Splinting traumatic dental injuries

The article entitled Dental Trauma Part 1: Acute Management of Luxation/Displacement Injuries Management was informative and provided readers with a comprehensive understanding of the management and sequelae of such injuries.¹ Interestingly the authors only mention splinting with composite and 0.018” stainless steel wire. The online dental trauma guide alludes to other possible splints to use in such instances, ‘acid-etch flexible resin splints, acid-etch-wire composite splints, acid-etch composite nylon line splints, acid-etch orthodontic wire splints and titanium trauma splints’.²

There doesn't appear to be any clear consensus on the exact type of splint to use according to the IADT trauma guidelines and online Dental Trauma Guide.^3,2 Clinicians have their own preferences, depending on their experience, availability for specialist input, place of work or department, availability of materials and availability of nursing staff for assistance. Having worked in Accident and Emergency, as well as on a Paediatric Dental Department, I have treated numerous patients with traumatic dental injuries requiring immediate management. The splints of choice proving to be the most effective in the units where I have worked have been constructed using orthodontic brackets and 0.014” NiTi wire. There are a number of advantages to using orthodontic brackets; ease of placement (especially if working single handily in A&E), the ability to encourage orthodontic movement if required, removal (and replacement if needed) of the wire for mobility and sensibility testing, and quick removal of brackets provided debonding pliers are available.