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Edema

Treatment of edema consists of reversingthe underlying disorder (if possible),

restricting dietary sodium to minimize fluidretention, and, usually, employing diuretictherapy.3 This approach highlights the needto establish a diagnosis and to use

nonpharmacologic approaches whenappropriate, rather than resorting to theimmediate use of diuretics.

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Mobile Teeth

Consequently, patients diagnosed withincreased toothmobilitymayneedonlyan

occlusal equilibration and, perhaps,conventional splint therapy. Thoseindividuals diagnosed with increasing toothmobility must first receive periodontaltherapy. Treatment should include an

occlusal analysis and equilibration, ifneeded, followed by a reevaluation for extraction or splintingof the affected teeth.

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Indication

One obvious indication for splinting is

when a patient presents withmultipleteeththat have become mobile as a

direct result of gradual alveolar bone

loss, a reduced periodontium.

Asecond indication for splintingiswhen the patient presents with

increased tooth mobility

accompanied bypain or discomfort in

the affectedteeth.

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ContraindicationSplinting teeth is not recommended if occlusal

Stability and optimal periodontal conditions

cannotBe obtained.

Any tooth mobility present before treatmentmust be reduced by means of occlusalequilibration combined with periodontaltherapy; otherwise if the tooth involved does not

respond, it must be extracted prior toproceeding from

provisional restorations to definitive treatment.

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Type of splintsThe Provisional Splints

As the name alone implies, the objective of aprovisional splint is to absorb occlusal forces andstabilize the teeth for a limited amount of time.Provisional splints can be useful adjuncts tomany different types of treatment. They provide

insight into whether or not stabilization of theteeth provides any benefit before anyirreversible definitive treatment is even initiated.

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Provisional splints can either be placedexternally or internally. External splints

typically are fabricated using ligature wires,nightguards, interim fixed prostheses, andcomposite resin restorative materials.Internalsplints, on the other hand, arefabricated using composite resin restorative

material with or without wire or fiber inserts.Most provisionalsplints are made using someform o fexternal support in their design.

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Provisional splinting can also be used when

treating periodontally compromisedpatients with conventional fixedprosthodontics. An interim restoration notonlycan improve esthetics, it can restore theocclusal scheme to be incorporated into

any definitive prostheses.

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Definitive Splints

Definitive splints are placed only after the completion of

periodontal therapy and once occlusal stability has beenachieved in order to eliminate or prevent occlusal trauma,increase functional stability, and improve esthetics on a long-term basis.

Such treatment includes conventional fixed prosthesesbecause they provide definitive rigidity and are better able to

control and direct occlusal forces than removable splints. For partially edentulous patients, the definitive splint of choice is acomplete coverage fixed partial denture. Fixed partialdentures not only stabilize the affected teeth, but theyalsoimprove esthetics and may even prevent further tooth loss.