Clinical skills session 2

Question 1

What is a splint?

Answer 1

passive divide than immobilised a traumatised permanent tooth in the correct anatomical position, preventing further trauma and allowing healing

Question 2

how us the time the splint is left in situ decided

Answer 2

nature of the injury

Question 3

composite and wire splint for a traumatised anterior permanent tooth

Answer 3

0.4mm stainless steel cut
form a safety handle
curve the wire to the curvature of the maxillary arch
cut the handle at junction between safety handle and the splint
isolate teeth and dry teeth
etch and bond labial surfaces
place composites on abutment teeth securing splint
apply composite to traumatised tooth
place composite superficially over the wire
ask the patient if any sharp edges

Question 4

completed splint characteristics

Answer 4

passive, less than 2mm off tooth surface, conforming to the dental arch curvature, not overlying gingival, flexible, no unnecessary plaque traps or overhangs, no sharp edges

Question 5

purpose of splint

Answer 5

to stabilise the teeth, allowing time for the PDL damage to repair

Question 6

measurement of stainless steel wire

Answer 6

0.4mm or 4 fingers width

Question 7

methods to remove splint

Answer 7

1. using rotary instruments
2. orthodontic bracket removing tools (composite placed as small cubes)

Question 8

How to form a safety handle

Answer 8

binding wire 1/3 from mesial end

Question 9

method 1 removal of composite

Answer 9

slow speed and tungsten carbide debond bur to remove the composite attached to the traumatised tooth first
assess degree of mobility of traumatised tooth
remove composite from one abutment tooth
remove composite from final abutment tooth
dispose spint in sharps bin
use composite finishing bur or orthodontist debunking burs to remove residual composite

Question 10

method 2 removal of splint

Answer 10

release composite from traumatised tooth first
assess mobility
bracket removers to denote one of the abutment teeth
before debunking final abutment tooth, ensure splint is grasped with locking instruments
residual composite should be removed with composite finishing burs or orthodontic debonding burs

Question 11

points to consider to definitive restoration of traumatised permanent tooth

Answer 11

bulbosity of composite bandage, important to not disturb plural dressing or composite placed over the actual fractured incisor edge or dentinal tubules