When does it make sense to splint teeth?

PD Dr. Kristina Bertl, PhD MSc MBA

Periodontitis and the related attachment loss inevitably lead to increased tooth mobility after a certain period of time. This increased tooth mobility often makes patients aware that “something is not right,” but for many patients it is also a very unpleasant side effect of periodontal disease and one which can make them feel as if they are losing their teeth.

When does it make sense to splint teeth?

In light of this, it makes sense to consider splinting teeth. There is literature which discusses both the advantages and disadvantages of teeth splinting. Examples of the advantages cited include, easier subgingival cleaning and improved quality of life relating to the mouth, while disadvantages included increased difficulty in home cleaning and the absence of possible correction of malpositioned teeth caused by periodontitis by reducing inflammation.

If you do opt to splint mobile teeth, this, in turn, raises the question of when is the best time to do so? A group of researchers from Germany (Sonnenschein et al. 2021, 2022) have been addressing this question as part of a randomised clinical study. In the study, 34 periodontitis patients had lower front teeth with a mobility grade II–III and bone loss ≥ 50% splinted, either prior to non-surgical periodontal therapy or seven months afterwards. Interestingly, one year after non-surgical periodontal therapy, there were no significant differences between the two groups. Only a slight tendency toward better clinical results in the group before treatment could be described, although no clear recommendation should be based on this tendency.

In light of this, it can be summarised that the decision as to if and when teeth should be splinted should be discussed individually with the patient. Factors such as the patient’s skill with home oral hygiene and the extent to which the mobile teeth are affecting their quality of life relating to the mouth play an important role here.

References

1. Sarah K Sonnenschein, Philipp Ziegler, Antonio Ciardo, Maurice Ruetters, Johannes Krisam, Ti-Sun Kim. The impact of splinting mobile mandibular incisors on Oral Health-Related Quality of Life – preliminary observations from a randomized clinical trial. J Clin Periodontol. 2021 Jun;48(6):816-825. doi: 10.1111/jcpe.13454. Sarah K Sonnenschein, Antonio Ciardo, Samuel Kilian, Philipp Ziegler, Maurice Ruetters, Marcia Splindler, Ti-Sun Kim. The impact of splinting timepoint of mobile mandibular incisors on the outcome of periodontal treatment-preliminary observations from a randomized clinical trial. Clin Oral Investig. 2022 Jan;26(1):921-930. doi: 10.1007/s00784-021-04075-4.