Periodontal splinting with a thin high-modulus polyethylene ribbon.

Vol. 22, No. 8 Today, there has been a trend toward changing demographics of dental practices with an increase in the number of older adults seeking care. For these patients, the success of periodontal and endodontic therapy have allowed them to keep their natural teeth longer. Also, these patients want to live their lifetime with their dentition intact. One problem facing the clinician in fulfilling these patient’s expectations is the increasing mobility of anterior teeth that results from loss of periodontal attachment. This is especially true of the mandibular incisors. For these circumstances, the treatment to reduce mobility by splinting periodontally involved teeth is accepted. For many years it was thought that splinting periodontally involved teeth was necessary to control gingivitis, periodontitis, and pocket formation. It was accepted that tooth mobility contributed to attachment loss and the formation of vertical osseous defects. Increased mobility of teeth was a direct consequence of traumatic occlusion, bruxism, and clenching. There was general acceptance that even normal physiologic function, including mastication and swallowing, contributed to tooth mobility.1 These concepts were investigated with clinical studies that reported that when teeth were occlusally overloaded and when other variables that contribute to periodontal disease were controlled, it was difficult to produce gingivitis, periodontitis, and pocket formation.2,3 In 1979, it was reported that there was not a correlation between splinting and reduced tooth mobility during initial periodontal therapy.4 These findings indicated that a reduction in tooth mobility was the result of changes in occlusal relationships and a decrease in gingival inflammation. It has been proven that while a splint is in place, there is a reduction in tooth mobility.5,6 Once the splint is removed, the mobility is unchanged. What has been unclear is the role of splinting of periodontally diseased teeth as a part of initial periodontal therapy.7,8 Tarnow and Fletcher summarized the indications and contraindications for splinting of periodontally involved teeth.9 They indicated that based on the dental literature, there are three primary rationales for controlling tooth mobility with periodontal splinting. These are: Periodontal Splinting With a Thin-High-Modulus Polyethylene Ribbon