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Reattachment of the original tooth fragment to the fractured tooth helps in maintaining the tooth’s color, wear resistance, morphology and translucency in the restoration. This article describes the reattachment of fractured fragment using a fiber post and dual cure resin cement with a self-etching adhesive.
Two young male patients reported with a...
Citations
... The treatment of complicated crown-root fracture is compromised by subgingival fracture margin which violate biological width and pose difficulty in proper isolation. Clinical crown lengthening surgery is viable method to reinstate biological width and to maintain dry field during reattachment procedure.5 ...
Crown-root fractures are commonly encountered in dental practice, and their management poses a challenge to clinicians. With the advent in adhesive dentistry, reattachment of the fractured segment became a viable restorative alternative. Reattachment is a conservative treatment option that allows for immediate restoration of function, esthetics and phonetics. This case report presents a minimal intervention approach to the management of a complicated crown root fracture. The tooth was endodontically treated followed by esthetic reattachment of the fractured fragment using composite fiber post. The patient was followed up for three years, and clinical and radiographic examinations showed a successful treatment outcome.
... The strength of anterior restoration should be high to withstand the heavy mastication or the impact forces during retrauma [12]. To gain more restoration stability, little or various additional tooth preparations were used such as placement of circumferential bevel, internal groove, chamfer, shoulder with or without bevel [13,14], and superficial over-contour. However, the substantial sacrifice of tooth structure and the compromised esthetic outcomes of several techniques may limit their uses in anterior restoration [15]. ...
... The mode of failure for each specimen was visually analyzed using a stereo-microscope at x10 magnification [31] and categorized to three The shade of Tetric N-Ceram composite was selected under natural light using a shade guide. 13 After local anesthetic administration and complete teeth isolation using a rubber dam , 14 the fractured tooth was separated from the adjacent by a celluloid strip. Glass and polyethylene fibers were cut after evaluating the required lengths by dead soft tinfoil. ...
... Color harmony immediately scored postoperative and during recall time for each 12 Parkell Products Inc., Farmingdale, NY, USA 13 Ivoclar Vivadent Tetric N-Family Shade Guide, Leicester.UK 14 Hygenic Dental Dam, Coltène, Mahwah, NJ, USA 15 Dentsply, Addlestone, York, PA, USA restoration using standardized photographs. An 18.0 megapixels digital single-lens reflex camera 16 with a 105-mm Microlens was used by focusing on the center of the restorations [33]. ...
Purpose: To evaluate in-vitro and in-vivo the fiber-reinforced composite (FRC) in the restoration of uncomplicated coronal fracture of upper permanent central incisors. Materials and Methods: I- in-vitro: standardized one-third coronal sections were prepared on 30 extracted human maxillary central incisors with close similarity. The specimens were embedded perpendicular to standard molds of self-curing acrylic resins and randomly assigned into 3 groups (n=10/each). Group I: restored with glass FRCs and particulate filler composite (PFC), group II: restored with polyethylene FRCs and PFC, and group III (control): restored with PFC. In the groups I and II, a shallow palatal preparation was prepared. The fracture resistance was determined by a universal testing machine. Failure modes were optically magnified and analyzed. II- in-vivo: a clinical prospective study was performed on 27 patients, aged 9-18 years, presented with Ellis class II fractures of maxillary central incisors. The teeth were randomly divided into 3 groups (n=10 teeth/ each) as in the in-vitro study. All patients were followed-up clinically and radiographically at 3, 6, 9, and 12-month. Results: In-vitro: the glass FRCs recorded the high fracture strength values, followed by polyethylene FRCs, and PFC and the difference was significant among them (P≤0.05). Mode of failures showed no significant difference among them (P≤0.05). However, in-vivo results showed 100% clinical success for FRCs groups compared with 80% for PFC, but the difference was not significant (P≥0.05). The radiographic findings showed 100% success. Conclusion: Only in the in-vitro study, the invisible substructure of glass followed by polyethylene FRCs seems to be significantly effective in restoration of Ellis class-II fractures of permanent incisors and promising to improve load-bearing capacity.
