Stents in Prosthodontics

Any supplementary device used in conjunction with a surgical procedure to keep a skin graft in place; often modified with acrylic resin or dental modeling plastic impression compound that was previously termed Stent’s mass; also refers to any device or mold used to hold a skin graft in place or provide support for anastomosed structures.1

Functions: 2

• Radiographic diagnostic template
• Surgical guide template
• Conserve the tissue after skin and mucosal grafts and stabilize them in place until their revascularization
• Prevent contamination of wounds and promote healing
• Protection of teeth and associated structures in contact sports.

Materials used: 2,3

Types of stents

I- Intra Oral Stents

• Occlusal stent.
• Periodontal stent.
• For lip and cheek support.
• Pedodontic stents.
• Mouth guard.
• Oral screen.
• Fluoride Carrier.

• Dental implantation
• After removal of exostoses
• For epulis fissuratum
• Cyst plugs
• Drainage stents
• In resected maxilla

II- Extraoral Stents

• Nasal Stent
• Auditory stent
• Radiation protection stent
• Stent for neck scar

The following are the most commonly used stents in dentistry:

Dental Implantation

The success of implant therapy depends primarily on appropriate treatment planning and properly performed implant placement surgery. Misaligned placement of the implant is a very common dilemma that frequently
complicates the clinical laboratory procedures intended for the fabrication of superstructures. The use of surgical guides to implant placement will undoubtedly assist the surgeon to create biomechanically sound implant locations. It also dictates to the surgeon about the implant body placement that offers the best combination of support for the repetitive forces of occlusion, esthetics and hygiene requirements.⁴

Surgical Stent

The prosthesis supports the skin graft and maintains normal anatomic facial contours. Also provides immediate postoperative restorations of mastication,deglutition and speech shortens the patient’s recovery time.⁵

Occlusal Stent

Commonly there are two different materials, based upon consistency, which are used in the fabrication of occlusal appliances. There are hard acrylic resin Occlusal appliances that are either self cured (by chemical reaction) or heat cured, resulting in hard and rigid tooth-borne and occlusal surface. In other hand, there are soft or resilient occlusal appliances, the soft appliance are somewhat flexible and pliable tooth-borne and occlusal surface. A third variation of material known as dual laminated, as its occlusal surface consists of hard acrylic resin and the tooth-borne surface consist of a soft material. This produces an occlusal appliances with advantages of a soft material (fitting well and providing comfort for the supporting teeth), and an adjustable occlusal surface of the hard acrylic resin.³

• Eliminates occlusal interferences.
• Minimizes the effect of bruxism and clenching on teeth (wearing).
• Guids the mandible into retruded position for treatment of T.M.J disorders

Periodontal Stent

A better reflection of periodontal destruction can be obtained by the measurement of the clinical attachment level (CAL), i.e., the distance from the probe tip to the level of the cementoenamel junction (CEJ). However, there were several problems in CEJ identification. Due to the time consumption and inherent problems in CEJ identification. The use of stent is recommended during clinical trials which will minimize the errors in terms of over and underestimation of CALs. The stent are used for vertical probing (vertical/occlusal stent), horizontal probing (furcation stent), and interdental papilla (IDP) stent for IDP‑deficiency measurement.⁶

Mouth Guard

The mouthguard (also referred to as a gumshield or mouth protector) is defined as a resilient device or appliance placed inside the mouth to reduce oral injuries, particularly to teeth and surrounding structures. Mouthguards are effective because they considerably diminish the deflection of teeth subjected to stress in comparison with unprotected teeth [46]. Theoretically, a properly fitted mouthguard should be protective, comfortable, resilient, tear-resistant, odourless, tasteless, inexpensive, easy to fabricate and should not interfere with speech. The most common types of mouthguard available to athletes comprise:⁷
Type I: stock mouthguards, bought over-the-counter and designed to be used without further modification, such mouthguards are no longer widely available;
Type II: mouth-formed boil-and-bite mouthguards

Pedodontic Stents

Bruxism is very common among children, both in the primary dentition and in the mixed dentition. Acrylic resin bite splints are widely used for bruxism treatment among children and adults, although there are claims in the literature that bite splints are only used to control or lessen symptoms, not to cure bruxism. Based on some studies that have suggested the use of bite splints in children who have bruxism signs and symptoms, the objective of this study is to evaluate theeffectiveness of acrylic bite splints to reduce the habit or to eliminate or reduce the symptoms caused by bruxism in children during mixed dentition and make them accept this treatment method.⁸

A custom-made stent for applying fluoride gel.⁸

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