Splint Material Research Articles

Bonding Interface and Repairability of 3D-Printed Intraoral Splints: Shear Bond Strength to Current Polymers, with and without Ageing.

This in-vitro study investigates the bonding interfaces reached by the conditioning of a splint material additively manufactured by digital light processing (AM base) as well as the shear bond strength (SBS) of resins bonded to these surfaces (repair material). Therefore, the AM base was either stored in dry for 12 h or wet environment for 14 days to simulate ageing by intraoral wear. The dry and wet group was bonded after physical and/or chemical conditioning to cylinders made from polymethylmethacrylate or four novel polymers allowing splint modifications. Blasted and methylmethacrylate (MMA)-conditioned Polymethylmethacrylate (PMMA) bonded to PMMA acted as the gold standard. The surface profiles revealed highest differences of Ra towards the gold standard in AM base conditioned with other than MMA after sandblasting. The adhesively bonded repair materials of the wet AM base were further aged in wet environment for 14 days. The SBS of the gold standard (25.2 MPa and 25.6 MPa) was only reached by PMMA bonded to blasted and MMA-conditioned AM base after dry (22.7 MPa) and non-conditioned after wet storage (23 MPa). Four repair materials failed to reach the threshold of 5 MPa after dry storage and three after wet storage, respectively. Non-conditioned AM base revealed the highest risk for adhesive fractures when using other resins than PMMA.

A Comparative Evaluation of the Positional Accuracy of Multiple Implants by Open Tray Impression Technique using Three Different Splinting Materials: An in vitro study


 Aim: To comparatively evaluate the positional accuracy of multiple implants by open tray impression technique using three different splinting materials namely self-cure acrylic resin, pattern resin and flowable composite.
 Materials and Methods: An edentulous maxillary model was fabricated with heat-cure acrylic resin. Four dummy implants were placed bilaterally at canine and second premolar positions in the acrylic model, perpendicular to the horizontal plane and parallel to each other. Open tray impression copings were attached to dummy implants. The copings were splinted with dental floss onto which self-cure acrylic resin was added, which was sectioned and rejoined (for Group A). Similarly, pattern resin (for Group B) and flowable composite (for Group C) were used as splinting materials after sectioning and rejoining as previously described for Group A. Open tray impressions were made using polyvinylsiloxane impression material to obtain 10 casts for each group categorized according to the splinting material used. Interimplant distances were measured between implants on the master model and between the implant analogs in the retrieved casts in three different groups using a Coordinate measuring machine and a comparative evaluation of positional accuracy was done.
 Results: Splinting with materials of all three Groups showed minimal variation in positions of multiple implants and within clinical limits. Group B (pattern resin) had more accurate values similar to master model compared to Group A (self-cure acrylic resin) and Group C (flowable composite), although statistically insignificant. The results with Groups A and C were similar. No statistically significant difference was derived between the three different groups.
 Conclusion: It was concluded that all the three splinting materials evaluated in the study can be recommended as splinting material of choice for multiple implants using open tray impression technique.

External Splinting Is Not Mandatory After All Rhinoplasties: A Prospective Randomized Trial.

Although casts or external splint materials are commonly applied on the external nose after rhinoplasty, their beneficial effects have not been previously demonstrated in controlled studies. A total of 40 adult patients who underwent primary rhinoplasty were included in this prospective study. The patients were randomized into 2 groups to use an external splint or not after surgery. Only surgical taping was applied to the nasal dorsum of the patients for whom external splints were not used. The periorbital edema and ecchymosis levels of the patients were recorded on the second and seventh days after surgery. Moreover, all patients had a computed tomography scan at the third postoperative week to measure the distance between the beginning of the osteotomy line on the right and left sides and the midline. On the second and seventh postoperative days, the levels of periorbital edema and ecchymosis were significantly lower in the patients with taping than in the patients with splints (P < 0.05 for each). No statistically significant difference was observed in terms of the difference in the distance between the beginning of the osteotomy line on the right and left sides to the midline between the group with external splints and that with tape (P = 0.661). External splinting may not be used in cases where osteotomy is not performed or in patients where the osteotomies are sufficiently stable. Thus, the disadvantages of external splinting are avoided, and at the same time, periorbital edema and ecchymosis are less common.

