| Objective: To evaluate the clinical effects of woven glass fiber reinforced Composites inlay splint in the treatment of periodontally compromised anterior teeth with severe periodontitis and construct a finite element model of mandible anterior teeth in order to determine the distribution of stresses and the lingual displacement by finite element analysis, which is try to discover the basis in theory of validity of the periodontal splint with the fiber -reinforced composite(FRC) on fixing the loosen teeth to improve the masticatory efficien(?)y and to restore the periodontal health. Method: Fourteen cases of chronic periodontitis patients were included. The periodontal splint with woven glass fiber reinforced composites inlay was performed on nine individuals with ten group of loosen teeth, five individuals were selected with no splint as controls. After two weeks of periodontal basic therapy, box cavities were prepared in the lingual side of contact loosen teeth, light-cured indirect composite inlay cemented with one coat bond. Recalled at 3 and 6 months, and the clinical examine was done, probing depth(PD) and attachment lost(AL) and bleeding index(BI) and radiograph( periodontal bone support, PBS;bone mineral density. BMD;periodontal ligament width, PLW ) were measured and the masticatory efficiency is estimated .Then a valid three-dimensional finite element model of mandible teeth with normal alveolar bone height was constructed to simulate clinical status before and after splinting mobile anterior teeth. By finite element analysis, the distribution of Von Mises stresses on the inner wall of the alveolus of mandibular anterior teeth and the lingual displacement were observed when loading 120N on top of the central incisors in 0, 15 or 30 degrees was applied.Results: The value of two group clinical baseline revealed no significant difference ( P > 0.05).The masticatory efficiency after splinting was 0.926±0.083. which was significantly higher than that of no splint(P<0.01). After 6 month of splinting, it was quite different with control group(P<0.0l), the value of clinical measure(PD.PBS,AL.BMD,PLW) was 1.375±0.707, 0.486±0.092. 3.500±1.606. 0.346±0.078.0.213±0.089,respectively.But the value of BI was 1. 625±0,707, which was no significant difference with control group(P>0.05). Compared clinical status with the baseline, the value of splint group in 3 and 6 month was quite different. Indetail ,PD an d PLW and BMD was different respectively, PBS(6 month) and AL(3 and 6 month) was different with baseline, BI(6 month) was different with baseline and 3 month. At the same process, the three-dimensional finite element model provided a basis for the future research of its biomechanical characteristics. At splinting condition, the stress on the surface of alveolus loaded in different degree was gradually reduced from the mandibular central incisor to canine, larger stress distribution present in the apical region and the trend was bottom>middle>crest, the maxi mum stress under different loading was 1.564Mpa, 3.649Mpa, 6.006 Mpa, lingual displacement was 0.014mm, 0.048mm, 0.095mm. Without splinting, the stress was larger when loading in same degree and trend was also bottom>middle>crest, the maximum stress in the surface of alveolus of mandibular central incisor was 8.33 7Mpa, 16.401 Mpa, 25.613Mpa, lingual displacement was 0.041mm, 0.172mm, 0.295mm. Conclusion:1. The clinical effects of woven glass fiber reinforced composites inlay in splinting compromised anterior teeth with severe periodontitis was satisfied, it revealed that this was one of the ideal and reasonable methods in fixing loosen teeth and the very good functional, durable splint with excellent aesthetics.2. The displaced teeth of adult periodontitis with alveolar loss are further compromised due to the normal occlusal forces, periodontal splint was required after periodontal basic therapy and treatment must be done again after 6 month to control the disease.3. Along with the loading degree inclined, stress on the surface of alveolus and the lingual displacement was increased gradually. However, inlay splint could decreased the movement and improved the stabilization of loosen teeth.4. Analysis of three-dimensional finite element model revealed that stress of alveolus decreased greatly and occlusal force dispersed effectively after splinting.5. In the condition of the alveolar height hadn't reduced obviously, the stress wouldn't concentrated on the crest part to farther accelerate absorption of alveolus . It was suggested that occlusal adjustment and splinting should be considered to avoid the farther damage of the periodontal tissues after basis and/or surgical treatment.
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