Pilot study of unidirectional E-glass fibre-reinforced composite resin splints: Up to 4.5-year clinical follow-up

Abstract

ObjectivesThis prospective clinical pilot study evaluated the performance of fibre-reinforced-composite resin (FRC) splints on mandibular anterior teeth. MethodsBetween June-2003 and January-2008, 19 patients (7 females, 12 males, 45–72 years old) from a group of consecutive patients who completed periodontal therapy received E-glass FRC splints (everStick Perio, StickTech) in combination with two types of flowable and restorative resin-composites (Filtek Flow, Filtek Supreme, n=11; Tetric Flow, Tetric-Ceram, n=8). Only patients with vital teeth, presenting mobility of grade 3, having at least one canine with no mobility on both sides of the dental arch were assigned for a splint therapy. The patients were recalled for periodical follow-up controls first at 6 months and thereafter annually. The evaluation protocol involved technical failures [chipping, debonding or fracture (tooth/restoration)] and biological failures (caries)]. Periodontal pocket depth (PPD) and clinical attachment level (CAL) were measured 6 months after splinting and annually. Six sites were measured for each natural tooth at the mesiobuccal, buccal, distobuccal, distolingual, lingual and mesiolingual sites. ResultsAll splints were applied from canine to canine in the mandible. In total, 5 recalls were performed and no drop-out was experienced. One partial debonding of the FRC splint with Tetric Flow/Tetric-Ceram combination was observed after 40 months. No caries was found around any of the splints and no teeth had to be extracted until the final follow up. The splinted teeth were found to be vital in the vitality tests. Overall survival rate was 94.8% (Kaplan–Meier). The survival rate was not significantly affected by the composite type (Filtek-Flow/Filtek Supreme: 100%, Tetric Flow/Tetric Ceram: 96% (p=0.92) [Kaplan–Meier, Log Rank (Mantel–Cox) (CI=95%)]. Hazard ratio for Tetric Flow/Tetric Ceram group was 0.05 (95% CI) and for Filtek Flow/Filtek Supreme group 0.00 (95% CI). Whilst overall PPD measurements of the dentition ranged between 6 and 12mm, the CAL measurements ranged between 4.9 and 10mm at baseline. The mean PPD for the splinted teeth decreased from 8.9±1.8mm to 5.2±1.2mm, and CAL decreased from 7.2±1.6mm to 4.6±1mm at the end point. ConclusionDirect tooth splinting with E-glass FRC material performed successfully up to 4.5 years. Periodontal status of the splinted teeth showed decreased PPD and CAL.