| Abstract|| |
In the past, direct stabilization and splinting of teeth using an adhesive technique required the use of wires, pins, or mesh grids. Problems with the current fiber reinforcement materials are their inherent thickness when embedded within composite resin, their availability in fixed widths and their high cost. This paper discusses the use of silane-coated industrial grade glass fibers, which can be bundled in the form of ribbon according to the required thickness and length. Of the three patients discussed in this paper, none has exhibited debonding or recurrent caries over 1-year period. By reinforcing composite splints with these industrial grade glass fibers, dentists can provide patients with restorations and splints that are economical, fracture resistant, and more durable than most alternative splinting materials of the past.
Keywords: Fiber splinting, glass fibers, industrial glass fibers, oral rehabilitation, periodontal splinting, tooth mobility
|How to cite this article:|
Agrawal AA, Chitko SS. The use of silane-coated industrial glass fibers in splinting periodontally mobile teeth. Indian J Dent Res 2011;22:594-6
Clinical prognosis of periodontally compromised teeth many times hinges on the presence of tooth mobility. ,, The principal causes of tooth mobility are loss of alveolar bone, inflammatory changes in periodontal ligament, and trauma from occlusion. The latter two are correctable, but mobility due to alveolar bone loss is not likely to be corrected. Flezar et al.  revealed that pockets on clinically mobile teeth do not respond as well to periodontal therapy as pockets on nonmobile teeth exhibiting the same initial disease severity. Therefore, the treatment to reduce mobility by splinting periodontally involved teeth is accepted. Apart from this splinting can be done for stabilization after orthodontic treatment and bonding a missing anterior tooth to adjacent firm teeth. It has been proved that while a splint is in place, there is a reduction in tooth mobility.  What has been unclear is the role of splinting of periodontally diseased teeth as a part of initial periodontal therapy. ,
|How to cite this URL:|
Agrawal AA, Chitko SS. The use of silane-coated industrial glass fibers in splinting periodontally mobile teeth. Indian J Dent Res [serial online] 2011 [cited 2019 Sep 20];22:594-6. Available from: http://www.ijdr.in/text.asp?2011/22/4/594/90307
Wires, pins, or mesh grids used earlier could only mechanically lock around the resin restorative. Because of this there was potential of creating shear planes and stress concentrations that would lead to fracture of the composite. Currently, there are a number of fiber reinforcement materials available in the market, which affects the physical properties and behaviors of composite materials. One problem with the commercially available fiber reinforcement materials that have been available is their inherent thickness when embedded within composite resin in a splint. In addition, they are available in fixed width and are costly. This paper discusses the use of silane-coated industrial grade glass fiber, which is available as isolated glass fibers as long bundles. The individual fibers can be bundled according to the required thickness desired and cut to desired length. Along with these advantages, they are significantly economical.
| Case Reports|| |
A 38-year-old patient reported with a mobility of grade II for teeth 31 and 41. The patient also had periodontal pockets of around 5 mm and 50% horizontal bone loss with other mandibular anterior teeth [Figure 1]a. Since it was obvious that flap surgery alone would not reduce the mobility of 31 and 41, it was decided to splint the teeth at the time of surgery itself to reduce patient's visit and assist healing.
|Figure 1: (a) Significant recession and pathologic migration seen in mandibular antral incisors. (b) Fiber splinting done in mandibular canine to canine after complete scaling and polishing|
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After scaling and polished, the teeth were then thoroughly rinsed and dried. The glass fibers were cut to desired length and impregnated with adhesive resin from a fourth-generation bonding system. A resin adhesive was applied to the etched enamel surfaces, light-cured and a flowable composite resin was placed onto the lingual surface. The bundle of partially cured/uncured glass fibers was placed into the composite resin starting at the midlingual surface of either canine and pushed into the composite resin. Cotton pliers and burnisher were used to adapt and embed the fibers into the composite resin. The lingual surfaces were then light-cured for 60 s/tooth. A high strength, wear resistant, flowable composite resin was applied to smooth the irregular surfacing on the lingual and provides an even thickness of composite covering the ribbon and light-cured for an additional 20 s/tooth. The lingual surfaces were polished with an aluminum oxide abrasive point. The final step was adjustment of the occlusion and esthetic appearance of the splint [Figure 1]b.
