Dental Travmada Kullanılan Splintler
Özet
Bu bölümde travmatik dental yaralanmaların tedavisinde önemli bir yer tutan dental splintler kapsamlı bir şekilde ele alınmaktadır. Travmatik dental yaralanmalar; diş sert dokuları, periodontal dokular, alveol kemiği ve çevre yumuşak dokuları etkileyebilen kompleks klinik durumlar olup doğru tanı ve uygun tedavi planlaması büyük önem taşır. Bu yaralanmaların yönetiminde dişlerin stabilizasyonu ve periodontal iyileşmenin desteklenmesi amacıyla splint uygulamaları sıklıkla tercih edilmektedir. Bölümde splintlerin kullanım amaçları, biyomekanik özellikleri ve klinik endikasyonları ayrıntılı olarak açıklanmaktadır. Ayrıca farklı travma tiplerinde önerilen splint türleri, splint materyalleri ve uygulama süreleri güncel literatür ve uluslararası kılavuzlar doğrultusunda ele alınmaktadır. Rijit ve esnek splintler arasındaki farklar, periodontal ligament iyileşmesi üzerindeki etkileri ve klinik başarı açısından önem taşıyan faktörler de tartışılmaktadır. Ayrıca splint uygulama teknikleri, klinik uygulama basamakları ve takip sürecinde dikkat edilmesi gereken noktalar sunulmaktadır. Bu bölümün amacı, travmatik dental yaralanmaların tedavisinde splint kullanımına ilişkin güncel bilgileri derlemek ve klinisyenlere tanı, tedavi planlaması ve klinik uygulamada rehberlik etmektir.
This chapter provides a comprehensive overview of dental splints used in the management of traumatic dental injuries (TDIs). TDIs are complex clinical conditions that may affect dental hard tissues, the periodontal ligament, alveolar bone, and surrounding soft tissues. Accurate diagnosis and appropriate treatment planning are essential for successful management. Stabilization of traumatized teeth using splints plays a crucial role in maintaining tooth position and supporting periodontal healing following trauma. The chapter explains the indications, biomechanical principles, and clinical purposes of splinting. Different types of splints, commonly used materials, and recommended splinting durations for various types of traumatic injuries are presented in accordance with current literature and international guidelines. The differences between rigid and flexible splints and their effects on periodontal ligament healing are also discussed, highlighting factors that influence clinical outcomes. In addition, practical aspects of splint application, clinical procedures, and important considerations during the follow-up period are described. The aim of this chapter is to summarize current knowledge on splinting in dental trauma and to provide clinicians with guidance for diagnosis, treatment planning, and clinical management.
Referanslar
. Filippi A, Tschan J, Pohl Y, Berthold H, Ebeleseder K. A retrospective classification of tooth injuries using a new scoring system. Clinical Oral Investigations. 2000;4(3):173-175. doi:10.1007/s007840000056.
Ebeleseder K. A suggestion of a new classification system of traumatic dental injuries. Endodontics & Dental Traumatology. 1994;10(1):39-42.
Andreasen JO, Andreasen FM, Andersson L. Textbook and color atlas of traumatic injuries to the teeth. John Wiley & Sons; 2018.
Levin L, Day PF, Hicks L, O’Connell A, Fouad AF, Bourguignon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: General introduction. Dental Traumatology. 2020;36(4):309-313. doi:10.1111/edt.12574.
Fouad AF, Abbott PV, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dental Traumatology. 2020;36(4):331-342. doi:10.1111/edt.12573.
Bourguignon C, Cohenca N, Lauridsen E, Flores MT, O’Connell AC, Day PF, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dental Traumatology. 2020;36(4):314-330. doi:10.1111/edt.12578.
Andreasen FM, Andreasen JO. Diagnosis of luxation injuries: the importance of standardized clinical, radiographic and photographic techniques in clinical investigations. Dental Traumatology. 1985;1(5):160-169.
