Manuals & Instructions
Anterior Splinting Kit
(sold without the Primer)
PREPARING THE TEETH
Determine the number of teeth to be splinted and then note the corresponding interproximal spaces to be separated. One interproximal Lexan Zeza tab should then be used as a spacer when teeth are being separated. The tab should fit snuggly, however, it should be able to slide freely between the teeth in a labiolingual direction.
FOR TIGHT CONTACTS
The included lightning strips are used to start the separation. This should be followed with the Mizzy separators. A hemostat or needle holder can be used to control the depth of the separation. For extremely mobile teeth, it might be necessary to use a fine diamond burr for separation. However, the interproximal areas should be flat planes where possible.
THREADING THE MESH INTO THE TABS
Now that the teeth have been separated, the necessary number of interproximal tabs must be threaded with an adequate length of mesh. When measuring the mesh, allow excess length for interproximal adaptation. When threading, be sure to notice that the tabs have a top and bottom to conform with the cingulum of the teeth.
ADAPTING THE MESH
The mesh and threaded tabs should then be placed in the mouth from an occlusogingival direction. Adaptation of the mesh begins at one side of the splint and proceeds to the other side. By pulling the tabs in a labial direction, the lingual mesh will then be adapted to the lingual surface. If properly performed, no slack will exist within the mesh. To aid in the final adaptation of the mesh, an amalgam plugger should be used to push from the lingual in a labial direction. At the same time, the interproximal tab should be pulled and gently guided from the labial side, The adapted splint, which is a unit of mesh with threaded lexan tabs that have been adapted to conform with the cingulum of the teeth, should then be removed from the mouth intact.
PREPARING THE SPLINT FOR PERMANENT PLACEMENT.
All Systems: The lexan tab should be primed with liquid primer NOT included in the anterior splint kit. Primer will make the lexan (polycarbonate) tabs universally compatible with the bonding material of your choice.
Light-Cure System: If a light-cured material is to be used, the bonding agent of the light cured material should be painted over that portion of the tab that has just been primed. We are referring only to the portion of the tab that will remain permanently between the teeth. The teeth should then be prepared for bonding. Acid-etching of the interproximal surfaces, as well as the lingual surfaces, should then be performed so that the tabs will be able to bond permanently to the interproximal surfaces, while the mesh bonds to the lingual surface. These surfaces should then be covered with an adequate amount of bonding agent. The paste should be mixed with a drop or two of the bonding agent to create a free-flowing filling material that will easily ooze through the mesh. The pre-adapted
splinting unit should then be placed back in the mouth, again, in an
occlusogingival direction, and reseated labially by using the labial
portion of the tab as a guide.
Self-Cure System: In those instances where the dental office does not have a light-curing system,we suggest and have developed a Micro-Macro Filled Resin specifically for the splinting of anterior teeth. Its properties maximize the bond between the tab and filling materials, while being less brittle. The lexan tab in conjunction with the Micro-Macro Filled Resin allows for some give without fracture, thus allowing for a variety of uses. Note that any of the liquid/powder orthodontic adhesives have proven to be very successful as well. Prime tab to be bonded with the Lexan Primer. Bond one tab at a time. Place the filling material between the mesh and the lingual surface of the tooth and also cover the tab. The buccal portion of the tab should then be pulled, seating the tab and mesh unit and carrying the filling material interproximally with it. The next tab should then be started before the filling material has cured on the first tab. Repeat for as many tabs as necessary.
All Systems: If any resistance to seating the splint takes place, we suggest the use of an amalgam plugger from the lingual surface to avoid breaking the lexan tabs. Remove excess filling material to insure open embrasures and to allow minimal bulk for the splint. A thin layer of filling material should remain or be painted on so that the lingual mesh is completely covered.
FINAL STEP.
Once the materials have cured, remove the excess labial section of the tabs and finish on the labial surface, leaving the remainder of the Zeza tab inter proximally. The mesh plus the lexan tab is the total splint. If necessary, a final wash of bonding material on the lingual surface can be used to thinly cover the mesh.
Advantages of the Anterior Splint by Zeza:
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We are now holding a splinted tooth on three sides as opposed to
other methods which rely on one-sided lingual reinforcement.
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The interproximal lexan tabs provide the retention that has been
missing up until now. Now you can provide long term splint for your
patient in a short, one visit, chairside procedure.
Titanium Splinting Bar
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STERILIZATION
Prior to use, the Zeza Bar should be sterilized in either an autoclave or dry heat sterilizer. Use of a cold sterilizing solution is not recommended.
PREPARATION
The preparation of the teeth to be splinted should be done in a conservative manner. The depth of the prep should be just deep enough to allow for a thin layer of composite to cover the Zeza Bar. The width of the prep should only be wide enough to allow the Zeza Bar to be placed and removed without rubbing the walls of the preparation.
The suggested length and position of the Zeza Bar inBicuspid/Bicuspid, Molar/Molar and Bicuspid/Cuspid situations is shown in diagrams 1-2-3 below.
DIAGRAM 1
FOR BICUSPID TO BICUSPID:
The ideal length of Zeza splinting bars for normal size teeth is a length containing three retentive holes when splinting bicuspid to bicuspid.
DIAGRAM 2
FOR MOLAR TO MOLAR:
Here the ideal length of splinting bar is a length containing at least three, but usually four, retentive holes as shown above.
DIAGRAM 3
FOR BICUSPID TO CUSPID:
When splinting the cuspid, adequate strength is attained when one retentive hole (with no excess length of bar) is placed within the preparation as shown in the diagram.
FILLING WITH A COMPOSITE
Once the teeth to be splinted have been prepped, a base/pulp protection material of your choice is placed to avoid sensitivity. Place composite in the preps so they are two-thirds full. There is no need to condense the material at this time. The seating of the Zeza Barwill act as a condenser when it is put in place. When the preps are two-thirds filled with composite, the Zeza Bar is laid over the composite and seated with an amalgam plugger using gentle but firm pressure to seat the Zeza Bar and at the same time condense the composite into all areas of the prep. After the Zeza Bar has been properly seated, the
occlusal one-third of the prep is filled using a plastic filling instrument. Place a mylar strip over the occlusal surface
until the composite has set.
FINISHING OF THE RESTORATION
We do not suggest that anything be placed interproximally while the composite is being placed in the adjacent preparations. This means excess material will be left between the teeth that will now have to be removed. Since the apical depth of the preparation has been made very shallow, the removal of this excess is easily accomplished with the use of a long, thin, very fine diamond high speed bur. How much of the composite should be cut away interproximally while trimming is determined by the cross sectional dimensions of the bar. Only a minimal amount of material need cover the bar thus giving you a very small contact point. This cannot be stressed enough, for this small contact point is what will permit the patient to keep the area clean and avoid gingival irritation. The occlusal surface can be finished using any of the conventional methods.