GUNNING SPLINTS

Management of fractured edentulous mandible has always been a challenging task for dental
practitioner. Such mandibles usually have reduced cross sectional dimension with limited contact
areas of the fractured ends. In addition the poorly vascularized dense and sclerotic bone exhibits
low regenerative potential. Severely atrophic edentulous mandible, especially those having a
radiographic height or 10 mm or less, are poor candidates for plate fixation under General
Anesthesia. In addition the older patient who may be malnourished and in poor general health
may preclude prolonged GA.

INDICATIONS

Gunning splints are indicated for the reduction, fixation and immobilization of unilateral and
bilateral fractures of the edentulous mandible, where the fractures lying proximal to these areas
can be controlled by intermaxillary fixation. These splints provide a form of indirect control on
the bone fragments, transmitted through the mucoperiosteum. Gunning splints offer control and
support for the fractured segments of mandible.

Gunning splints are contra indicated in

1) unfavourably displaced fractures lying outside the denture bearing areas,

2) in projectile injuries involving grossly comminuted soft tissue and bone loss, and
3) in severe posterior displacement of fractures of the anterior part of the mandible.
4) Extreme atrophy of the maxilla or mandible also complicates this technique.

Gunning splints can also be constructed from

a. The patient’s existing dentures suitably modified.

b. Impressions made from patient’s mouth.

c. Models cast from the fitting surface of the patient’s

dentures.

d. Prefabricated Gunning type splints.

e. Disposable, edentulous impression trays without

their handles.
In order to prevent any kind of movement between the maxillary and mandibular components of
the splint a locking mechanism was incorporated. The anteroposterior movement was
prevented by preparing a vertical rectangular keyway having a dimension of 3cm x 5cm on the
maxillary occlusal rims and a corresponding key was fabricated on the mandibular occlusal rims
that exactly fits into the keyway. A longitudinal ‘step-like’ preparation on the occlusal rims was
incorporated so as to prevent any lateral movement. Stainless steel wire hooks were attached on
each quadrant of wax occlusal rim on the buccal aspect approximately 5 mm above the occlusal
plane. These hooks were used for passing ligature wire during immobilization. A rectangular
window was made on the anterior segment (4 cm x 4 cm) in dimension from canine to canine
region for feeding purpose. The wax rim was finished, polished and processed in acrylic. The
patient was recalled on the third day for the insertion of gunning splint. The extensions, centric
relation position, key-key way relationship were evaluated.