Search

Anterior tooth fractures in children are often caused by their active lifestyles. If these fractures affect only the enamel or dentin, composite restoration suffices as treatment. However, if the damage extends to the pulp, root canal therapy becomes necessary before final restoration. One of the advantages of fiber reinforced composite (FRC) posts is that they provide additional strength to the tooth after root canal treatment, helping to prevent further cracking or fracturing. This case report focuses on treating Class III Ellis fractures of anterior teeth in an 11-year-old boy who had sustained injuries. The fractured teeth caused pain and required root canal treatment due to pulp involvement. The patient in this case report used FRC posts after root canal treatment because the tooth crown fractured more than half of the crown and the canal walls were thin because the pulp canals in young adult teeth were still wide. FRC posts offer elasticity, translucency, adaptability, and resistance to friction and impact, making them a valuable alternative to conventional posts for post-traumatic anterior tooth fractures. [ABSTRACT FROM AUTHOR]

Background/Aim: Crown fractures are common traumatic dental injuries and tooth fragment reattachment is a viable option for restoring a fractured tooth. The aim of this study was to assess the knowledge and experience of dentists in the Federal District regarding the tooth fragment reattachment technique for enamel and dentin fractures. Materials and Methods: For the cross‐sectional observational study, an electronic form was designed with objective and self‐report questions for dentists. The data were analyzed using descriptive statistics, with their absolute and relative frequencies. For the analysis of categorical variables, the nonparametric chi‐squared or Fisher exact association tests were used in the statistical software R (version 4.2.1). Results: A total of 416 dentists participated in the study (58.9% female and 41.1% male). Of these, 70% declared they knew about fragment reattachment, but only 42.3% reported previous experience with this procedure. The most common storage medium used for the fractured fragment was milk (78.1%), and the bonding material used for reattachment was light‐cured composite resin (86.3%). A majority (66.3%) reported that for a patient with enamel and dentin fracture, with the crown fragment in good condition, they would choose to do the reattachment. Conclusion: Dentists demonstrated that they had adequate knowledge about the tooth fragment technique, although many did not have previous experience with this procedure. [ABSTRACT FROM AUTHOR]

ABSTRACT Tooth fractures are a common consequence of dental trauma in young patients, requiring prompt and effective restorative interventions that ensure both functional integrity and esthetic appeal. Although resin stratification (layering) is the gold standard for achieving life‐like restoration of fractured teeth, many clinicians find it technically challenging due to the time and effort required for precise shade matching, concealing the fracture line, and accurate placement of resin composite layers with different levels of opacity. The more recent generation of monoshade composites, with their ability to adapt to various tooth shades, reduce the complexity of multi‐layer restorations, and improve chairside efficiency. Additionally, the composite cutback technique has gained attention as an effective method for restoring fractured teeth in young patients. This method combines the benefits of monoshade composites and the precision of simple additional layering to enhance both the esthetic and functional outcomes of the restorations. This mini‐review provides a comprehensive analysis of the composite cutback technique, the role of monoshade composites, and their clinical application in the restoration of fractured young teeth. [ABSTRACT FROM AUTHOR]

Background: Uncomplicated crown fractures of maxillary anterior teeth are common dental injuries, and the bonding of fractured fragments is recommended for management. Rehydration of fragments improves bonding and fracture resistance. Therefore, the aim of this study was to compare the fracture resistance of the reattached tooth fragment of the incisor crown after rehydration using either a steamer or a humidifier. MATERIALS AND METHODS: Bovine teeth were used as a model. Fractured fragments were divided into three groups: Group I (no rehydration), Group II (rehydration by humidifier), and Group III (rehydration by steamer). Fragments were reattached using a standard bonding protocol. Fracture resistance was tested using a universal testing machine. Statistical analysis was performed using analysis of variance and Chi-square tests. Results: The force required to fracture the reattached fragments was significantly higher in Group II (humidifier) compared to Group I (no rehydration) (P = 0.005). Group III (steamer) had a force value similar to Group I, indicating no significant improvement in fracture resistance with steamer rehydration. The temperature inside the steam-based chamber reached an average of 95.7°C with 95% humidity, whereas the conventional humidification chamber had an average temperature of 39.2°C and 84% humidity. Conclusion: Within the limitations of the present study, the rehydration protocol using a steam-based chamber was found to have a significantly lower force required to fracture the reattached fragments as compared to humidifier-based chamber. This was not significantly different from the fragments which were reattached without rehydration.

Background: Uncomplicated crown fractures of maxillary anterior teeth are common dental injuries, and the bonding of fractured fragments is recommended for management. Rehydration of fragments improves bonding and fracture resistance. Therefore, the aim of this study was to compare the fracture resistance of the reattached tooth fragment of the incisor crown after rehydration using either a steamer or a humidifier. Materials and Methods: Bovine teeth were used as a model. Fractured fragments were divided into three groups: Group I (no rehydration), Group II (rehydration by humidifier), and Group III (rehydration by steamer). Fragments were reattached using a standard bonding protocol. Fracture resistance was tested using a universal testing machine. Statistical analysis was performed using analysis of variance and Chi-square tests. Results: The force required to fracture the reattached fragments was significantly higher in Group II (humidifier) compared to Group I (no rehydration) (P = 0.005). Group III (steamer) had a force value similar to Group I, indicating no significant improvement in fracture resistance with steamer rehydration. The temperature inside the steam-based chamber reached an average of 95.7°C with 95% humidity, whereas the conventional humidification chamber had an average temperature of 39.2°C and 84% humidity. Conclusion: Within the limitations of the present study, the rehydration protocol using a steam-based chamber was found to have a significantly lower force required to fracture the reattached fragments as compared to humidifier-based chamber. This was not significantly different from the fragments which were reattached without rehydration. [ABSTRACT FROM AUTHOR]