Day PF, Flores MT, O’Connell AC, Abbott PV, Tsilingaridis G, Fouad AF, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dental Traumatology. 2020;36(4):343-359. doi:10.1111/edt.12576.
von Arx T. Splinting of traumatized teeth with focus on adhesive techniques. Journal of the California Dental Association. 2005;33(5):409-416.
Ayhan E. Ön bölge dental travmalar ve tedavilerinde kullanılan fiksasyon yöntemlerinin klinik araştırması [Doktora tezi]. İzmir: Ege Üniversitesi Sağlık Bilimleri Enstitüsü; 1999.
Malmgren B, Andreasen JO, Flores MT, Robertson A, DiAngelis AJ, Andersson L, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dental Traumatology. 2012;28(3):174-182. doi:10.1111/j.1600-9657.2012.01146.x.
Trope M. Avulsion of permanent teeth: theory to practice. Dental Traumatology. 2011;27(4):281-294. doi:10.1111/j.1600-9657.2011.01003.x.
Andersson L, Andreasen JO, Day P, Heithersay G, Trope M, DiAngelis AJ, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dental Traumatology. 2012;28(2):88-96. doi:10.1111/j.1600-9657.2012.01125.x.
Andreasen JO, Bakland LK, Flores MT, Andreasen FM, Andersson L. Travmatik dental yaralanmalar el kitabı. İstanbul: Elma Basım; 2014.
Pozzobon MH, de Sousa Vieira R, Alves AMH, Reyes-Carmona J, Teixeira CS, de Souza BDM, et al. Assessment of pulp blood flow in primary and permanent teeth using pulse oximetry. Dental Traumatology. 2011;27(3):184-188. doi:10.1111/j.1600-9657.2011.00976.x.
Andreasen JO, Lauridsen E, Gerds TA, Ahrensburg SS. Dental Trauma Guide: a source of evidence-based treatment guidelines for dental trauma. Dental Traumatology. 2012;28(5):345-350. doi:10.1111/j.1600-9657.2011.01059.x.
Robertson A, Andreasen FM, Andreasen JO, Noren JG. Long-term prognosis of crown-fractured permanent incisors: the effect of stage of root development and associated luxation injury. International Journal of Paediatric Dentistry. 2000;10(3):191-199. doi:10.1046/j.1365-263x.2000.00191.x.
Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, et al. Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth. Endodontic Topics. 2006;14(1):102-110. doi:10.1111/j.1600-9657.2007.00592.x.
Keçeci AD. Sporcularda dental travma. Egzersiz. 2007;1(1):6-15.
Andreasen JO. Traumatic injuries of the teeth. Copenhagen: Munksgaard; 1972.
Kahler B, Hu JY, Marriot-Smith C, Heithersay G. Splinting of teeth following trauma: a review and a new splinting recommendation. Australian Dental Journal. 2016;61(Suppl1):59-73. doi:10.1111/adj.12398.
Sevinç D. Çocuk diş hekimliğinde travma hastalarında kullanılan splint tipleri [Bitirme tezi]. İstanbul: İstanbul Üniversitesi; 2020.
Altan H, Coşgun A. Çocuk diş hekimliğinde travma hastalarında kullanılan splint tipleri. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi. 2016;26(4):82-87.
Filippi A, von Arx T, Lussi A. Comfort and discomfort of dental trauma splints: a comparison of a new device (TTS) with three commonly used splinting techniques. Dental Traumatology. 2002;18(5):275-280.
Garg N, Garg A. Textbook of endodontics. Boydell & Brewer Ltd; 2010.
Andreasen JO, Andreasen FM, Mejare I, Cvek M. Healing of 400 intra-alveolar root fractures. 2. Effect of treatment factors such as treatment delay, repositioning, splinting type and period and antibiotics. Dental Traumatology. 2004;20(4):203-211.
Özbaş H, Öztürk E, Kocaelli H. Travmatik diş yaralanmalarında splint uygulamaları. Journal of Istanbul University Faculty of Dentistry. 41(4):45-50.
