Case Clinical technique

Class III can't splint lingual --> Place bucally

• Position (check the occlusion) Normally = Can't splint bucally so splint labially
and extent of splint (identify the number of teeth to be splinted)

• Isolation with rubber dam- desirable

• Shade selection

• Tooth preparation if necessary

• Sizing and trimming of the reinforcement material

• Acid etching of the prepared teeth

• Application of bond layer
• Placement of the flowable composite and the reinforcement material
• Final polymerization of the fibre

• Completing the splint with regular composite, if necessary

• Occlusal adjustment/polishing/ID brush access

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 Case Clinical technique

Extent of splint (identify the number of teeth to be splinted)

Number of mobile teeth and the severity of the mobility,

The individual tooth position and location of the teeth along the dental arch

To include terminal stable teeth

Cross-arch splint

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 Case Clinical technique

Isolation

Same as for conventional bonding dentistry

e.g. for lower anterior teeth (rubber dam first premolar – first premolar)
Clamp is not necessary, place wedges or silicone to compensate for bone loss)

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 Case Clinical technique
Tooth preparation, if necessary
Advantage: aesthetic, less bulky, easy to pack material

The groove position and dimensions:

Maxilla – incisal third of the labial surface
Mandible – middle third of the lingual surface, above cingulum

Thick blunt tapering fissure bur at 90º to the tooth surface

2/3 of mesio-distal length

Cross-arch splint

Depth = 0.5-0.75mm
Width = depends on the width of the fibre

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 Clinical technique
Sizing and trimming
Use dental floss or a piece of foil to measure the length of the fibres

Glass fibres

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 Clinical technique

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 Case Clinical technique

Etching and bonding of the tooth surface

Etching for 45-60 sec, bonding and polymerization 20 sec

Flowable composite first layer - no polymerization

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 Case Clinical technique
Adaptation of the fibres and subsequent spot application
and bonding of the tooth surface

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 Case Clinical technique

Completing the splint with composite (flowable), trimming and polishing

Glass fibres must be covered with a layer of composite at least 1-2mm of thickness

The fibre should be fully covered with composite

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 Case Clinical technique

Occlusal check and adjustment

Balanced occlusal load should be distributed to splinted teeth

Final splint

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Maintenance of splints
Interdental calibration and hygiene training

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 Case Clinical technique
The aesthetic (labial) splint

2-3 layers of net are Layer #1

placed over each other

Layer #2

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 Case Clinical technique
The aesthetic (labial) splint

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 Case Clinical technique
Provisional surface retained (adhesive) anterior bridge
with extracted tooth as a pontic

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 Provisional surface retained (adhesive) bridge
with extracted tooth as a pontic

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