Background/Aim: Anterior teeth are prone to traumatic dental injuries (TDIs). Although a number of techniques ranging from original tooth fragment reattachment (TFR) to direct composite restoration (DCR) can be used to restore uncomplicated crown fractures, there is no consensus on which method is best. The purpose of this study was to investigate the fracture resistance of bovine incisors restored by two different techniques (TFR and DCR) in three different fracture models. Materials and Methods: Sixty extracted bovine lower incisors were randomly divided into three groups (n = 20). Angle, oblique, or transverse sections of all the teeth in a group were prepared by using a disk. The cut surfaces were scanned, and the cross‐sectional areas (CSA) of the enamel and dentin were measured. Half the teeth in each group were restored by DCR (n = 10) and the other half by TFR (n = 10). The forces required to fracture the restored teeth were then measured using a Universal testing machine, and the fracture modes were analyzed (cohesive, adhesive, or mixed). Results: No statistically significant differences between the TFR and DCR restorations were detected for total and enamel CSAs in any of the restoration shapes (p >.067). The fracture forces required to break DCR angle and transverse restorations were significantly greater than for the corresponding shapes restored with TFR (p <.033). However, the difference in the forces needed to fracture oblique section restorations by DCR or TFR was not statistically significant (p =.239), despite a similar trend (143.4 ± 51 N and 120.9 ± 25 N, respectively). Conclusion: This study revealed that a greater force is required to fracture teeth restored by the DCR than by the TFR technique, especially for a transverse section. This demonstrates that restoring a fractured tooth provides a superior outcome compared to reattaching the fractured fragment. [ABSTRACT FROM AUTHOR]

A definitive method to predictably treat propagated longitudinal fractures remains elusive. A proof-of-concept case report series documenting nonsurgical removal of propagated longitudinal fractures has shown up to 5 years of clinical and radiographic success. This installment of the case report series further documents these teeth with 7.5-year to 11.5-year recall evaluations. Three previously reported cases of fracture removal were followed at 11.5 years (1 case), 9.75 years (1 case), and 7.5 years (1 case) after treatment to determine the long-term clinical and radiographic success of nonsurgical fracture removal. This case report series has demonstrated 10-year success (clinically and radiographically) for the treatment of progressive longitudinal fractures. Propagated fractures can be nonsurgically removed and the iatrogenic defect repaired with long-term success providing a foundation for treatment and further investigation. [ABSTRACT FROM AUTHOR]

Background: Determination of the eligibility of several tooth analog materials for use in crown fracture testing. Methods: A standardized premolar crown preparation was replicated into three types of resin dies (C&B, low modulus 3D printed resin; OnX, high modulus 3D printed resin composite; and highest modulus milled resin composite). 0.8 mm zirconia crowns were bonded to the dies and the maximum fracture load of the crowns was tested. Twelve extracted human premolars were prepared to a standardized crown preparation, and duplicate dies of the prepared teeth were 3D printed out of C&B. Zirconia crowns were bonded to both the dies and natural teeth, and their fracture load was tested. Results: There was no statistical difference between the fracture load of zirconia crowns bonded to standardized dies of C&B (1084.5 ± 134.2 N), OnX (1112.7 ± 109.8 N) or Lava Ultimate (1137.5 ± 88.7 N) (p = 0.580). There was no statistical difference between the fracture load of crowns bonded to dentin dies (1313 ± 240 N) and a 3D-printed resin die (C&B, 1156 ± 163 N) (p = 0.618). Conclusions: There was no difference in the static fracture load of zirconia crowns bonded to standardized resin dies with different moduli or between a low modulus resin die and natural dentin die. [ABSTRACT FROM AUTHOR]

Background: To determine what thickness of 5 mol% yttria zirconia (5Y-Z) translucent crowns cemented with different cements and surface treatments would have equivalent fracture resistance as 3 mol% yttria (3Y-Z) crowns. Methods: The study included 0.8 mm, 1.0 mm, and 1.2 mm thickness 5Y-Z (Katana UTML) crowns and 0.5 and 1.0 mm thickness 3Y-Z (Katana HT) crowns as controls. The 5Y-Z crowns were divided among three treatment subgroups (n = 10/subgroup): (1) cemented using RMGIC (Rely X Luting Cement), (2) alumina particle-abraded then luted with the same cement, (3) alumina particle-abraded and cemented using a resin cement (Panavia SA Cement Universal). The 3Y-Z controls were alumina particle-abraded then cemented with RMGIC. The specimens were then loaded in compression at 30° until failure. Results: All 5Y-Z crowns (regardless of thickness or surface treatment) had a similar to or higher fracture force than the 0.5 mm 3Y-Z crowns. Only the 1.2 mm 5Y-Z crowns with resin cement showed significantly similar fracture force to the 1 mm 3Y-Z crowns. Conclusion: In order to achieve a similar fracture resistance to 0.5 mm 3Y-Z crowns cemented with RMGIC, 5Y-Z crowns may be as thin as 0.8 mm. To achieve a similar fracture resistance to 1.0 mm 3Y-Z crowns cemented with RMGIC, 5Y-Z crowns must be 1.2 mm and bonded with resin cement. [ABSTRACT FROM AUTHOR]

Acute dental trauma is unscheduled and presents infrequently to the majority of practitioners. Therefore, a consistent, logical and systematic process for examination, prioritisation and management is imperative for all sustained injuries to have an optimal outcome. Fractures are a frequent sequela to dental trauma and can involve any aspect of the tooth structure or supporting alveolar bone. While some minor crown fractures may initially seem inconsequential, they may be a subtle indication to a more serious underlying root fracture. Concomitant injuries and injuries that have been initially missed are generally associated with poorer outcomes. The time sensitive management of traumatic dental injuries aims to preserve pulpal and periodontal health where possible. The follow up period for tooth or alveolar fractures are important to allow for early intervention if pathology develops. [ABSTRACT FROM AUTHOR]