An in vitro Study to Assess the Positional Accuracy in Multiple Implants using Different Splinting Materials in Open-Tray Impression Technique

Context: Numerous implant techniques have been suggested in the literature to obtain an accurate master cast. One of those is to splint the impression copings; however, many controversies exist in type of splinting materials used. Aim: The aim of this study is to evaluate and compare the positional accuracy in multiple implants using different splinting materials in open-tray impression technique. Settings and Design: The study design involves an in vitro study. Materials and Methods: An acrylic resin model of a mandibular edentulous arch was used as a reference model in which four 3.75 mm × 10 mm implant analogs were placed and sequentially numbered as 1, 2, 3, and 4 from left to right. Open tray impression copings were attached to each of them and were then splinted by three different materials and divided into three Groups as Group I, Group II, and Group III splinted with pattern resin, composite resin, and titanium wire, respectively. Five implant level impressions were made from each group and poured in Type IV dental stone. The implant analogs were transferred to the casts and inter-implant distances were compared to the reference model using the Coordinate Measuring Machine. Statistical Analysis Used: One-way ANOVA test was used as a test of significance. Results: The present study revealed that all the three splinting materials can be used for the accurate reproduction of spatial relationship. There was no significant difference between the centroids of implant analogs 1 and 2, 1 and 3, 1 and 4, 2 and 3, 3 and 4, and 2 and 4 of reference model with the master models. Conclusion: Clinically acceptable accuracy in transferring the position of implants to the master cast could be obtained from all the three splinting materials used. However, splinting of impression copings with titanium wire showed greatest accuracy.

Elution behavior of a 3D-printed, milled and conventional resin-based occlusal splint material

ObjectiveThe elution of unpolymerized (co-)monomers and additives from methacrylic resin-based materials like polymethyl methacrylate (PMMA) can cause adverse side effects, such as mutagenicity, teratogenicity, genotoxicity, cytotoxicity and estrogenic activity.The aim of this study was to quantify the release and the cytotoxicity of residual (co-)monomers and additives from PMMA-based splint materials under consideration of real splint sizes. Three different materials used for additive (3D printing), subtractive (milling) and conventional (powder and liquid) manufacturing were examined. MethodsThe splint materials SHERAprint-ortho plus (additive), SHERAeco-disc PM20 (subtractive) and SHERAORTHOMER (conventional) were analysed. 16 (n = 4) sample discs of each material (6 mm diameter and 2 mm height) were polished on the circular and one cross-section area and then eluted in both distilled water and methanol. The discs were incubated at 37 °C for 24 h or 72 h and subsequently analysed by gas chromatography/mass spectrometry (GC/MS) for specifying and quantifying released compounds. XTT-based cell viability assays with human gingival fibroblasts (HGFs) were performed for Tetrahydrofurfuryl methacrylate (THFMA), 1,4-Butylene glycol dimethacrylate (BDDMA) and Tripropylenglycol diacrylate (TPGDA). In order to project the disc size to actual splint sizes in a worst-case scenario, lower and upper jaw occlusal splints were designed and volumes and surfaces were measured. ResultsFor SHERAeco-disc PM20 and for SHERAORTHOMER no elution was determined in water. SHERAprint-ortho plus eluted the highest THFMA concentration of 7.47 μmol/l ±2,77 μmol/l after 72 h in water. Six (co-)monomers and five additives were detected in the methanol eluates of all three materials tested. The XTT-based cell viability assays resulted in a EC50 of 3006 ± 408 μmol/l for THFMA, 2569.5 ± 308 μmol/l for BDDMA and 596.7 ± 88 μmol/l for TPGDA. SignificanceWith the solvent methanol, released components from the investigated splint materials exceeded cytotoxic concentrations in HGFs calculated for a worst-case scenario in splint size. In the water eluates only the methacrylate THFMA could be determined from SHERAprint-ortho plus in concentrations below cytotoxic levels in HGFs.

