Emergency management of dental trauma

Comparison of shear bond strengths with different bevel preparations for the reattachment of fractured fragments of maxillary central incisors

BACKGROUND/AIMS

Fractures of anterior teeth are a highly prevalent form of dental trauma. Among the various treatment options, reattachment of the fractured part to the remaining tooth has a lot of advantages. The aim of this study was to compare different bevel preparation techniques when reattaching fractured fragments to maxillary central incisors.

METHODS

This study was performed on 52 maxillary central incisors that were randomly divided into 3 experimental groups and 1 control group. In the control group, the repair was done by attaching the fractured fragment using bonding and composite resin without any bevel preparation. In the second and third groups, the bevel preparation was done to a depth of 0.5 mm before attachment of the fragment on the palatal side of the fracture and on the labial and palatal sides, respectively. In the fourth group, after tooth preparation, a 0.5 mm composite veneer was placed on the labial surface. The amount of force needed to refracture the tooth was measured with a universal testing machine, and shear bond strength was calculated in MPa.

RESULTS

The mean and standard deviation (mean ± SD) of shear bond strengths in the control group were 81.48 ± 8.18 MPa. In the palatal bevel group, they were 97.74 ± 11.41 MPa; in the labial and palatal bevel group, 131.56 ± 9.25 MPa; and in the composite veneer group, 104.36 ± 5.50 MPa. Significant differences were observed between the groups, but there was no significant difference between the palatal bevel and composite veneer groups.

CONCLUSIONS

Reattachment of the fractured fragments by all three methods increased the shear bond strength. The highest shear bond strength was obtained when both labial and palatal bevels were used.

Occurrence of dental avulsion and associated injuries in patients with facial trauma over a 9-year period

INTRODUCTION

This retrospective study aimed to assess the occurrence of dental avulsions in patients with facial trauma over a 9-year period.

MATERIALS AND METHODS

Data was collected from records of patients attended to at the Division of Oral and Maxillofacial Surgery at Piracicaba Dental School-State University of Campinas, Piracicaba (SP), Brazil.

RESULTS

Two hundred three patients with 387 avulsed teeth were evaluated, the central incisors being the most common teeth involved (42 % of permanent and 61 % of primary teeth). Thirty-four percent of the cases occurred on weekends, mainly on Saturdays (20 %) and the distribution in relation to the time of year was similar with slight peaks in January. The most prevalent associated dentoalveolar injury was lateral luxation (26 %) and 19 % of the patients presented with an associated facial fracture. The most common sign presented was laceration (23 %), and the main symptoms found were pain (58 %). Associated general trauma was present in 139 patients (68 %), and the most prevalent was the upper limb (41 %).

DISCUSSION

Special emphasis should be given not only to diagnosis and treatment of dental avulsion but for prevention, too. An understanding of the etiology, severity, and distribution of associated traumatic injuries can help for future studies and for an effective prevention of these injuries.