Objective: Analyse factors associated with dental trauma in 12‐year‐old adolescents. Methods: An epidemiological survey was carried out in the five largest cities in the state of Mato Grosso do Sul, Brazil. Data on traumatic dental injuries (TDI) based on the World Health Organization (WHO), sociodemographic characteristics and individual clinical and behavioural characteristics in 615 adolescents were collected. Univariate and adjusted multilevel logistic regressions were performed to test the association of dental trauma with behavioural and sociodemographic factors. The study was approved by the Ethics Committee (CAAE number 85647518.4.0000.0021). Results: The prevalence of TDI at 12 years was 3.4% (95% CI 1.8; 6.4). In the adjusted models, clinical characteristics of adolescents such as overjet >3 mm (OR = 1.51 [95% CI 1.00; 2.41]) were associated with trauma. Sociodemographic characteristics such as female sex (OR = 0.13 [95% CI 0.07; 0.25]), income above the poverty level (OR = 0.34 [95% CI 0.15; 0.78]), who declared themselves white (OR = 0.23 [95% CI 0.11; 0.47]) and with sedentary behaviour (OR = 0.69 [95% CI 0.59; 0.80]) were associated with trauma, as protective factors. Conclusion: Sociodemographic, behavioural and individual clinical characteristics were associated with TDI in adolescents. Oral health teams should focus on the most vulnerable groups, encouraging the use of mouthguards and access to treatment services. [ABSTRACT FROM AUTHOR]

Elderly patients have a high incidence of falls that result in facial injuries. Many cases present with dental crown fractures and soft-tissue lacerations. The initial diagnosis is especially important in this type of dental trauma, since an initial error can result in the failure to establish the correct treatment from the very beginning, worsening the prognosis, which, in the worst case, can compromise the teeth affected by the trauma. Case report: We present the case of a patient, a 79-year-old woman, who suffered an accidental fall. The patient was examined by a dentist in the emergency room. She was diagnosed with a simple crown fracture of the right upper central incisor and right upper lateral incisor without any pulpal involvement and with laceration of the lower lip. Months later, she had an episode of inflammation in the lower lip, and she developed edema and pain. An X-ray of the lower lip revealed a radiopaque mass compatible with a fragment of dental tissue due to the inclusion of remnants of the dental tissue resulting from the previous accident fall. Conclusions: The population of geriatric patients is steadily increasing in our society, and a higher frequency of falls has been observed in this age group, affecting the maxillofacial region, with consequent dental trauma on many occasions. Therefore, as professionals, we must pay special attention to the prevention and treatment of this problem, insisting on the importance of routine investigation in the emergency visit for dental trauma, which includes a meticulous examination of the soft tissues accompanied by a radiographic examination, when the inclusion of foreign bodies is suspected. [ABSTRACT FROM AUTHOR]

Background: Fragment reattachment is the recommended treatment modality in uncomplicated crown fractures. There is a paucity of literature regarding the mechanisms responsible for increased resistance to fracture after fragment rehydration in such cases. Hence, the aim of this proof‐of‐concept study was to decipher the microscopic changes in the penetration characteristics of resin in tooth fragments after different rehydration protocols. Material and Methods: Sixty bovine incisors free of structural deformities were fractured as per a standard protocol and the fragments were stored in saline at 4°C. They were randomly allocated into three groups (n = 20)—Group 1: negative‐control, no‐rehydration, Group 2: rehydration by immersion in distilled water for 15 min, Group 3: rehydration by humidification for 15 min. They were subjected to the "experimental bonding protocol" using an eighth‐generation bonding agent mixed with rhodamine‐B dye. The samples were subjected to decalcification and sectioned into cubical blocks (2 × 2 × 2 mm3). They were embedded in paraffin wax, sectioned by an ultramicrotome and evaluated by using a confocal laser scanning microscope. The depths and width of the resin tags were assessed by image analysis software, and the number of tags was counted manually by blinded evaluators. Statistical analysis was done with Stata‐14. Results: The depth of penetration of the resin tags was greatest in Group 2 (927.81 ± 280.38 μm) followed by Group 3 (902.03 ± 371.85 μm) and Group 1 (287.74 ± 124.80 μm). Similarly, the width of the penetrated resin tags was greatest in Group 2 (58.29 ± 21.15), followed by Group 3 (35.53 ± 22.15) and Group 1 (23.89 ± 6.88). The number of resin tags in the majority of the samples in Group 1 had less than 25 tags (65%), whereas there were more than 25 tags in Group 2 (70%) and Group 3 (75%). These differences were statistically significant (p <.05). Conclusion: The resin penetration, as observed by the number of tags and their depth and width, was significantly affected by the rehydration of the fragments. The fragments rehydrated in the distilled water had greater penetration of resin tags than those rehydrated in a humidification chamber. [ABSTRACT FROM AUTHOR]