Effect of post-rinsing time on the mechanical strength and cytotoxicity of a 3D printed orthodontic splint material

ObjectiveSince the post-rinsing time is inconsistently recommended, this study aims to investigate the effect of post-rinsing time on the flexural strength and cytotoxicity of an stereolithographically (SLA) printed orthodontic splint material. MethodsSLA-printed specimens were ultrasonically rinsed with isopropanol (IPA) for 5 min, 12 min, 20 min, 30 min, 1 h, and 12 h, respectively. Surface characterization was conducted by scanning electron microscopy and roughness measurements. Flexural strength was evaluated using a three-point bending test. Cytotoxicity was determined by direct contact test and extract test. For both tests, cell viability (live/dead staining) and cell metabolic activity (CCK-8 assay) were evaluated. Additionally, water sorption and water solubility were tested to analyze the mass loss from immersion. ResultsNo apparent surface alterations could be detected on the samples post-rinsed for less than 1 h. In contrast, when the post-rinsing time was prolonged to 12 h, surface fissures could be observed. Flexural strength linearly decreased with increasing post-rinsing time. All post-processed specimens did not show an obvious cytotoxic effect. SignificanceThe removal of cytotoxic methacrylate monomers by post-rinsing with IPA could be achieved in 5 min. Extending post-rinsing time could not improve the cytocompatibility of the SLA-printed orthodontic splint material, and may result in a decrease in flexural strength.

Splinting of the Anterior Maxillary Teeth Using Glass-Ceramic Materials: A Case Report

Objective:The aim of this study was to present the technique of splinting anterior maxillary teeth using heat-pressed glass-ceramic material in a clinical case with long-term follow-up.Clinical Considerations:Various materials, including fiber-reinforced tapes, glass fibers, composite resin, and partial coverage metal frameworks, have been used as splinting materials with encouraging clinical results.Conclusion:As shown in the presented case, glass-ceramic heat-pressing materials can be used successfully for the splinting of anterior teeth.

Comparative Study between the Overall Production Time of Digitally Versus Conventionally Produced Indirect Orthodontic Bonding Trays.

The purpose of this study was to compare the production time for indirect digitally and laboratory-produced orthodontic bonding trays. Orthodontic study casts were used in this study (n=40). The specimens were equally and randomly divided. In the digitally produced indirect bonding tray (DIBT) group (n=20), the brackets were set virtually using the Orthoanalyzer program (3Shape, Copenhagen, Denmark) to produce an indirect bonding tray that was virtually designed and 3D printed using VarseoWax® Splint material with a Varseo S 3D printer (Bego, Bremen, Germany). In the laboratory-produced indirect bonding tray (LIBT) group, the brackets were adhesively bonded to the study casts in the dental laboratory (Danube Private University, Krems, Austria), and a transfer bonding silicone tray was manufactured. The t-test results showed a significant difference between the passive time during the production of DIBTs (153.8±32.8 min) and LIBTs (7 min). However, the active production time was 13.6±0.8 min for DIBTs and 17.7±1.9 min for LIBTs. Every individual process step in both groups was measured in minutes, and statistical analysis was performed. The total production time, including active working and passive non-working time, was higher for DIBTs than for LIBTs. However, the actual active production time for DIBTs was shorter than that for LIBTs. Within the study limitations, the digital planning and production of indirect orthodontic trays can be considered a time-efficient production method.

Comparison of hardness and polishability of various occlusal splint materials

ObjectivesTo measure polishability of occlusal splint materials manufactured by various methods. MethodsSeven occlusal splint materials manufactured by four different methods – Heat cured (Vertex Rapid simplified Clear), CAD-milled (Ceramill a-splint), Vacuum-formed (Proform splint) and 3D-printed (Freeprint Ortho, KeySplint Soft, DentaClear and FreePrint Splint 2.0) were tested for gloss, roughness, and surface hardness and elastic modulus. For all groups, the tests were repeated with the materials polished with three different polishing burs, pumice and high shine. All polishing procedures were standardised by applying the force of 1 N for 1 min at the set speed. 3D printed materials were further tested with additional specimens manufactured at different printing angles of 0°, 45° and 90°. Data was statistically analysed using ANOVA (SPSS Version 26) and MatLab (R2020a). Polished surfaces of each specimen were analysed under scanning electron microscope. ResultsVacuum-formed materials showed the highest polishability (80.61 ± 0.98 GU) with no statistical significance to heat-cured or CAD-milled (p = 1.00). Pumice and high shine polish significantly improved the gloss for all groups. The mean gloss and surface roughness for all 3D-printed materials ranged from 75.24 ± 25.05 GU to 0.18 ± 0.21 GU and 2.73 ± 3.18 μm to 0.06 ± 0.01 μm, which was significantly lower (p < 0.001) than heat-cured, CAD-milled and vacuum-formed materials. The highest hardness (0.40 ± 0.009 GPa), elastic modulus (6.06 ± 1.49 GPa) and gloss were found when materials were 3D-printed at 45°, with the lowest surface roughness. ConclusionStatistically significant differences in polishability were found among the different occlusal splint materials. The polishability and surface hardness of 3D-printed occlusal splint materials was influenced by the print angle. The 0° 3D-printed occlusal splint materials produced the highest gloss and the lowest surface roughness pre-polished, indicating that no polishing is required. While the 3D-printed occlusal splint materials at 45oand 90° required polishing with burs, pumice and high shine to reduce the surface roughness, there were layering structures created during printing.