A 42-years-old patient complained of mobility in mandibular anterior teeth and discomfort on chewing. After careful examination, it was found that 31, 41 were grade II mobile, whereas 32, 42 were grade I mobile. There were no periodontal pocket but significant recession and horizontal bone loss was present with 31, 32, 41, 42 [Figure 2]a. Coronoplasty was performed to eliminate the trauma and periodontal splinting of mandibular anterior was planned using glass fiber. Following the above procedure, fiber splinting was done on lingual surface from mandibular canine to canine [Figure 2]b.
|Figure 2: (a) Significant recession and pathologic migration seen in mandibular anterior teeth. (b) Fiber splinting done in mandibular canine to canine after complete scaling and polishing|
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A 27-year-old female patient had malaligned 41 which was grade III mobile with gingival recession up to the apical one-third and the remainder of the lower incisors were grade I mobile [Figure 3]a. The patient required root coverage of 41 and stabilization of the others. Considering the hopeless prognosis of 41, it was extracted during flap surgery [Figure 3]b, but the patient wanted immediate replacement in that place. The root of the extracted tooth was resected and the crown was supposed to be used for immediate replacement. Since there was some recession in adjacent teeth also, some part of coronal root was kept intact for better esthetics. Pulp chamber and root canal of the teeth was cleaned and filled with glass ionomer cement. The crown of extracted tooth was reduced mesiodistally to fit into the available space. All the incisors, including the crown of extracted tooth, were prepared as discussed before for splinting. The fiber-glass material in the form of a uniform ribbon was first bonded and cured on the extracted teeth [Figure 3]c. It was then adjusted into the desired position and then similar bonding and curing was performed on adjacent teeth [Figure 3]d. This procedure produced a structurally superior esthetic replacement and the stabilized teeth exhibited no mobility.
|Figure 3: (a) Severe recession with malaligned 41. (b) Tooth no. 41 extracted. (c) Root of tooth no. 41 resected and fiber splint bonded to crown of tooth no. 41. (d) Crown of tooth no. 41 bonded to adjacent teeth|
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| Discussion|| |
A new and improved means for reinforcing composite resin systems for restoring and/or splinting teeth, which utilized an etched glass fiber material, and treated with an organofunctional silane. In fiber-glass reinforcement, the reactive sites are the silanols on the glass surface. The very fact that the industrial glass fibers available are silane coated, gives them the adequate bonding properties and flexural strength. Commercially available fiber splint materials have limited thickness and length apart from the fact that they are less economical. The basic reinforcement used in these splints is ''glass fibers,'' which in fact can be obtained at much cheaper rate from any industry, which also uses fiberglass for reinforcement such as plastic industries, glass industries, or industries making radio-installation for navy, etc. The other major advantage is that the clinician is not limited with the commercially available thickness and length of the ribbon. The individual raw glass fibers can be bundled in desired thickness and length and partially cured with bonding agent before use. Although no in vitro experiment has been done, we have found that the strength and fracture resistance of this splint is satisfactory. Of the three patients discussed in this paper, none has exhibited debonding or recurrent caries over a 1-year period.
| Conclusion|| |
This paper described an innovative technique using a desired number of industrial glass fibers forming thin or thick ribbon like bundle as splinting material for reinforcing dental resins. These fracture resistant restorations will be more durable than most alternative splinting materials of the past.
| References|| |
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|3.||McGuire MK, Nunn ME. Prognosis versus actual outcome. III. The effectiveness of clinical parameters in accurately predicting tooth survival. J Periodontol 1996;67:666-74. |
|4.||Fleszar TJ, Knowles JW, Morrison EC, Burgett FG, Nissle RR, Ramfjord SP. Tooth mobility and periodontal therapy. J Clin Periodontol 1980;7:495-505. |
|5.||Laudenbach KW, Stoller N, Laster L. The effects of periodontal surgery on horizontal tooth mobility [abstract]. J Dent Res 1977;56:596. |
|6.||Muhlemann HR, Sardir S, Reteitschak KH. Tooth mobility: Its causes and significance. J Periodontol 1965;36:148-53. |
|7.||Renggli HH, Schweizer H. Splinting of teeth with removable bridges and biological effects. J Clin Periodontol 1974;1:43-6. |
Amit A Agrawal
Department of Periodontics, KBH-MGV Dental College and Hospital, Nashik
Source of Support: None, Conflict of Interest: None
[Figure 1], [Figure 2], [Figure 3]