Although tooth wear is a normal process due to aging, severe tooth wear causes various complications such as increased tooth sensitivity, loss of tooth structure, and pulp complications. In the treatment of patients with excessive tooth wear, the evaluation of loss of vertical occlusal dimension should be prioritized. If it is necessary to increase the vertical dimension to secure the restoration space, it is important to establish a treatment plan with the comprehensive analysis and determine the minimum vertical dimension elevation. In this case, 66-year-old male patient with severe worn dentition wanted to restore masticatory function and improve esthetic restoration. In order to determine the appropriate vertical dimension of the patient, we evaluated oral examination, radiographic examination, and diagnostic cast examination, and performed rehabilitation with minimum vertical dimension elevation. As a result of observation for 8 months, the definitive prosthesis was completed with contact of all teeth in centric occlusion, and proper anterior/posterior guidance. Through the above process, satisfactory aesthetic and functional outcomes were obtained. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Dental Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Traumatic dental injuries (TDI) are frequent among individuals of all ages, with a prevalence ranging from 12–22%, with crown and crown–root fractures being the most common. Fragment reattachment using light-cured nanocomposites is the recommended method for the management of these fractures. Though there are several clinical studies that have assessed the efficacy of such materials, an in-silico characterization of the effects of traumatic forces on the re-attached fragments has never been performed. Hence, this study aimed to evaluate the efficacy of various adhesive materials in crown and crown–root reattachments through computational modelling. A full-scale permanent maxillary anterior tooth model was developed by segmenting 3D scanned cone beam computed tomography (CBCT) images of the pulp, root, and enamel precisely. The full-scale 3D tooth model was then subjected to a novel numerical cutting operation to describe the crown and crown–root fractures. The fractured tooth models were then filled computationally with three commonly used filler (or adhesive) materials, namely flowable composite, resin cement, and resin adhesive, and subjected to masticatory and traumatic loading conditions. The flowable composite demonstrated a statistically significant difference and the lowest produced stresses when subjected to masticatory loading. Resin cement demonstrated reduced stress values for crown–root fractures that were masticatory loaded after being reattached using adhesive materials. During traumatic loading, resin cement demonstrated lower displacements and stress values across both fractures. The novel findings reported in this study are anticipated to assist dentists in selecting the most appropriate adhesive materials that induce the least stress on the reattached tooth when subjected to second trauma, for both crown and crown–root fractures. [ABSTRACT FROM AUTHOR]

|| Brief Background Treatment of tooth fractures is challenging for practitioners. However, the appropriate diagnosis of tooth fractures aids in better treatment planning. Additionally, better diagnosis can help improve fracture treatment, thus, underscoring the importance of clinicians requiring thorough knowledge of diagnosing the fracture. However, to date, there is a lack of a good evidence base that clinicians can adopt for accurate diagnosis of tooth fracture. This review attempts to fill that gap by discussing the current methods of diagnosing tooth fractur [ABSTRACT FROM AUTHOR]

Background/Aim: In case of crown fractures after traumatic dental injuries, the affected teeth can be restored either with reattachment of the fractured fragment or with a direct composite restoration. So far, longevity data for reattachments and direct composite restorations with regard to different failure types (pulp necrosis and infection, restoration loss) are scarce. Therefore, the aim of this retrospective study was to evaluate the restorative and biological survival of reattached fragments and composite restorations after crown fractures in permanent teeth. Material and Methods: Dental records of patients treated between 2000 and 2018 were retrospectively analysed regarding the restoration (reattachment or direct composite restorations) of teeth with crown fractures. Survival (no further intervention) and restorative and/or biological failure of all restored teeth were recorded. Statistical analysis was performed using Kaplan–Meier statistics, and the mean annual failure rates for two and 5 years were calculated. Furthermore, the effect of potential risk factors on survival was assessed. Log‐rank tests and univariate Cox regression models (likelihood ratio tests) were used to assess the univariate effect of all variables of interest. Variables with a p‐value ≤.10 were included in a multivariate Cox regression model with shared frailty (p <.05). Results: Overall, 164 patients with 235 teeth (uncomplicated crown fracture: N = 201, complicated crown fracture: N = 34) were included (1.6 ± 2.5 years observation time). Of these, 59 teeth were restored with reattachment of the fragment and 176 with a composite restoration. Overall, composite restorations had a significantly higher survival rate than reattachments (p =.002). The cumulative survival after 2 years was 42.9% and 65.0% for teeth treated with a reattachment (mAFR = 34.5%) and a composite restoration (mAFR = 19.3%), respectively. When differentiating between failure types, restoration failure and pulp necrosis were significantly more frequently detected in reattached crown fractures compared to composite restorations (restorative failure: p =.001; biological failure: p =.036). In the multivariate Cox regression model, the variable jaw and luxation significantly influenced the survival when the tooth was restored with a composite restoration. The survival was not influenced by the fracture type. Conclusions: Restorative and biological failures were more frequently detected when the tooth was restored with a reattached fragment compared to a direct composite restoration. Both, restoration failure and pulp necrosis with infection should be considered as frequent complications after restoration of crown‐fractured teeth which emphasizes the necessity of regular and short follow‐up intervals throughout the first 2 years. [ABSTRACT FROM AUTHOR]

Copyright of European Oral Research is the property of Istanbul University, Faculty of Dentistry and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Partial pulpotomy is a procedural intervention that can maintain the vitality of pulp during the management of traumatized permanent teeth with pulpal involvement. Aim: To evaluate whether partial pulpotomy can be considered a reliable conservative treatment option for treating traumatized permanent anterior teeth with pulpal involvement. Methodology: A computerized systematic search was performed in PubMed, Science Direct, Cochrane, and LILACS databases from 1980 to May 2021. Five studies were included in the final analysis. Quality assessment, Meta-analysis, and Publication bias of the studies were evaluated. This systematic review was registered in PROSPERO (ID – CRD42021262031). Result: The comprehensive Meta-Analysis Software was used. The test of the heterogeneity was analysed using Cochran's Q statistics. The Q value was 7.186 (df = 6) with a P value of 0.3 and I2 as 16.5%. The studies were considered homogenous, and the fixed-effect model showed an overall point estimate of 0.89 with a 95% confidence interval (0.86–0.91). The Begg and Egger funnel plot indicated that there was no publication bias in the included studies. Conclusion: Evidence indicates that partial pulpotomy may be considered a reliable definitive treatment option in asymptomatic traumatized permanent anterior teeth with exposed pulp rather than total pulpotomy.

