FEATURES OF THE USE OF DENTAL SPLINTS FOR COMPLETE DISLOCATION OF TEETH

Abstract

Among dental injuries, complete dislocation of a tooth has a prevalence of 1.2 to 14.8% in the permanent dentition, and is defined as a complete displacement of the tooth from the socket with rupture of the fibers of the periodontal ligament. Among the teeth, the upper central incisors are most often affected. Among children aged seven to eleven, boys are more susceptible to this type of injury than girls. This is mostly associated with industrial and auto traumatism and sports activities, protrusion of front teeth, open bite, etc. In such cases, the severity of the damage is higher, the more pronounced the tooth protrusion.
 The purpose of the study: comparison and analysis of clinical data on the use of rigid and semi-rigid dental splints after tooth replantation under the conditions of its complete dislocation and immobilization time.
 We conducted a retrospective study of the medical records of 65 outpatient dental patients with complete dislocation of a tooth on the basis of the Poltava Regional Center of Stomatology Dental Clinical Polyclinic.
 In 26% of cases, a semi-rigid splint was used for 7-10 days, which was fixed with composite resin and a steel wire with a diameter of 0.02 cm. With rigid fixation, a higher degree of bone tissue regeneration in the periodontal space was observed in 57.5% of cases. According to our data, it was established that in relation to dental splints, semi-rigid nylon splints were used in 62% of cases, steel wire in 9%, and restorative material in 18%. According to the received data on the processing and preparation of the tooth for replantation and immobilization, physiological solution is the most suitable medium for storage (62.4%), the ideal extraalveolar time period was 25-27 minutes (58.5%), while the teeth were in a dry place within 10 minutes after storage in physiological solution. Due to the presence of serious inflammatory root resorption, which demonstrates a connection with the periodontal tissue associated with increased tooth mobility, in 27.6% of cases an intervention regarding extraction, use of a temporary prosthesis, followed by prosthetics with adhesive materials is chosen. Autotransplantation is used in 12.9% of cases and is positioned as an alternative for replacing missing incisors. However, this method has limitations, as the root of the donor tooth must be 2/3 formed, in addition to anatomical problems, where approximately 60% of autografted teeth are dissimilar in appearance in terms of asymmetric gingival width or color mismatch.
 When evaluating pulp and periodontal tissue regeneration for permanent teeth, the best results were observed with the use of platelet-rich plasma, especially for incisors, with separation after more than 8 hours of extraoral storage of the tooth and delayed replantation. The obtained data allow us to state that several factors can influence the success of replantation: the duration of the injury, the extra-alveolar period of permanence, means of preservation, contamination, manipulation and condition of the extracted tooth, the type of splint used and the time of application.
 Conclusion. Based on a retrospective analysis of medical records and literature data, it can be stated that after replantation, the use of a splint is mandatory to ensure immobilization of the teeth in the initial period, which is necessary for the restoration of the periodontal ligament.