Clinical Outcomes and Re-Splinting in Pediatric Dental Trauma Managed with Titanium Trauma Splints: Insights from a Hospital-Based Retrospective Study

Background and Objectives: Traumatic dentoalveolar injuries (TDI) in children often require urgent stabilization using splints. Titanium trauma splints (TTS) represent a practical option; however, pediatric evidence from hospital-based emergency settings remains limited. This study describes the clinical and contextual characteristics of children treated with TTS and explores factors associated with early complications and splint stability. Materials and Methods: A retrospective observational cohort study was conducted at a Pediatric Dentistry Service, including children with TDI managed with TTS and followed for a minimum of three months. Clinical records were reviewed to collect demographic, contextual, and clinical variables. Early complications and the need for re-splinting were recorded, and associations between selected variables and outcomes were analyzed. Results: Seventy-three patients (64.4% male; mean age 10.29 ± 2.99 years) and 127 traumatized teeth (98.4% permanent) were included. A predominance of school-based injuries was observed (52.1%). The most frequent injury types were subluxation (39.1%), avulsion (26.6%), and extrusion (16.4%). A longer interval between trauma and splint placement was associated with inflammatory root resorption (p = 0.011), although this finding should be interpreted with caution given the limited number of events. Mixed-dentition splints showed a higher likelihood of requiring re-splinting (OR = 12.23; 95% CI: 1.18–126.60); however, this estimate was imprecise and should be interpreted as an exploratory signal. Overall, 90.4% of patients completed treatment with a single splint. Conclusions: Within the limitations of this retrospective observational cohort, TTS showed satisfactory short-term clinical stability in pediatric traumatic dental injuries. Longer time between trauma and splint placement was associated with inflammatory root resorption, while mixed-dentition splints emerged as a potential signal of increased re-splinting. These findings are exploratory and hypothesis-generating and require confirmation in future studies.