Introduction: Knowledgeable and timely management of traumatic dental injuries (TDIs) plays a decisive role in their long-term prognosis. The aim of this study was to assess knowledge of managing traumatic tooth fracture of permanent teeth among endodontists and general practitioners (GPs) set in two different countries. Materials and Methods: A two-part self-administered questionnaire assessing knowledge of traumatic tooth fracture management was distributed among 400 professionals in Saudi Arabia and the United Kingdom. The first part contained seven questions related to the participants' demographic data, and the second part included ten questions related to the management of trauma case scenarios focused on crown and root fracture. Data were statistically analyzed. Results: One hundred and eighty-two individuals participated in this survey. Endodontists managed TDIs more frequently, and the mean number of their correct answers was significantly higher when compared with GPs (P = 0.004). Specialty was the constant predictor of level of knowledge (P = 0.001) excluding geographic location and frequency of treating TDIs. Conclusion: The level of knowledge of the participants in both countries in managing traumatic tooth fracture was moderate. Correct answer score was influenced by having a specialty in endodontics. Dental professionals' perception of their knowledge did not reflect their objectively measured level.

Abstract Dental trauma can result in different kinds of injuries based on the extent, direction, and location of the impact. Multidisciplinary management of traumatized teeth is critical for successful treatment and improvement of the prognosis.

Traumatic injury to the upper anterior teeth is common in young children, especialy when it is combined whit orthodontic problem – overjet. This paper reports the presence of traumatized maxillary permanent central incisors which are successfully restored whit wax-up technique. Case report: The case describe the treatment of traumatized maxillary permanent central incisors whit wax-up technique. A 9-year-old girl came to the dental clinic with an injury of the two maxillary central incisors with oblique partial crown fracture without pulp exposure. Traumatized anterior teeth require quick functional and esthetic repair, and wax-up technique is commonly used for their restoration. The wax-up technique seems to be a promising restorative option. This is a rational restorative alternative and less invasive prosthodontic treatment. The patient and the parents are satisfied whit the result which confirmed the success of the rehabilitation.

Traumatic dental injuries (TDI) are frequent among individuals of all ages, with a prevalence ranging from 12–22%, with crown and crown–root fractures being the most common. Fragment reattachment using light-cured nanocomposites is the recommended method for the management of these fractures. Though there are several clinical studies that have assessed the efficacy of such materials, an in-silico characterization of the effects of traumatic forces on the re-attached fragments has never been performed. Hence, this study aimed to evaluate the efficacy of various adhesive materials in crown and crown–root reattachments through computational modelling. A full-scale permanent maxillary anterior tooth model was developed by segmenting 3D scanned cone beam computed tomography (CBCT) images of the pulp, root, and enamel precisely. The full-scale 3D tooth model was then subjected to a novel numerical cutting operation to describe the crown and crown–root fractures. The fractured tooth models were then filled computationally with three commonly used filler (or adhesive) materials, namely flowable composite, resin cement, and resin adhesive, and subjected to masticatory and traumatic loading conditions. The flowable composite demonstrated a statistically significant difference and the lowest produced stresses when subjected to masticatory loading. Resin cement demonstrated reduced stress values for crown–root fractures that were masticatory loaded after being reattached using adhesive materials. During traumatic loading, resin cement demonstrated lower displacements and stress values across both fractures. The novel findings reported in this study are anticipated to assist dentists in selecting the most appropriate adhesive materials that induce the least stress on the reattached tooth when subjected to second trauma, for both crown and crown–root fractures.

Crown fractures are a common type of traumatic dental injury. Various factors may affect the outcome of crown fractures. This study aimed to evaluate the treatment outcomes of immature teeth with a crown fracture. This retrospective cohort study included patients who presented to a dental trauma center from 2008–2018 with a history of a crown fracture of immature teeth and at least 6 months of follow-up. Outcomes of primary endodontic or restorative interventions as well as reinterventions were evaluated. Kaplan-Meier curves were used to compare the unadjusted differences in survival time. Logistic and Cox regression analyses were performed to identify potential predictors for complication and survival time, respectively. The success rates of the primary interventions for 99 teeth (72 patients) after a median follow-up of 22 months were as follows: cervical pulpotomy (90.4%), partial pulpotomy (85.2%), mineral trioxide aggregate apical barrier (80.0%), root canal treatment (66.6%), and only restoration (47.2%). Teeth that received vital pulp therapy were less prone to complications (adjusted hazard ratio = 0.21; 95% confidence interval, 0.09–0.53; P <.05), whereas those with concomitant luxation injuries were more susceptible to complications (adjusted odds ratio = 2.90; 95% confidence interval, 1.01–8.29; P <.05). Crown fractures had a relatively high favorable prognosis. Vital pulp therapy (partial or cervical pulpotomy) had the highest success rate, whereas cases that received only restoration had the lowest success rate. Teeth with concomitant luxation injuries had more odds and hazards of complications. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Ege University School of Dentistry / Ege Üniversitesi Dis Hekimligi Fakültesi Dergisi is the property of Ege University Faculty of Dentistry and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: It has been suggested that fissures of the occlusal surface of equine cheek teeth may develop into crown fractures.Objectives: To examine the evolution of fissures present on the occlusal surface of cheek teeth. Furthermore, to investigate the presence of a fissure as a risk factor for the development of a subsequent crown fracture.Study Design: Observational longitudinal study.Methods: Bi-annual dental examinations were performed on 36 horses for 3 years. Video-recordings were made to evaluate the evolution of detected fissures. The effect of possible predictors on the development of tooth fractures was investigated by regression analysis.Results: The evolution of 785 fissures (467 type 1a, 271 type 1b, 47 type 2) was recorded. Fissure characteristics were observed to remain unchanged, disappear, become longer, shorter, change in configuration or change in color. Partial crown fractures (22 maxillary, 50 mandibular) were recorded in 52 cheek teeth in 22/36 horses. Fifty-nine of these fractures evolved from previously observed fissures (24 type 1a, 29 type 1b, 6 type 2). All fissure types proved to be a significant risk factor for the development of a crown fracture (p < 0.001), with the highest odds for type 2 fissures (OR = 14.27; 95% CI = 4.88–41.71). Other significant risk factors were the time of follow-up (p < 0.001), mandibular teeth (p < 0.001) and the lingual side of a tooth (p < 0.001). All fractures were non-complicated.Main Limitations: Some horses were prematurely lost for follow-up, which perhaps influenced the results. A longer follow-up period would have also allowed an evaluation of the risk for pulp disease on the long term subsequent to partial crown fractures.Conclusions: The presence of a fissure of any type, mandibular cheek teeth, the lingual side of cheek teeth, and time of follow-up proved to be significant risk factors for development of a cheek tooth crown fracture. Type 2 fissures showed the highest odds followed by type 1b fissures. The observed partial crown fractures demonstrated a low clinical impact whereby no tooth showed signs of development of endodontal disease.