Evaluation of the mechanical properties and degree of conversion of 3D printed splint material

ObjectiveTo evaluate the effect of post-curing method, printing layer thickness, and water storage on the mechanical properties and degree of conversion of a light-curing methacrylate based resin material (IMPRIMO® LC Splint), used for the fabrication of 3D printed occlusal splints and surgical guides. Methods96 bar-shaped specimens were 3D printed (Asiga MAX), half of them with a layer thickness of 100 μm (Group A), and half with 50 μm (Group B). Each group was divided in three subgroups based on the post-curing method used: post-curing with light emitting diode (LED) and nitrogen gas; post-curing with only LED; and non-post-curing. Half of the specimens from each subgroup were water-stored for 30 days while the other half was dry-stored (n = 8). Flexural strength and flexural modulus were evaluated. Additional specimens were prepared and divided in the same way for surface hardness (n = 96), fracture toughness, and work of fracture (n = 96). Five specimens were selected from each subgroup for evaluating the degree of conversion (DC). Data were collected and statistically analyzed with 1-way, 2-way ANOVA, and Tukey post-hoc analysis (α = 0.05). ResultsThe 2-way ANOVA showed that the post-curing method and water storage significantly affected the investigated mechanical properties (P < 0.001). The 1-way ANOVA revealed a statistically significant difference among the tested groups on the investigated properties (P < 0.001). After water storage, the 100 μm subgroup post-cured with only LED showed higher flexural strength (51 ± 9) than the 50 μm and 100 μm subgroups that were post-cured with LED in addition to nitrogen gas atmosphere (38 ± 5, 30 ± 3) (p < 0.05). The 50 μm subgroup post-cured with only LED showed the highest significant flexural modulus values (1.7 ± 0.08) (p < 0.05). However, the 50 μm subgroup post-cured with LED plus nitrogen showed significantly higher surface hardness values (p < 0.05) among the investigated groups. The non-post-cured subgroups showed the lowest values, which were significantly different from the other subgroups (p < 0.05). ConclusionThe post-curing method, water storage, and printing layer thickness play a role in the mechanical properties of the investigated 3D Printed occlusal splints material. The combination of heat and light within the post-curing unit can enhance the mechanical properties and degree of conversion of 3D printed occlusal splints. Flexural strength and surface hardness can increase when decreasing printing layer thickness.

Assessment of a Power Chain as a New Dental Trauma Splint and Its Comparison with Two Commonly Used Splinting Materials

Background: Stabilization of luxated, avulsed, and root-fractured teeth is a part of the dental trauma treatment. The aim of the study was to assess the power chain and its comparison with two commonly used splinting materials. Methods: The evaluated splints were a wire-composite splint (WCS) with a diameter of 0.5 mm, a titanium trauma splint (TTS), and a power chain-composite splint (PCS). The splints were all fixed to the labial surfaces of permanent maxillary incisors in 10 human volunteers. The following parameters were measured: tooth mobility with Periotest before and after the splint application and removal, Aproximal Plaque Index (API), Sulcus Bleeding Index (SBI), and time needed to apply and to remove the splint. Each volunteer was also given a visual analogue scale (VAS) questionnaire to assess his/her subjective attitudes to splint materials. Results: The PCS was the most flexible material as it had the lowest horizontal Periotest values. For the two other methods, horizontal splint effects were similar and were also low. The PCS was the fastest to apply and remove and was also the most aesthetic splint. Conclusion: In this experimental study among volunteers, all three tested materials were found suitable for splinting the PCS has some advantages worth it to be further evaluated clinically in trauma patients.