Keywords: fibre-reinforced composite, fracture resistance uncomplicated, coronal fracture
... Usually males are subjected to dental trauma more frequently than females as they perform more activities such as bicycle riding, sports, fighting [2]. Dental trauma often affects patient socially and psychologically, so it is of a great importance to the clinician to manage the psy¬chological impact as well as the physical injury of the pa¬tient [3,4]. As a result restoring a patient's lost natural smile becomes an important topic of today's dentistry [5]. ...
... Whenever the fractured fragment is available intact, the reattachment treatment has to be the most desired treatment. This allows for conservative, simple and esthetic treatment option [4,9]. However, the availability of the fractured fragment is not the only indicator for reattachment treatment with good prognosis [10]. ...
... 5,6 The most common injuries are in the maxillary anterior region, which can have a physical as well a psychological impact on the patient. 7 Reattachment of the fragment, previously a provisional restoration, is now the permanent treatment of choice-made possible by the introduction of resin composites that ensure a lasting solution. The type of treatment depends on pulp vitality and the stage of root development or resorption. ...
The case of a nineteen-year-old female with atypical fractures to three maxillary incisors (#11 FDI, #8 universal; #21 FDI, #9 universal and #22 FDI, #10 universal) with one showing a complicated crown fracture and pulp exposure is reported. A partial pulpotomy had been carried out immediately after trauma and the patient complained of acute pain on percussion of the left central incisor. Direct restoration with resin-based composite was carried out on the two teeth where fragments were not available (tooth #8 and #10) and root canal treatment with reattachment of fragments and fiber post was carried out on the third (tooth #9). An innovative method was used to reattach the tooth fragments whereby the fiber post was inserted without drilling a hole in the crown thus preserving the integrity of the crown. Follow-up visits confirmed the success of treatment based on clinical and radiographic evaluations. The patient was pain free with no tooth sensitivity and good function and esthetics after four years of follow-up.
Clinical significance:
Case report with a follow-up of 4 years, provides confirmatory evidence of the long-term efficacy of an innovative method to reattach tooth fragments whereby fiber post is inserted without drilling a hole in the crown thus preserving the integrity of the crown. (J Esthet Restor Dent 29:172-177, 2017).
... The treatment options for this type of cases include reattachment (if fracture fragment is available), post-supported direct composite build-up, prosthetic restoration or tooth e xtraction followed by rehabilitation. 11 In the presented case the patient was unable to retrieve the fracture fragment, so restoration with glass fiber post and direct composite crown buildup was planned. This technique has some major advantages: it eliminates the need for sacrificing any tooth structure, less time-consuming, more economic and cheaper than indirect r e storations that have additional laboratory cost. ...
p>Restoration of a fractured tooth is routinely performed in clinical practice. Many factors are considered in an effort to provide optimal mechanical properties, aesthetics, longevity as well as patient acceptance. In this type of challenging endeavour, main effort should be made to save as much of the coronal tooth structure to increase survival rate of endodontically-treated teeth. This case report presents a 35-year-old male with an oblique complicated crown fracture of maxillary left central incisor tooth. The procedure used to repair the fracture was gingivectomy followed by endodontic treatment. The root canal was filled with a root canal sealer and gutta-percha points. After root canal obturation, the tooth was restored with a glass fiber post and composite resin without additional crown coverage. The restoration made it possible to maintain the remaining tooth structure in a good occlusion and resulted in a high level of patient satisfaction.
J Enam Med Col 2017; 7(1): 35-38</p
... Similarly, several others have described success with reattachment cases (4,5). The use of composites as adhesives to the tooth made reattachment, with conservative management, promising for fractured teeth (6,7). Reattachment procedures can be used with a successful outcome on both uncomplicated and complicated fractures (8,9). ...
... This design produces a post with an elastic behavior (modulus of elasticity) similar to that of dentin, unlike metal or ceramic posts. Hence, in the presented case, an FRC Postec Plus post was used for the retention of the core build-up (7). ...