Anterior crown fractures are a common form of traumatic dental injuries that mainly affect the maxillary incisors especially in children and adolescents. Complicated crown fractures although less common can be a challenging task to the clinician. Since the development of adhesive dentistry, the patient's own broken tooth fragment can be used to restore the fractured tooth. Reattachment of fractured tooth fragments with fiber postreinforcement offers a viable restorative alternative. Such procedure is economical and needs less chair-side time as compared to many traditional methods. In addition, the procedure provides good and long-lasting esthetics, as the original morphology, color, and surface texture are preserved. The main objective while treating such cases is successful pain management and immediate restoration of function, esthetics and phonetics. This paper presents a report of two cases of coronal tooth fracture that is successfully managed using tooth fragment reattachment.

Traumatic dental injuries are not only a serious public health problem, but they are also the most common injuries among children according to the epidemiological data. Subluxation is defined as the loosening of a tooth without displacement. Coronal fractures are the most common injuries. Considering the treatment options, which are suitable for the concomitant occurrence of these two traumatic injuries, there are only limited number of studies in the literature. In the concomitant occurrence of these two trauma types, like in other traumatic injuries, if the treatment is not implemented timely, long-term problems may develop. The objective of this case report was to describe the therapeutic approach to the subluxation concomitant with a coronal fracture.

Objective The present study observed the clinical effects on reattachment and pulpotomy of young crown⁃fractured and pulp⁃exposed permanent incisors. Methods In a one⁃year retrospective clinical observation study, 30 traumatic intact segments of permanent incisors with crown fracture and pulpal exposure were treated using a pulpot⁃ omy and reattachment technique with an enamel⁃dentin luting agent and composite resin. Results The number of sub⁃ sequent visit teeth was 30, 29, 25 at 1, 3, 6 months follow⁃up respectively. The pulpotomy success rates were 100% at 1 month, 93.1% at 3 months, 93.1% at 6 months. The retention rates using the reattachment technique were 100% at 1 month, 100% at 3 months, 100% at 6 months. Conclusion Pulpotomy is the preferred method of preserving live pulp after pulpal exposure of young permanent incisors, and the clinical effect is prominent. The fragment reattachment tech⁃ nique is an effective middle⁃ and short⁃term method for temporary restoration of young crown⁃fractured permanent inci⁃ sors.

Dental trauma can result in different kinds of injuries based on the extent, direction, and location of the impact. Multidisciplinary management of traumatized teeth is critical for successful treatment and improvement of the prognosis. [ABSTRACT FROM AUTHOR]

Most common consequences of trauma is the crown fracture, mainly maxillary anterior tooth due to its forward positioning in the arch. Understanding the outcome of the planned treatment gives an idea regarding the prognosis of that particular treatment. Various options are available for the treatment of fractured tooth. Among all reattachment of fractured coronal segment to that tooth provides instant esthetic, as it restores the original form, colour, contour, surface texture and also gives a psychological comfort to the patient. This clinical case report focuses on the successful reattachment of two fractured coronal crowns using glass-fibre reinforced composite post. Since, both of the fractured teeth were of complex type, endodontic treatment was performed for both of the cases. At the end, a natural-looking restoration is achieved. [ABSTRACT FROM AUTHOR]

Traumatic dental injury (TDI) is an unanticipated event, which has to be managed efficiently to avoid any serious consequences for the patient. Traumatic dental injury is most commonly seen in anterior teeth, main cause being sports activities, accidental fall, physical assaults, vehicle accidents. Among the TDIs crown fracture and luxation are the most common dental injuries which require proper diagnosis, treatment plan and follow up for favourable prognosis. The International Association of Dental Traumatology (IADT) has developed the guidelines for the management of these dental traumatic injuries based on literature search and professional opinion. The main objective of these guidelines is to delineate an approach for the immediate or urgent care of TDIs, while subsequent treatment requires interventions involving specialist consultations, services, and/or materials/methods not always available to the primary treating clinician. The recent IADT Guidelines 2012 has given the guidelines for management of TDI as three parts 1) fractures and luxations of permanent teeth 2) Avulsion of permanent teeth 3) Injuries in the primary dentition .Complicated crown fracture involves enamel, dentin and pulp. Treatment of such complicated fracture depends on various factors like cause of trauma, time elapsed between the occurrence of trauma and the treatment seeked for the same, condition of the oral supporting structures, root development stage, pulpal involvement, availability of fractured tooth fragments, level and position of fracture line. Recent advances in adhesive dentistry has paved the way for more conservative and esthetic approach for the treatment of crown fracture thus preserving the tooth structures. [ABSTRACT FROM AUTHOR]

