T. B. Gunning (–89), American dentist] n. A solid metal splint linking the mandible and maxilla together to provide fixation for a fractured mandible. A splint is. Undisplaced or minimally displaced fractures of the mandible in elderly patients are usually treated by closed reduction. Gunning-type splints or. Gunning splint is a prosthetic aid designed to stabilize the reduced fractured mandibular segments. It is a viable treatment option for atrophic edentulous.
|Published (Last):||15 April 2013|
|PDF File Size:||19.24 Mb|
|ePub File Size:||6.84 Mb|
|Price:||Free* [*Free Regsitration Required]|
Medical Record New York ; Hence, it was decided to perform closed reduction of gjnning fractured mandible with Gunning splint instead of open reduction. If mandible is atrophic, then the fractured fragments will be more easily displaced. Br J Oral Surg 7: Fractures of the edentulous mandible: Intermaxillary splinting can be done by connecting two splints with wire loops or elastic bands [ 34 ].
Impression of fractured mandibular arch was made with irreversible hydrocolloid impression material Tropicalgin, Zhermack, Italywhile for maxillary arch, medium fusing impression compound was used.
He designed splint with extraoral wings for treating fracture in edentulous cases.
An improved Gunning splint.
Fractures of edentulous mandible are common in elderly persons. A Gunning splint for the edentulous mandible splinnt of a type of monoblock resembling two bite blocks joined together. Cochrane Database Syst Rev 24 1: Conservative treatment has a distinct advantage as a treatment option. Then the occlusal rims were altered.
Wood reported healing with transmucosal fixation in 5 patients out of 8 patients included in the study. Short conservative procedure without general anesthesia spilnt less risk than open surgical procedure under general anesthesia. During surgical procedure, first the maxillary splint was fixed with per-alveolar wiring.
The splints may become foul, if proper oral hygiene is not maintained. Atrophy of mandible is most important factor. J Prosthet Dent A 60 years old male patient presented with pain on the right side of the lower jaw.
The major blood supply of mandible, subperiosteal plexus, may severely impair the vascularity during open reduction resulting in nonunion of fracture treated by open reduction. Also, open reduction of fracture site is not helpful due to compromised medical condition of the patient at older age. Prosthodontic procedure Impressions were made with irreversible hydrocolloid impression material and casts were poured with Type III gypsum product.
Use of Gunning Splint for the Treatment of Edentulous Mandibular Fracture: A Case Report
These parts were then repositioned to resemble normal mandibular contours Fig. The complication rate of infection or malunion is higher compared to fractures in younger, dentulous patients.
Fractures of the atrophic spplint experience at Tel-Aviv Medical Center. Morbidity and mortality are increased in geriatric patients after trauma. Long period of stabilization is required which further add to increased complications. It is a minimally invasive technique.
Miniplates osteosynthesis is less invasive treatment and sutaible for atrophic edentulous mandible except for comminuted defects. It holds together fractured spljnt of mandibular bone and immobilizes the jaws in occlusion. Due to decrease in bone height, it is not suitable for screwing and plating the fracture site. These splints take form of modified dentures with bite block placed in posterior region and a space in incisal area to facilitate feeding.
Mandibular splint was fixed by circum-mandibular wiring Fig. Progressive systemic sclerosis with spontaneous fracture due to resorption of the mandible: Fracture line was extending till the base of the mandible in vertically favourable manner. Close reduction with Gunning splint is advantageous because, not only it preserves the periosteal blood supply, but also provides firm mandibular fixation and immobilization. Procedure Used for the Fabrication of Gunning Splint Impression of fractured mandibular arch was made with irreversible hydrocolloid impression gunnung Tropicalgin, Zhermack, Italywhile for maxillary arch, medium fusing impression compound was used.
If fracture segments are not grossly displaced, clinical management with Gunning splint serves the purpose with less complications such as infection and nonunion. Transmucosal fixation of the fractured edentulous mandible. For edentulous patients, treatment planning poses greater difficulties during reduction and fixation of fractured atrophic mandible.
An improved Gunning Splint. Philip L, David R Spontaneous mandibular fracture in a partially edentulous patient: Dilip Kakade Department of Prosthodontics, Dr.
Gunning splint – Oxford Reference
The Elderly Surgical Patient: Radiographic examination revealed left subcondylar fracture and right parasymphyseal mandibular fracture. Compound splint for comminuted mandibular fracture.
Contraindicated in unfavourably displaced fractures. Due to decreased vascularity and dense sclerotic nature of bone, open reduction of mandible will lead to slow and complicated healing process of the fracture site [ 6 ]. The advancing age, residual ridge resorption and decreased vascularity impairs the mandibular bone strength, predisposing it to fracture during traumatic event and even to spontaneous fracture.
Gunning splint, Edentulous patient, Mandibular fracture, Intermaxillary fixation. Due to edentulism, guidelines provided by occluding teeth for reduction and fixation of fracture, are absent.
In the present case report, the vertical dimension of occlusion for the splint was determined using the lone standing tooth as reference before its extraction, providing adequate interocclusal space.
The splints are easy to fabricate, are cost effective and minimally invasive for the treatment of fractured jaw segments.