Oikarinen K. Comparison of the flexibility of various splinting methods for tooth fixation. International Journal of Oral and Maxillofacial Surgery. 1988;17(2):125-127. doi:10.1016/S0901-5027(88)80166-8.
King BJ, Christensen BJ. Hybrid arch bars reduce placement time and glove perforations compared with Erich arch bars during the application of intermaxillary fixation: a randomized controlled trial. Journal of Oral and Maxillofacial Surgery. 2019;77(6):1228.e1-1228.e8. doi:10.1016/j.joms.2019.01.030.
Bathla S. Periodontics revisited. JP Medical Ltd; 2011.
Zaim SB, Kahvecioğlu F. Evaluation of dental trauma splints in early permanent dentition through finite element analysis. Applied Sciences. 2025;15(19):10307. doi:10.3390/app151910307.
Rao A, Rao A, Shenoy R. Splinting – when and how? Dental Update. 2011;38(5):341-346. doi:10.12968/denu.2011.38.5.341.
Jacob J, Nandlal B. Bond strength of wire-composite resin interface of dental splints using different wire surface treatments: an in vitro study. Endodontology. 2003;15(1):2-6. doi:10.4103/0970-7212.351405.
Referanslar
. Filippi A, Tschan J, Pohl Y, Berthold H, Ebeleseder K. A retrospective classification of tooth injuries using a new scoring system. Clinical Oral Investigations. 2000;4(3):173-175. doi:10.1007/s007840000056.
Ebeleseder K. A suggestion of a new classification system of traumatic dental injuries. Endodontics & Dental Traumatology. 1994;10(1):39-42.
Andreasen JO, Andreasen FM, Andersson L. Textbook and color atlas of traumatic injuries to the teeth. John Wiley & Sons; 2018.
Levin L, Day PF, Hicks L, O’Connell A, Fouad AF, Bourguignon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: General introduction. Dental Traumatology. 2020;36(4):309-313. doi:10.1111/edt.12574.
Fouad AF, Abbott PV, Tsilingaridis G, Cohenca N, Lauridsen E, Bourguignon C, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dental Traumatology. 2020;36(4):331-342. doi:10.1111/edt.12573.
Bourguignon C, Cohenca N, Lauridsen E, Flores MT, O’Connell AC, Day PF, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations. Dental Traumatology. 2020;36(4):314-330. doi:10.1111/edt.12578.
Andreasen FM, Andreasen JO. Diagnosis of luxation injuries: the importance of standardized clinical, radiographic and photographic techniques in clinical investigations. Dental Traumatology. 1985;1(5):160-169.
Day PF, Flores MT, O’Connell AC, Abbott PV, Tsilingaridis G, Fouad AF, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dental Traumatology. 2020;36(4):343-359. doi:10.1111/edt.12576.
von Arx T. Splinting of traumatized teeth with focus on adhesive techniques. Journal of the California Dental Association. 2005;33(5):409-416.
Ayhan E. Ön bölge dental travmalar ve tedavilerinde kullanılan fiksasyon yöntemlerinin klinik araştırması [Doktora tezi]. İzmir: Ege Üniversitesi Sağlık Bilimleri Enstitüsü; 1999.
Malmgren B, Andreasen JO, Flores MT, Robertson A, DiAngelis AJ, Andersson L, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 3. Injuries in the primary dentition. Dental Traumatology. 2012;28(3):174-182. doi:10.1111/j.1600-9657.2012.01146.x.
Trope M. Avulsion of permanent teeth: theory to practice. Dental Traumatology. 2011;27(4):281-294. doi:10.1111/j.1600-9657.2011.01003.x.
Andersson L, Andreasen JO, Day P, Heithersay G, Trope M, DiAngelis AJ, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 2. Avulsion of permanent teeth. Dental Traumatology. 2012;28(2):88-96. doi:10.1111/j.1600-9657.2012.01125.x.
Andreasen JO, Bakland LK, Flores MT, Andreasen FM, Andersson L. Travmatik dental yaralanmalar el kitabı. İstanbul: Elma Basım; 2014.
