ORAL REHABILITATION : Fixed Orthodontic Appliances in the Management of Severe Dental Trauma

Dental trauma is common in the pediatric population, affecting approximately 1 in 3 children. 

Trauma to the mixed dentition can be complicated because of the varying stages of tooth eruption and root development. 


Luxation injuries to the dentition are classified according to resulting tooth mobility and displacement. These injuries include concussion, subluxation, lateral luxation, extrusion, intrusion and avulsion. 

Potential complications include pulp necrosis, pulp canal obliteration, internal and external root resorption, cessation of root development, ankylosis and loss of marginal bone. 

The goal of management is to mitigate these complications and prevent tooth loss. Splinting is the principle method for treating dental trauma, as splinting stabilizes the traumatized teeth, maintaining them within the periodontium, precluding further trauma and facilitating periodontal healing. 

Splinting is indicated when a tooth is displaced, avulsed or excessively mobile or for the comfort of the patient. 

Ideally, the splinting procedure should be simple, fast and atraumatic. The splint should provide adequate stabilization and fixation; be esthetic, hygienic, passive and non-irritating; not interfere with occlusion; and allow for endodontic access, physiological mobility and easy assessment of teeth on follow-up visits. 

Many splinting methods and materials have been described, including suture splints, direct resin splints, wire-composite splints, nylon-monofilament-composite splints, polyethylene fibre-reinforced splints, orthodontic splints and titanium trauma splints.

Canadian Dental Association 
Fouad-Hassan Ebrahim, Gajanan Kulkarni

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