Long-term survival and maintenance efforts of splinted teeth in periodontitis patients

Objectives: This study assessed the survival and maintenance needs of splinted teeth in periodontitis patients. Methods: Patients receiving active and supportive periodontal treatment involving teeth splinting in a university setting were retrospectively assessed. Tooth and splint survival and number of splint-repairs were recorded. Multilevel Cox and generalized-mixed linear regression analyses were performed. Results: Fifty-seven patients with 227 splinted teeth (maxilla/mandible: 148/79) were followed over mean +/- SD 11.0 +/- 7.2 [range: 2.0-32.4]) years. Twenty-six splinted teeth were extracted during this period, the mean (95% CI) time of splint retention was 7.3 +/- 5.7 (0.1-22.7). Splinted teeth did not show significantly increased risk of tooth loss compared with non-splinted teeth (HR; 95% CI: 1.30; 0.87-1.93); while age (1.07; 1.05-1.09), PPD > 6mm (4.24; 1.26-14.31), bone loss (mean HR was 5.07-15.36 depending on severity), tooth location (posterior versus anterior teeth: HR 2.08; 1.24-3.49) and the number of occlusal contact areas (mean HR was 4.38-17.34 depending on the number of antagonistic contact areas) were associated with tooth loss. 75.3% splints required repair, with a mean of 2.6 +/- 1.9 [1.0-8.0] repairs per splint during the mean observation time (0.4 +/- 0.6 [0.0-3.5] repairs per splint/year). Conclusion: Splinting did not significantly increase the risk of tooth loss; splinted teeth showed long-term survival. To maintain splints, frequent repairs were needed. Clinical significance: Splinted teeth were not at significantly higher risk of tooth loss than non-splinted teeth. While splinting does not improve the prognosis of periodontally affected teeth, it can assist their retention by reducing their mobility.