Background/aims: Following coronal tooth fracture, keeping the fragment hydrated is of the utmost importance in the tooth fragment bonding technique. The aim of this study was to evaluate the effects of different immersion times in different storage media on multimode adhesive bonding between reattached fragments and teeth.Materials and Methods: A total of 195 bovine incisors were fractured and randomized into the following storage groups (n = 15): G0-control group (sound tooth); GA-saline solution: for 1 hour (A1) or 24 hours (A2); GB-artificial saliva: for 1 hour (B1) or 24 hours (B2); GC-coconut water: for 1 hour (C1) or 24 hours (C2); GD-tap water: for 1 hour (D1) or 24 hours (D2); GE-milk: for 1 hour (E1) or 24 hours (E2); GF-dry (dehydration): for 1 hour (F1) or 24 hours (F2). Tooth fragments were then reattached using a multimode adhesive in a self-mode technique with a flowable resin composite. Fracture resistance was evaluated in a universal testing machine under a compressive load (1 mm/min). The data were submitted to two-way analysis of variance and the post hoc Tukey test (5%).Results: The group submitted to the dehydration factor (GF) exhibited a mean value of 599.1 ± 144.2 N, while those submitted to all hydration protocols (GA, GB, GC, GD, GE) exhibited a mean value of 751.8 ± 285.4 N. Dehydration significantly affected the fracture strength values (P = .005). No significant interaction between the rewetting solutions was observed (P > .05).Conclusions: Hydration of the tooth fragment increased fracture resistance, regardless of the storage solution and/or immersion time. [ABSTRACT FROM AUTHOR]

Dental trauma can lead to a wide range of injuries of which crown and root fractures are examples. This report describes the management of previously untreated crown- and root-fractured maxillary permanent incisors in an 18-year-old patient. The patient underwent no treatment for 8 years and then presented with the complaint of recurrent pain and swelling. Intraoral examination showed crown fractures in the maxillary right central and left lateral incisors, while radiographic examination revealed large radiolucent lesions related to the periapical area of these teeth and a horizontal root fracture in the middle third of the maxillary left central incisor. Endodontic therapy and periapical surgery were performed for the persistent periapical periodontitis associated with the crown-fractured teeth. Connective tissue healing was detected for the root-fractured tooth. However, because of its proximity to periapical lesions, this root-fractured tooth was also included in the periapical surgery. Follow-up 1 year later showed clinical and radiographic healing. [ABSTRACT FROM AUTHOR]

A case of dens invaginatus in a maxillary lateral incisor with a periapical lesion (that was discovered by chance after a panoramic radiographic examination despite the abnormal anatomy) responded successfully to non-surgical treatment involving chemomechanical root canal preparation associated with longterm treatment with calcium hydroxide. [ABSTRACT FROM AUTHOR]

Pulpal necrosis after dento-alveolar trauma of immature permanent teeth can cause a substantial problem for both patient and practitioner. Traditional therapy includes apexification with calcium hydroxide or the one-step apical plug procedure with mineral trioxide aggregate. The case presented here illustrates how an immature central incisor in a young individual, in which treatment was planned for a one-step apical plug technique after trauma and subsequent pulp necrosis, displayed root maturation due to the longterm course of the treatment. [ABSTRACT FROM AUTHOR]

A 14-year-old male patient reported with a horizontal fracture of almost the entire crown of a maxillary incisor, extending subgingivally at the palatal side. After root canal therapy and electrosurgery, the tooth fragment was reattached using a total-etch dentin-bonding system and a hybrid composite. Due to enamel cracks and the necessity for more retention, the labial surfaces of the teeth were veneered with a micro-filled composite. The clinical situation of the reattached teeth was confirmed successful by radiographic and photographic assessment after 1, 3, 6, and 12 months. The restoration of an anterior tooth with original tooth fragment in young patients has advantages over conventional composite or prosthetic restorations. However, reattached teeth with fracture extending subgingivally, require long-term follow-up. (Quintessence Int 2004;35:601-604) [ABSTRACT FROM AUTHOR]

Most dental trauma requires immediate action to preserve the affected teeth. Furthermore, the trauma has often a great impact on the appearance and well being of the patient. In this case trauma resulted in a very deep complicated crown-root fracture of one incisor and a complicated crown fracture in another incisor of a 47-year-old woman. A combination of surgical extrusion and adhesive restoration was chosen to provide good prognosis for the teeth as well as an instant esthetic result that was well accepted by the patient. Eleven months after trauma, the treated teeth exhibited good healing and normal function. [ABSTRACT FROM AUTHOR]

Dental trauma is one of the most prevalent problems encountered in clinical practice. Traumatic injuries involving fractures of the anterior tooth are one of the most common problems among children and adolescents. There is a physical and social impact on patients' quality of life due to traumatic dental injuries (TDIs). Children and adolescents frequently present with a crown fracture that necessitates immediate intervention. Clinicians need to be aware of various treatment modalities for TDIs and have to address these injuries immediately. Due to advances in adhesive technologies, fragment reattachment is the treatment of choice when the fragment is available and well stored. The purpose of this article is to cover various techniques for reattaching fractured fragments and the most current developments in adhesive systems for this purpose., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Rathod et al.)

Traumatic dental injuries can occur due to various reasons such as accidents, sports injuries, fights, falls, and others. These injuries can affect the teeth, gums, and surrounding tissues, and can range from minor chips and cracks to severe fractures, dislocations, and avulsions (when the tooth is completely knocked out of the socket). The most common way to address this is by replacing affected teeth with dental implants. The purpose of this research is to evaluate the use of composite materials in dental implants and compare them with the traditionally used materials using a patient specific cone beam computed tomography (CBCT) based finite element model (FEM). To conduct this research, two different implant groups i.e., traditional implant and composite implant were designed using Titanium grade 4, zirconium oxide-reinforced lithium silicate (ZLS), and Zirconia (ZrO 2 ). Six dental implants were designed namely Ti implant, ZLS implant, ZrO 2 implant, Ti-ZrO 2 composite, Ti-ZLS composite, and ZLS-ZrO 2 composite using 3D modelling software. Detailed full-scale 3D models of patient specific dental implant were developed and traumatic loading conditions were applied to the enamel of central incisor teeth or crown of dental implant, and maxilla was constrained in all directions. It was found that the use of composite materials for dental implants can reduce the stresses over the surface of abutment and implant as compared to traditional implants. The detailed models developed as a part of this study can advance the research on dental implants, and with further experimental validation allow the use of composite materials for fabrication of more stable dental implants., (© 2024 IOP Publishing Ltd.)