Pozzobon MH, de Sousa Vieira R, Alves AMH, Reyes-Carmona J, Teixeira CS, de Souza BDM, et al. Assessment of pulp blood flow in primary and permanent teeth using pulse oximetry. Dental Traumatology. 2011;27(3):184-188. doi:10.1111/j.1600-9657.2011.00976.x.
Andreasen JO, Lauridsen E, Gerds TA, Ahrensburg SS. Dental Trauma Guide: a source of evidence-based treatment guidelines for dental trauma. Dental Traumatology. 2012;28(5):345-350. doi:10.1111/j.1600-9657.2011.01059.x.
Robertson A, Andreasen FM, Andreasen JO, Noren JG. Long-term prognosis of crown-fractured permanent incisors: the effect of stage of root development and associated luxation injury. International Journal of Paediatric Dentistry. 2000;10(3):191-199. doi:10.1046/j.1365-263x.2000.00191.x.
Flores MT, Andersson L, Andreasen JO, Bakland LK, Malmgren B, Barnett F, et al. Guidelines for the management of traumatic dental injuries. I. Fractures and luxations of permanent teeth. Endodontic Topics. 2006;14(1):102-110. doi:10.1111/j.1600-9657.2007.00592.x.
Keçeci AD. Sporcularda dental travma. Egzersiz. 2007;1(1):6-15.
Andreasen JO. Traumatic injuries of the teeth. Copenhagen: Munksgaard; 1972.
Kahler B, Hu JY, Marriot-Smith C, Heithersay G. Splinting of teeth following trauma: a review and a new splinting recommendation. Australian Dental Journal. 2016;61(Suppl1):59-73. doi:10.1111/adj.12398.
Sevinç D. Çocuk diş hekimliğinde travma hastalarında kullanılan splint tipleri [Bitirme tezi]. İstanbul: İstanbul Üniversitesi; 2020.
Altan H, Coşgun A. Çocuk diş hekimliğinde travma hastalarında kullanılan splint tipleri. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi. 2016;26(4):82-87.
Filippi A, von Arx T, Lussi A. Comfort and discomfort of dental trauma splints: a comparison of a new device (TTS) with three commonly used splinting techniques. Dental Traumatology. 2002;18(5):275-280.
Garg N, Garg A. Textbook of endodontics. Boydell & Brewer Ltd; 2010.
Andreasen JO, Andreasen FM, Mejare I, Cvek M. Healing of 400 intra-alveolar root fractures. 2. Effect of treatment factors such as treatment delay, repositioning, splinting type and period and antibiotics. Dental Traumatology. 2004;20(4):203-211.
Özbaş H, Öztürk E, Kocaelli H. Travmatik diş yaralanmalarında splint uygulamaları. Journal of Istanbul University Faculty of Dentistry. 41(4):45-50.
Oikarinen K. Comparison of the flexibility of various splinting methods for tooth fixation. International Journal of Oral and Maxillofacial Surgery. 1988;17(2):125-127. doi:10.1016/S0901-5027(88)80166-8.
King BJ, Christensen BJ. Hybrid arch bars reduce placement time and glove perforations compared with Erich arch bars during the application of intermaxillary fixation: a randomized controlled trial. Journal of Oral and Maxillofacial Surgery. 2019;77(6):1228.e1-1228.e8. doi:10.1016/j.joms.2019.01.030.
Bathla S. Periodontics revisited. JP Medical Ltd; 2011.
Zaim SB, Kahvecioğlu F. Evaluation of dental trauma splints in early permanent dentition through finite element analysis. Applied Sciences. 2025;15(19):10307. doi:10.3390/app151910307.
Rao A, Rao A, Shenoy R. Splinting – when and how? Dental Update. 2011;38(5):341-346. doi:10.12968/denu.2011.38.5.341.
Jacob J, Nandlal B. Bond strength of wire-composite resin interface of dental splints using different wire surface treatments: an in vitro study. Endodontology. 2003;15(1):2-6. doi:10.4103/0970-7212.351405.
