ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Splinting of Mobile Teeth Improves Outcomes in Guided Tissue Regeneration
Clinical Question In patients with mobile teeth and associated vertical bony defects, does splinting the teeth before guided tissue regeneration provide a better clinical outcome than splinting after regeneration?
Clinical Bottom Line When attempting guided tissue regeneration on a mobile tooth, splinting of mobile tooth will improve clinical outcomes.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 11218508Schulz A./200045 patients with mobile teethRandomized Controlled Trial
Key resultsSplinting of mobile teeth to at least two adjacent rigid teeth prior to bone replacement graft surgery showed a pocket depth (PD) reduction of 5.4 mm and clinical attachment level (CAL) gain of 5.1 mm. Teeth that were splinted 1 week after surgery had PD reduction of 4.3 mm and CAL gain of 3.5 mm. Non-splinted teeth had 2.2 mm of PD reduction and 1.7 mm of CAL gain.
Evidence Search splinting[All Fields] AND ("tooth"[MeSH Terms] OR "tooth"[All Fields] OR "teeth"[All Fields]) AND periodontal[All Fields] AND ("reconstructive surgical procedures"[MeSH Terms] OR ("reconstructive"[All Fields] AND "surgical"[All Fields] AND "procedures"[All Fields]) OR "reconstructive surgical procedures"[All Fields] OR "reconstruction"[All Fields])
Comments on
The Evidence
The article suggests that providing more stability to mobile teeth when attempting periodontal bone grafting will provide better pocket depth reduction and clinical attachment gain. There are minimal differences between splinting before bone graft versus after graft. However, to provide the patient with the best possible outcome, the practitioner should consider splinting before guided tissue regeneration. With only one article addressing this topic, the data are limited; further studies are needed to evaluate the relationship between tooth mobility and periodontal bone grafting surgery.
Applicability This study evaluated tooth mobility and success of bone replacement grafting with splinting at various time points. Only calcium carbonate bone replacement graft material was used in the study; however, the concepts presented in the article may hold true with other bone replacement graft materials.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords Splinting; bone graft; guided tissue regeneration; periodontal reconstruction; periodontics
ID# 3100
Date of submission: 11/01/2016spacer
E-mail Trobough@uthscsa.edu
Author Kyle Trobough, DDS
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Brian Mealey DDS, MS
Faculty mentor/Co-author e-mail mealey@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
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Comments on the CAT
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