Periodontal Abscess Occurrence Post Wire Splint Therapy on Mobile Teeth

Abstract

Tooth mobility is one of the cases of periodontal disease caused by the destruction of the bone that supports the teeth. Stabilization of loose teeth using splinting wire can be one of the treatment options. The use of splinting wire may increase plaque accumulation and is sometimes difficult to clean. Plaque accumulation will cause bacterial invasion into the surrounding tissues of the periodontal pockets which will eventually develop into an inflammatory process. As time goes by, connective tissue destruction and pus formation will occur which eventually leads to a periodontal abscess. Periodontal abscess is a localized accumulation of pus in the gingival wall of a periodontal socket with periodontal tissue destruction. The purpose of this case report is to report the incidence of periodontal abscess after wire splinting application in a case of tooth unsteadiness. A 76-year-old female patient came to RSGM with complaints of feeling uncomfortable because some of her teeth were loose. The complaint has been felt approximately 1 year ago. The complaint was accompanied by pain when used to eat and toothbrushing. Objective examination showed reddish gingiva, rounded interdentals, soft consistency, and unstippling texture on the labial and lingual side of teeth 33, 32, 31, 41, 42 and 43 with BOP (+) at all points. The patient's Oral Hygiene Index (OHI) was 2.16 and PI was 18.67%. Probing depth average was 3 mm, recession was 3 mm, and tooth decay was grade 2. Supportive examination showed horizontal bone destruction in the anterior region of the mandible. The first visit was carried out wire splinting on the lingual part of the loose tooth, at the time of control there was a periodontal abscess on the labial side so the splinting was moved to the labial side. The increase in socket depth and the appearance of periodontal abscesses are caused by plaque accumulation which eventually makes bacteria invade the periodontal tissue. Periodontal therapy really needs to pay attention to the patient's OHI, therefore plaque control and removal of bacterial deposits must be carried out by scaling and root planning regularly and carrying out other periodontal therapies such as curettage if tissue destruction is severe enough