Ribbond splinting?

Ribbond splint on typodont from the Ribbond site

As a general dentistry a dentist has to be a jack of all trades and the "Buck stops here" is sometimes true. We are called on to perform some procedures infrequently. While I can perform Crown preparations and fillings almost on automatic pilot, but not so much for procedures I called on for once every two or three years.

Several years ago a patient came to my office with extremely loose lower anterior teeth. Her radiographs showed that her lower front teeth had experienced over 50 percent bone loss and taking some of them out and having implants placed was her best option. As it happened, she was referred to me by my periodontist and the orthodontist who practiced with him to do something else. She explained that they felt that maybe I could do some ribbond splinting so she could retain her teeth.

I took a study impression and did some online research on the best technique for ribbond splinting. I had done some splinting 5 years before for several patients with mixed results. The splinting had worked but it was difficult to get the ribbond splint material to conform closely to the position of the teeth and I thought the splints had turned out bulky on the lingual. Also some of the fibers became exposed over time and collected plaque.

I decided to do a little internet research on the ribbond website. They had an excellent video that documented how to best place a ribbond splint. I watched it several times and I was ready for action.
I followed the steps and technique shown on the video and the splinting turned out great. I modified the technique slightly since my patients teeth were extremely mobile. I applied composite on the facial interproximal areas first while pushing her teeth back into the proper contact position. By doing this I added to the length of her contact area and splinted the teeth together enough that I could place the ribbond without the teeth moving away.

I did this procedure about 4 years ago and I see the patient regularly for her three month recall and her teeth no longer are mobile nor do they seem to be at imminently at risk. She is very satisfied and I am glad that I was able to help rescue her lower anterior teeth.



from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/05/ribbond-splinting.html - http://lspindelnycdds.blogspot.com/

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