Design of protective splint for endotracheal intubation in patients with partially edentulous maxillary anterior arch

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  • 気管挿管時に上顎前歯部部分欠損歯列へ適応する保護用スプリントのデザイン
  • キカンソウカンジ ニ ジョウガク ゼンシブ ブブン ケッソンシレツ エ テキオウ スル ホゴヨウ スプリント ノ デザイン

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<p>Purpose: To demonstrate the appropriate design of a protective splint for surgical use during endotracheal intubation under general anesthesia in patients with partially edentulous maxillary anterior arch.</p><p>Methods: Different splint designs were evaluated by using a maxillary jaw model with foil strain gauges bonded to each artificial tooth, and three patterns of partially missing anterior teeth were prepared. Three different splints with a thickness of 2, 3, and 4 mm, respectively, were fabricated and loaded onto a pharyngoscope blade located between teeth number 11 and 12. The distribution and change of the load on each artificial tooth were analyzed. The effects of each splint design due to factors such as adding autopolymerized resin, embedding cobalt chrome wires, and limiting the coverage area only between teeth 14 and 24 were also examined.</p><p>Results: The load at 11 with three defect patterns was significantly greater than that without defect regardless of the splint thickness. The loads significantly decreased with increasing splint thickness, but the load distribution was different for each defect pattern. The load was significantly increased with resin addition, and embedding wire did not produce a sufficient reinforcing effect. The loads measured at the remaining teeth in the partially edentulous front teeth area were significantly higher than those in complete dentition.</p><p>Discussion: Comparing the load of 11 under the 2-mm thick splint with no defects as the reference, the 3-mm thick splint showed insufficient protection effect for all defect patterns, and the 4-mm thick splint achieved a similar level of load regardless of defect patterns.</p><p>Conclusion: A protective 4-mm thick splint with complete dentition coverage is recommended in patients with partial edentulous maxillary anterior arch for conventional endotracheal intubation under general anesthesia.</p>

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