MODERN APPROACHES TO THE DIAGNOSIS AND STABILIZATION OF MOBILE ANTERIOR TEETH IN CASES OF INCOMPLETE DENTITION
DOI:
https://doi.org/10.32782/2786-7684/2026-3-14Keywords:
splinting, periodontitis, intraoral scanning, fremitus, fiber-reinforced compositeAbstract
Partial edentulism with associated dental arch defects is a common reason for seeking care from an orthodontist and is accompanied by occlusal collapse, redistribution of the masticatory load, and pathological mobility of the anterior teeth, which is often combined with generalized periodontitis. Despite advances in modern diagnostic and treatment methods, approaches to assessing tooth mobility, determining indications for stabilization, and selecting optimal treatment strategies remain insufficiently systematized. The purpose of this study is to summarize the literature on the pathogenesis, diagnosis, and methods of stabilizing mobile anterior teeth and to justify their role in the orthopedic treatment of patients with closed dental arch defects. Materials and Methods. A narrative literature review was conducted using the PubMed, Scopus, and Web of Science databases, as well as the clinical guidelines of the European Federation of Periodontology for 2022–2025, with no restrictions on classical works. Peer-reviewed articles, systematic reviews, meta-analyses, and randomized controlled trials were selected; the synthesis was performed using a descriptive method without quantitative meta-analysis. Results. The loss of posterior teeth leads to a redistribution of occlusal load onto the anterior teeth, resulting in mobility that is exacerbated by periodontitis. Fremitus has been identified as an underrecognized early marker of occlusal overload. Splinting, primarily with fiber-reinforced composite, is an adjunctive measure following periodontal therapy and occlusal correction. However, the level of evidence supporting its effectiveness is low. Intraoral scanning is a promising monitoring tool that requires validation. A six-step algorithm for clinical decision-making is proposed. Conclusions. Stabilization of mobile anterior teeth should be carried out as part of an integrated periodontal-orthopedic approach. Splinting should be considered in cases of persistent mobility after completion of basic therapy, and the role of intraoral scanning requires further study
References
Zasčiurinskienė E, Rastokaitė L, Lindsten R, Basevičienė N, Šidlauskas A. Malocclusions, pathologic tooth migration, and the need for orthodontic treatment in subjects with stage III–IV periodontitis. A cross-sectional study. Eur J Orthod. 2023;45(4):418–429. doi:10.1093/ejo/cjad003
Dommisch H, Walter C, Difloe-Geisert JC, Gintaute A, Jepsen S, Zitzmann NU. Efficacy of tooth splinting and occlusal adjustment in patients with periodontitis exhibiting masticatory dysfunction: a systematic review. J Clin Periodontol. 2022;49(Suppl 24):149–166. doi:10.1111/jcpe.13563
Sonnenschein SK, Ciardo A, Kilian S, Ziegler P, Ruetters M, Spindler M, et al. The impact of splinting timepoint of mobile mandibular incisors on the outcome of periodontal treatment – preliminary observations from a randomized clinical trial.
Clin Oral Investig. 2022;26(1):921–930. doi:10.1007/s00784-021-04075-4
Zhang Y, Kang N, Xue F, Duan J, Chen F, Cai Y, et al. Survival of nonsurgically splinted mandibular anterior teeth during supportive maintenance care in periodontitis patients. J Dent Sci. 2023;18(1):229–236. doi:10.1016/j.jds.2022.05.025
Kim GY, Kim S, Chang JS, Pyo SW. Advancements in methods of classification and measurement used to assess tooth mobility: a narrative review. J Clin Med. 2024;13(1):142. doi:10.3390/jcm13010142.
Schlenz MA, Schlenz MB, Wöstmann B, Glatt AS, Ganss C. Intraoral scanner-based monitoring of tooth wear in young adults: 24-month results. Clin Oral Investig. 2023;27(5):2775-2785. doi:10.1007/s00784-023-04858-x
Machado AC, Phillips TS, Zimmerman R, Scaramucci T, Amaechi BT. Monitoring erosive tooth wear with intraoral 3D scanner: A feasibility study. Am J Dent. 2022;35(1):49-54.
Hrelja M, Laškarin M, Čimić S, Kraljević S, Dulčić N, Badel T. Prosthodontic aspects of splinting the mandibular anterior teeth by fiber reinforced composites. J Dent Probl Solut. 2025;12(1):4-8. doi:10.17352/2394-8418.000131
Mikami R, Ishimaru M, Mizutani K, Shioyama H, Matsuura T, Aoyama N, et al. Effect of tooth splinting on clinical outcomes following periodontal regenerative therapy in teeth with mobility degree 1 or 0: a propensity score-matched analysis. J Clin Periodontol. 2025;52(9):1254-1262. doi:10.1111/jcpe.14190
Herrera D, Sanz M, Kebschull M, Jepsen S, Sculean A, Berglundh T, et al. Treatment of stage IV periodontitis: the EFP S3 level clinical practice guideline. J Clin Periodontol. 2022;49(Suppl 24):4-71. doi:10.1111/jcpe.13639
Angelone F, Ponsiglione AM, Ricciardi C, Cesarelli G, Sansone M, Amato F. Diagnostic applications of intraoral scanners: a systematic review. J Imaging. 2023;9(7):134. doi:10.3390/jimaging9070134
Nulty AB. A comparison of full arch trueness and precision of nine intra-oral digital scanners and four lab digital scanners. Dent J (Basel). 2021;9(7):75. doi:10.3390/dj9070075
Caron T, Lesclous P, Descroix V. The relevance of intraoral scanner (IOS) for periodontal diagnosis: a scoping review. J Dent. 2025;160:105851. doi:10.1016/j.jdent.2025.105851