... Similarly, several others have described success with reattachment cases (4,5). The use of composites as adhesives to the tooth made reattachment, with conservative management, promising for fractured teeth (6,7). Reattachment procedures can be used with a successful outcome on both uncomplicated and complicated fractures (8,9). ...
... This design produces a post with an elastic behavior (modulus of elasticity) similar to that of dentin, unlike metal or ceramic posts. Hence, in the presented case, an FRC Postec Plus post was used for the retention of the core build-up (7). ...
Introduction:
The fracture of front teeth is one of the routine presentations of traumatic injuries. The treatment of a fractured tooth involving the pulp includes root canal therapy and post placement followed by core build-up or by the extraction of the fractured tooth if it is not restorable.
Case Presentation:
We report a case of an adult male who had traumatized both his maxillary central incisors following a blow experienced during domestic violence. He had lost a fractured fragment of the right central incisor, while the left incisor had complicated fractures with fragments retained attached to the soft tissue. Following radiovisiography (RVG), both incisors were conservatively treated in a single visit by reattachment and post and core techniques.
Conclusions:
The treatment reported for reattachment of the tooth fractures and post and core techniques are reasonably easy while providing immediate and lasting results in patients? regaining of social confidence and functionality.
... [2] The incidence of complicated coronal fractures ranges from 2% to 13% of all dental injuries, and the most commonly involved tooth is the maxillary central incisors. [3] This could be due to their anterior position and protrusion caused by eruptive pattern. [2] One of the options for managing coronal fractures, especially when there is no or minimal violation of the biological width, is the reattachment of the dental fragment when it is available. ...
... The case of reattaching a fractured incisor fragment was reported in 1964 by Chosack was the first who reported case of reattaching a fractured in¬cisor fragment in 1964. [3] Since then, the technique has been subjected to various modifications and enriched with the advent of refined restorative techniques and materials. [2] Reattachment is a way to restore the natural shape, contour, translucency, surface texture, occlusal alignment, and color of the fragment along with a positive emotional and social response from the patient to the preservation of natural tooth structure. ...
... Whenever the fractured fragment is available intact, the reattachment of the fragment should be considered as the most desired treatment as the reattachment procedure does not preclude any future treatment. [3,5] In the pre-adhesive era, fractured teeth needed to be restored either with pin retained inlays or cast restorations that sacrificed the healthy tooth structure and were a challenge for clinicians. [3] Clinical trials and long-term follow-up have reported that reattachment using modern dentin bonding agents or adhesive luting systems may achieve functional and esthetic success. ...
Coronal fracture of anterior teeth is a common form of dental trauma that affects children and adolescents. It is a tragic experience, which requires immediate attention and quick functional and esthetic repair. The major challenge for the clinician for managing such type of dental injuries is to re-establish the natural esthetics of the traumatized anterior tooth. Traditionally, such injuries have been restored with composite resins. They have the primary disadvantage of color mismatch and variable wear. Therefore, if a broken fragment is available, the restoration of the tooth using its own fragment should be the first treatment of choice. This clinical report describes reattachment of tooth fragment of complicated crown-root fracture of a deciduous maxillary central incisor in a 4-year-old child following trauma.
Caring for the adolescent dental patient is a rewarding experience. The use of dental techniques and materials to help young people obtain a healthy and beautiful smile is a clinical challenge requiring knowledge, attention to detail, and skill. In return for their efforts, dentists receive the satisfaction of seeing a young person develop a healthy self-image that can have a positive effect on his or her maturation into adulthood.
The choice of materials is an important consideration for optimizing adolescent dental restorations. When considering which material to choose for a restoration, it is essential to evaluate the tooth to be restored, the patient's caries risk, the location of the restoration, and the forces to which the restoration will be subjected.
There are numerous materials to select from when restoring the young posterior permanent dentition. In the selection process the dentist should consider the size of the caries/defect, the occlusal forces expected to load on the restoration, the patient's caries risk, the ability to isolate the tooth, and the patient's preference.