Dental autotransplantation as a treatment alternative. A review of literature

Background: The main problems in oral health are tooth decay and periodontal disease. These pathologies, if left untreated, trigger dental loss. Nowadays we have many treatments to replace dental loss, such as fixed prosthesis, removable prosthesis and dental implants. There is a NO-prosthetic alternative to the implant, tooth autotransplantation. The popularity of implants has led to the fact that transplantation has been overlooked as a treatment option. Aim/Hypothesis: The objective of this poster is to provide information and evidence about dental autotransplantation through a literature review in order to know its indications thoroughly, to discuss the different surgical or endodontic aspects of the current protocol, and its prognosis at short and long term. Materials and Methods: To carry out this work, a review of the literature was performed. A research of articles found in the electronic database of Medline PubMed, in the Cochrane Library and in the digital library of the International University of Catalonia (UIC) was carried out. Eight journals: Dental Traumatology, Endodontic topics, Journal of Endodontics (JOE), Japanese Society of Oral Implantology, Swedish Dental Journal, International Journal of Oral Surgery, European Journal of Endodontics, and Journal of Oral Rehabilitation were also included. This search included publications between the years 1970 and 2017. The keywords were: “tooth”, “dental” and “autotransplantation”. The keywords are registered and included in the MeSH terms of the NCBI. portal. Results: The initial search, using the keyword “tooth autotransplantation” in the electronic databases available, resulted in a total of 390 articles since 1970. All titles and abstracts were analyzed, discarding those that referred to another type of transplants, seeking agreement and relationship with the research topic. Finally 29 articles were included in this review. A total of 1393 autotransplants with open apex and 746 with closed apex are reported, of which 1232 and 597, respectively, were considered successful in a more than 1 year of follow-up. The overall success rate of autotransplants with open apex was 88.5% and that of closed apex was 80%, during a follow-up between 1 and 20 years. The percentage of total success of autotransplants of this review is 86.1%. Other aspects were evaluated: root formation, the splinting materials and the endodontic need. Conclusions and Clinical Implications: According to this literature review we can conclude that dental autotransplantation is a predictable treatment in the short and long term. Teeth with open apex show a success rate of 90.7%, while closed apex 80%. Autotransplantation with open apex presents a better short- and long-term prognosis than a closed apex, revascularizing and allowing full root development in its new alveolus. Closed apex autotransplants require root canal treatment to avoid possible pulpal and periodontal complications.

A New Orthotic Device for Maintaining Neck Flexion Following Tracheal and Cricotracheal Resection.

View Video S1 Laryngoscope, 131:1805–1809, 2021

Dental trauma simulation training using a novel 3D printed tooth model.

Opportunities for dental students to obtain experience in the management of traumatic dental injuries are limited, and most encounter their first trauma patient after graduation. Recognizing this need, the aim of this study was to investigate dental students' experiences of a workshop using a 3D printed tooth. The hypothesis was that the simulation experience with the aid of a 3D printed tooth would enhance their learning experience. A total of 73 students completed a questionnaire after completing dental trauma simulation training. With the aid of a 3D printed avulsed tooth, students constructed a nylon fishing line/GC Fuji Ortho LC splint and a wire/composite splint. Descriptive data analysis was performed to determine the perceptions of the experience gained through the simulation training. Over a third of the participants (38%) agreed that the dental trauma simulation training felt realistic. Additionally, 59% agreed and 22% strongly agreed that they felt engaged in the learning activity. Furthermore, 81% agreed/strongly agreed that they felt more prepared to treat patients who present with a traumatic dental injury in the future, and 93% agreed/strongly agreed that it added value to their training when compared to relying solely on didactic training. After the use of splinting materials, 38% of participants disagreed/strongly disagreed that nylon fishing line/GC Fuji Ortho Splint was easier to place than wire/composite splint. However, 52% of participants found that it was easier to remove the GC Fuji Ortho Splint. Overall, 93% of participants agreed/strongly agreed that dental trauma simulation training should be a mandatory component of the dental curriculum. The use of dental trauma simulation training offers an additional means of learning about dental traumatology. Simulation has the potential to be used as an adjunct tool in the learning and management of dental traumatology as it has demonstrated increased student engagement, but limitations still remain.