Objective: This study evaluated the effect of preparation utilization and design, and addition of resin composite to the bonding interface, on the fracture resistance of reattached incisal fragments. Method and materials: Sixty bovine incisors were distributed among 1 control group and 5 experimental groups. Experimental specimens were sectioned 3.0 mm from the incisal edge with a 0.15-mm wafering blade at a 25-degree inclination apically in a faciolingual direction. Two groups received no further preparation. Specimens in the other 3 groups received either external bevels, internal bevels, or combined external and internal bevels. One preparationless group was reattached with dentin bonding agent alone. All other fragments were reattached with a dentin bonding agent-resin composite interface. After thermocycling and 4 weeks of bond weathering, specimens were sheared to failure in a universal testing machine. Results: No significant differences in fracture strength were observed among any of the experimental groups, yet each displayed significantly less resistance to fracture than the control group. Reattachment of fragments in all groups restored approximately one half or one third the fracture strength of the control teeth for crown or root fractures, respectively. Conclusion: Compared to the simple, expedient regiment of using a dentin bonding agent alone, nonconservative tooth modification and the addition of resin composite to the bonding interface did not increase resistance to fracture and thus provided no retentive advantage. (Quintessence Int 1999;30:637-643) [ABSTRACT FROM AUTHOR]

Background/Aims: Uncomplicated crown fracture is the most common traumatic dental injury. The International Association of Dental Traumatology has recommended fragment reattachment as the best method for restoring uncomplicated crown fractures of permanent teeth. Dehydration can affect fracture resistance after reattachment. However, a standard protocol for rehydration is still lacking. Hence, the aim of this study was to design a humidification chamber and assess its efficacy for improving the rehydration of tooth fragments and increasing fracture resistance after reattachment. Materials and Methods: Sixty mandibular bovine incisors with similar dimensions and free of any structural deformities were fractured and randomized into five groups: Group I, Control Group (sound teeth); Group II (dehydrated for 24 hours); Group III (rehydrated in distilled water for 15 minutes); Group IV (rehydrated in a humidification chamber for 15 minutes); and Group V (restored with composite). A humidification chamber was designed and used for rehydration for 15 minutes in Group IV. Fragments in Group III were immersed in distilled water for 15 minutes. Reattachment procedures and materials remained the same in all groups. Fracture resistance was tested in a universal testing machine, and statistical analysis was done by Stata‐14. Results: The Control Group with sound teeth (Group I) exhibited a maximum value of 282 ± 10.32 N, while Group II (fragment reattached without rehydration) had the least fracture resistance, 49.75 ± 5.2 N. Rehydration by means of the humidification chamber protocol (Group IV) resulted in significantly higher fracture resistance (150.54 ± 6.49 N) than in Group III (rehydration by means of immersion). Conclusions: Fracture resistance after fragment reattachment was significantly affected by the rehydration of fragments for 15 minutes in the humidification chamber. Fragment reattachment after rehydration showed better fracture resistance than the composite restorations. [ABSTRACT FROM AUTHOR]

Objective: Among the techniques used by pediatric dentists for the crown fracture is the fragment reattachment. The aim of this study was to evaluate the long‐term survival of the tooth reattachment in comparison to the composite restoration technique. Methods: The study included 67 patients aged 7‐9 years (males 38/56.7%; females 29/43.3%), with noncomplicated fractures of permanent teeth. The patients were divided into two groups; group A included 32 patients (males 18/56.2%; females 14/43.8%; total number of affected tooth 36), and group B comprised 35 patients (males 20/57.1%; females 15/42.9%; 36 affected tooth). In group A patients the reattachment was conducted after the trauma, and the direct composite restoration technique was used for patients in group B. All patients were evaluated for complications and pulp status for 5 years. Results: There were no significant differences (P > 0.05) in terms of the occurrence of complications observed between groups throughout the 5‐year observation period. Conclusion: Both methods provide similar results over the 60 months of observation. Clinical Significance: Reattachment technique has shown to be a reliable treatment option that might be considered as a primary technique when the fragment is saved after the trauma. [ABSTRACT FROM AUTHOR]

As a result of a skiing accident, a ten-year-old girl suffered combined injuries to both maxillary central incisor teeth (#1.1 and #2.1). The injuries were uncomplicated crown fractures, apical horizontal root fractures, and a severe extrusive luxation of the coronal segments of the teeth. Her mother repositioned the teeth immediately, resulting in good initial healing. Nine months later, the patient was referred to a specialist to manage the endodontic consequences of the trauma. The apexification treatment of the fractured roots, using a preformed apical barrier technique with bioactive cement, was the treatment of choice, administered to both the avulsed roots at two separate recall visits. The best option for managing the fractured apical segments was to continue with the follow-up, which was conducted to assess the overall case at 30 months. The fractured apexes remained normally positioned inside the socket and were asymptomatic (as they presumably maintained a physiological vascular-nerve supply and, consequently, their vitality), while the apexification treatment led to the healing of the periodontal tissues and to hard tissue formation in the area of the interrupted roots in the avulsed portion of the teeth. The management of traumatic injuries in teeth often requires multiple treatment approaches, because these injuries rarely represent one single type of trauma.