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.
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Contraindicated in unfavourably displaced fractures. Impression of fractured mandibular arch was made with irreversible hydrocolloid impression material Tropicalgin, Zhermack, Italywhile for maxillary arch, medium fusing impression compound was used.
This was done to compensate for any discrepancy between the splint and the mandible and also to provide firm immobilization of mandibular segments [ 5 ]. Gunning splint, Edentulous patient, Mandibular fracture, Intermaxillary fixation.
Case Report A year old male patient was referred to Department of Prosthodontics, from Department of oral and maxillofacial surgery for the fabrication of Gunning splint. A case of progressive hemiatrophy presenting with spontaneous fractures of the lower jaw. No other significant finding was observed in the oral cavity.
Also, open reduction of fracture site is not helpful due to compromised guhning condition of the patient at older age.
It is an acrylic, single unit prosthesis with gap in the anterior region to allow food intake. External fixation appliance or Joe Hall Morris appliance may be used for edentulous mandible fracture. Medical Record New York ; For edentulous patients, treatment planning poses greater difficulties during reduction and fixation of fractured atrophic mandible. Advanced age as a contraindication to operation.
Several treatment modalities have been successfully used for clinical management of such injuries in patients with advanced age. J Oral Maxillofac Surg ; In edentulous cases, even the previous dentures can also be used as splints to stabilize the fractured segments, if the fracture line is present in the denture bearing area 4. During surgical procedure, first the maxillary splint was fixed with per-alveolar wiring. The splints are easy to fabricate, are cost effective and minimally invasive for the treatment of fractured jaw segments.
J Dent Tehran Summer. Miniplates osteosynthesis is less invasive treatment and sutaible for atrophic edentulous mandible except for comminuted defects.
Use of Gunning Splint for the Treatment of Edentulous Mandibular Fracture: A Case Report
Results of treatment of fractures of the atrophic edentulous mandible splijt compression plating: On clinical examination, there was pain and swelling at the fracture site. Wood reported healing with transmucosal fixation in 5 patients out of 8 patients included in the study.
This coupled with reduced central blood supply makes it vulnerable to fracture.
Due to decreased splnt and dense sclerotic nature of bone, open reduction of mandible will lead to slow and complicated healing process of the fracture site. The arch bar was incorporated on buccal side of each splint within the modeling wax. Less precise alignment in edentulous patients may be acceptable as no opposing teeth and occlusion is involved.
Aziz SR, Najjar T. The technique, which crosses the boundaries of conventional fracture gunjing provides, promising results with minimum morbidity thus imparting optimum quality of life ahead for the patient.
There was history of trauma four days back. Published online Jun Conclusion In almost all the selected and planned cases of fractured atrophic edentulous mandible, a satisfactory union of the fractured segments can be obtained with Gunning type of splint.
In the present case report, the vertical dimension of occlusion for the splint was gunninb using the lone standing tooth as reference before its extraction, providing adequate interocclusal space.
An improved Gunning splint.
The rationale of conservative treatment approach using Gunning splint in elderly patient with case report is discussed. Impressions were immediately poured in dental stone to obtain casts Fig 5. Fracture line was extending till the base of the mandible in vertically favourable manner. Case Report A year old male patient was referred to Department of Prosthodontics, from Department of oral and maxillofacial surgery for the fabrication of Gunning splint.
Fractures of edentulous mandible are common in elderly persons.
An improved Gunning splint.
Also, open reduction of fracture site is not helpful due to compromised medical condition of the patient at older age. Author information Article notes Copyright and License information Disclaimer. Inadequately secured splints—if circummandibular wires placed too close to the fracture site. Conservative treatment has a distinct advantage as a treatment option.
These parts were then repositioned to resemble normal mandibular contours Fig.
Orthopantomograph showed displaced mandibular fracture in left mandibular anterior region. The splints were tried-in Fig 4 and stabilized. Management of atrophic mandible fractures. In this clinical ggunning, step by step method for fabrication of Gunning splint and its intraoral fixation in gunninv edentulous patient is discussed.
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. The splints are easy to fabricate, are cost effective and minimally invasive for the treatment of fractured jaw segments. Procedure Used for the Fabrication of Gunning Splint Impression of fractured mandibular arch was made with irreversible hydrocolloid impression material Tropicalgin, Zhermack, Italywhile for maxillary arch, medium fusing splunt compound was used.
Orthopantomograph of patient showing displaced fractured segments.
Keywords atrophic edentulous mandible, gunning splint, mandible fracture. Intermaxillary splinting can be done by connecting two splints with wire loops or elastic bands [ 34 ].