Two-body wear of occlusal splint materials against different antagonists

BackgroundThis study aimed to demonstrate that the material of the occlusal splint can be chosen according to the needs of individual patients and contribute to the knowledge of the wear rate of these materials.MethodsIn this study, four occlusal splint materials (Sr Ivocap Heat Cured, Valplast, SR Ivocap Elastomer and Eclipse) and three antagonists (natural tooth enamel, inCoris TZI and IPS e.max Press ceramic materials) were used. Each wear test was performed using a chewing simulator (n = 16; test load: 50 N; number of cycles: 10,000, 20,000 and 30,000; continuous rinsing with water at 30 °C for the wet condition). The Shapiro Wilk test was used for normal distribution suitability. Antagonist on average wear quantities both main effects and interactions of material, cycle and condition factors were investigated by Univariate variance analysis. Multiple comparisons were examined using the Games-Howell test.ResultsThere was a statistically significant effect of the difference in materials on the amount of wear (p < 0.001). Furthermore, there was a statistically significant difference among the mean values of all materials (p > 0.001). The highest mean value was obtained with Eclipse (0,318 μm3), and the lowest mean value was obtained with Valplast (0,134 μm3).ConclusionOur study found differences in the in vitro wear rate among various occlusal splint materials.

Technical note on introducing a digital workflow for newborns with craniofacial anomalies based on intraoral scans - part II: 3D printed T\xfcbingen palatal plate prototype for newborns with Robin sequence

BackgroundOrthodontic treatment of newborns and infants with Robin-Sequence using the Tübingen Palatal Plate (TPP) is a complex procedure that could benefit from simplification through digitalization. The design of the velar extension (spur) and the palatal base determines the success of the treatment. Therefore, a prototype must be produced and inserted under endoscopic supervision in order to determine the appropriate shape, length and position of the spur. This technical note demonstrates a fully digital workflow for the design and manufacturing of a functional TPP prototype, based on an intraoral scan. This prototype can be altered and individualized digitally for each patient. After the shape and position of the spur have been optimized, the prototype is duplicated using a silicone mold. Then the definitive TPP is manufactured and inserted. We aim to present a workflow which facilitates the fitting procedure and does not require a conventional impression or a physical model to create the appliance.MethodsAs described in part I of this series, the intraoral scan is performed using the 3Shape TRIOS3 scanner and its corresponding acquisition software. The virtual model is rendered in the 3Shape ortho appliance designer and the base of the palatal plate is designed in the 3Shape dental designer. The palatal plate and the virtual model are then imported into Autodesk Meshmixer and a standardized spur is positioned and merged with the base. The TPP is exported in Standard Tessellation Language (STL) format and manufactured on a W2P Solflex 170 DLP printer using VOCO VPrint Splint material (MDR Class IIa).ResultsBased on an intraoral scan, the TPP prototype could be successfully manufactured and proved suitable for the patients’ treatment.ConclusionThe new digital workflow for the design of the TPP can been successfully implemented into daily clinical routine in our facility. Patients could be alleviated from having to undergo conventional impression procedures and fitting of the TPP could be facilitated by producing multiple functional prototypes for endoscopic evaluation. Through rapid prototyping, the expenditure of the fitting process was reduced, which makes the TPP therapy more efficient and accessible to a wider range of clinicians.

