenny DJ. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol. 2012; 28:2-12
Allison J, Garlington G. Orthodontics: treating avulsed permanent teeth. Br Dent J. 2015; 219:514-515
Djemal S, Alani A. Dental trauma: splinting with wire and composite. Br Dent J. 2016; 220:220-221
International Association for Dental Traumatology. International Association for Dental Traumatology: For Professionals. http://www.iadtdentaltrauma.org/for-professionals.html (Accessed 15 December 2016)

Splinting traumatic dental injuries

From Volume 44, Issue 3, March 2017 | Pages 262-263

Authors

Emily Jane Hooper

DCT 3 in Paeds, Newcastle Dental Hospital

Articles by Emily Jane Hooper

Article

The article entitled Dental Trauma Part 1: Acute Management of Luxation/Displacement Injuries Management was informative and provided readers with a comprehensive understanding of the management and sequelae of such injuries.1 Interestingly the authors only mention splinting with composite and 0.018” stainless steel wire. The online dental trauma guide alludes to other possible splints to use in such instances, ‘acid-etch flexible resin splints, acid-etch-wire composite splints, acid-etch composite nylon line splints, acid-etch orthodontic wire splints and titanium trauma splints’.2

There doesn't appear to be any clear consensus on the exact type of splint to use according to the IADT trauma guidelines and online Dental Trauma Guide.3,2 Clinicians have their own preferences, depending on their experience, availability for specialist input, place of work or department, availability of materials and availability of nursing staff for assistance. Having worked in Accident and Emergency, as well as on a Paediatric Dental Department, I have treated numerous patients with traumatic dental injuries requiring immediate management. The splints of choice proving to be the most effective in the units where I have worked have been constructed using orthodontic brackets and 0.014” NiTi wire. There are a number of advantages to using orthodontic brackets; ease of placement (especially if working single handily in A&E), the ability to encourage orthodontic movement if required, removal (and replacement if needed) of the wire for mobility and sensibility testing, and quick removal of brackets provided debonding pliers are available.

I would refer readers to the previous correspondence earlier in the year on this topic in the British Dental Journal which highlights the various opinions on this topic.4,5

I would urge readers to be aware of the importance of diagnosing and managing traumatic dental injuries and refer them to the wealth of information available via journals, articles and online guides to aid this process.6