I clinical technique _ direct splinting Maintenance of periodontally compromised teeth with direct splinting— current materials and options Author_ Dr Ajay Kakar, India Fig. 1_A common periodontal situation with mobile anterior maxillary teeth causing discomfort. Fig. 2_Grooves prepared on the buccal surface of the incisors at the incisal third to enable placement of the fibre. Fig. 3_The fibre in place and polymerised after being coated with flowable composite. Fig. 4_The completed splint with direct bonding composite build-up to achieve a pleasing aesthetic result. Fig. 5_A case of migration of the central incisors. Fig. 6_A splint done followed by recontouring of the tooth and direct bonding composite build-ups. _Periodontal disease is initiated in the main as gingivitis, which in a smaller subset of individuals progresses to the more advanced form referred to as periodontitis. Gingivitis is restricted to the marginal gingival area and does not lead to destruction of osseous tissue. Gingivitis is the progression to periodontitis, which encompasses extensive loss of bone surrounding the tooth. Modern-day therapy can generally ensure the arrest of the progression of periodontal destruction and, in favourable situations, even the regeneration of all the components of the periodontal apparatus, albeit to a much lesser extent than the original. Of the periodontal structures, the loss of soft tissue makes the process of complete regeneration much more difficult. In such circumstances, wherein the inflammation and infection has been controlled and the disease activity has been curbed, it becomes imperative that the dentition, which is definitely compromised owing to the pre-existing damage, be supported and additional aids provided to create the optimum function, coupled with aesthetics. One of the key issues in such dentitions is the mobility of the teeth. Such mobility may be localised to certain teeth and in a specific path of motion or may be much more generalised and afflict many teeth. In either case, the benefits of immobilisation are multiple. The comfort level of the patient is sufficient reason to use this treatment option for mobile teeth. Additionally, this also leads to tremendous patient motivation and compliance in maintaining oral hygiene, which Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 22 I cosmetic dentistry 4_ 2009