Disastrous Complications Following Rhinoplasty: Soft Tissue Defects

Rhinoplasty has become one of the most frequently performed worldwide aesthetic procedures thanks to the successful results obtained by plastic surgeons. In this study, soft tissue defects, encountered as an undesirable and fearsome complication following rhinoplasty, its causes and precautions are presented by authors. Eight patients operated between December 2015 and December 2018 were enrolled in this study. According to the causes of soft tissue defects observed following rhinoplasty; patients were examined in 5 groups consisting of excessive subcutaneous adipose tissue defatting, improper dissection plane, compression of cast, splint and strip materials, pressure applied to skin by cartilage grafts, and overresection. Herein, while subcutaneous excessive defatting and intense cigarette smoking was responsible of the necrosis in the first patient we defined, high pressure on skin due to tight bandaging or external splint materials lead to skin necrosis in our patients 2, 3, and 4. The 5th and 6th patients were candidates of a revision rhinoplasty; however, both resulted with necrosis probably by reason of inaccurate dissection and/or possible diminished vascularity by previous rhinoplasty operations. In the 8th patient, necrosis was observed due to the compression of the bulky autologous cartilage graft used in the skin. In conclusion, skin necrosis is a rare but bothersome complication of rhinoplasty. The importance of atraumatic techniques and appropriate dissection plane during the rhinoplasty operation as well as the importance of the effect and control of the postoperative applied splint and bandage materials is so obviously seen.

638 Auricular Splinting Following Severe Facial Burn Injury and Reconstruction

Abstract Introduction With a severe facial burn, injury often involves the ear(s) resulting in damage or loss which may require reconstruction. In consideration of the functional and psychological effect that loss of a defined ear lobe may entail, reconstruction is an important consideration for the burn survivor. Two cases described in detail with illustration will highlight an auricular contracture release; one with V-Y Advancement and the other with a transposition flap. Preservation of the auricular reconstruction is accomplished by implementing necessary splinting. The auricular splint fabricated was made from a combination of silicone and low-temperature thermoplastic material. A step-by-step process will illustrate the needed materials and techniques to fabricate a worthy splint in order to preserve what was surgically achieved. The splint maintains the space between the ear and head to properly position and prevent contracture through the healing and scar maturation process. It secured with a one-inch head band that is sublime enough to foster compliance with wear. The auricular splint material also serves as scar management with the many proven benefits of silicone. Methods Two case studies are reviewed with auricular contractures that required release and reconstruction. The auricular splints were fabricated to stabilize and preserve the reconstructed ear lobe. The wear schedule was intermittent during the day and overnight in combination with scar massage. The patients reported good compliance with wear and stability of splint position with overnight wear. Skin integrity was not compromised with overnight or intermittent wear. The splint fabrication process is reviewed and illustrated with a simplistic innovative end result that is user friendly. Results Surgical reconstruction was required following development of auricular contractures and partial loss. With post-operative bandage removal and wound closure, positioning was a necessary consideration to preserve post-surgical reconstruction. Conclusions In conclusion, the peri-auricular splint is fabricated with low temperature splinting material lined in silicone proved worthy for effective positioning and reported comfort with wear. Effective splinting is necessary for the preservation of surgical reconstruction and to prevent contracture from sabotaging surgical efforts. Applicability of Research to Practice Consideration of fabrication of silicone auricular splints to preserve the accomplishments of auricular surgical reconstruction.

Integration of Thermoplastic Splinting for Palatal Stabilization and Hemorrhage Control in Trauma and Oncology

Traumatic injury and pathological palatal defects can present a challenge in both acute care and clinical settings. Due to the vascularity of the maxillary region, thin mucosa, and difficulty of isolated stabilization, effective management and treatment planning are paramount to long-term patient outcomes. Palatal and dentoalveolar splinting has been widely used to manage palatal defects both intraoperatively and postsurgically with acrylic or polyvinyl chloride vacuum form materials as the basis for splint fabrication. We propose a method for palatal stabilization and hemorrhage control through the use of thermoplastic splinting material.

Comparison the Tensile and Transverse Strength between the Biostar Machine Sheets and Heat-Cure Acrylic Resin

The Biostar foils (Duran ® ) used a substitute material to the heat cure acrylic in splint therapy. Dentists often prefer to make and deliver a splint shortly (1 to 2 hours) rather than having them fabricated in a laboratory when treating temp or mandibular joint disorders patients. The Duran ® became widely used and popular, the wear resistant and strength of the splint materials are the most important properties that improve the splint therapy. The study compared the tensile and transverse strength of the (Duran ® ) Biostar foil and heat-cure acrylic resin. 40 samples were constructed in total, 20 samples for heat cure acrylic resin and 20 samples for Biostar foils. The result showed Duran sheets have the greatest mean values of transverse strength and tensile strength compared to heat cured resin