Fracture resistance of reattached incisor fragments with mini fibre-reinforced composite anchors

Evaluation of Fracture Resistance of Reattached Tooth Fragments Restored Using Fiber-reinforced Composites: A Systematic Review

AIM AND BACKGROUND

This systematic review examined the current literature to evaluate the fracture resistance of the tooth fragments reattached using fiber-reinforced composites (FRC).

MATERIALS AND METHODS

An electronic search was performed on Scopus, PubMed, and Web of Science databases according to specific inclusion and exclusion criteria to identify relevant articles to be included until January 2023. Articles with full text available in the English language for randomized control studies, observational studies, retrospective studies, and in vitro studies conducted on permanent human teeth were selected. The risk of bias was assessed in all studies using the OHAT tool.

RESULTS

Out of 16 search results, seven in vitro studies with a total of 415 samples were included in the review. Three studies reported that reinforcement using rigid FRC posts improves fracture resistance of reattached anterior teeth, three studies reported that reinforcement using flexible fiber bundles enhances the fracture strength of reattached posterior teeth and one study reported that the use of flexible polyethylene fibers improves fracture resistance in molars with reattached cusps.

CONCLUSION

Within the limitations of the studies included in the review, there is low-quality evidence that reinforcement of reattached fragments using FRC posts or fibers improves fracture resistance.

CLINICAL SIGNIFICANCE

The reattached fractured fragments may be susceptible to re-fracture. The use of FRC to reinforce the resin composite used for reattachment may enhance the bond strength and increase resistance to fracture. How to cite this article: Albar NHM. Evaluation of Fracture Resistance of Reattached Tooth Fragments Restored Using Fiber-reinforced Composites: A Systematic Review. J Contemp Dent Pract 2024;25(6):605-615.

Efficacy of Palatal Applications on Fracture Resistance of Reattached Maxillary Central Incisors: An In Vitro Study

The purpose of this study was to evaluate the effects of different palatal applications on fracture strength of the fractured anterior tooth. Sixty caries-free human maxillary incisors were used. Endodontic treatments of the teeth were performed. Then, the teeth were divided randomly into five groups (n = 12). Crowns of all teeth in groups A–D were cut with diamond discs at a fixed distance of 3 mm from the incisal margin in a plane normal to the buccal surface. In all groups, coronal fragments were reattached to the remaining teeth by bonding with hybrid composite resin. After then, the teeth were restored to the following; group A, bonding and palatal laminate; group B, bonding and creation of a vertical groove; group C, bonding and creation of two slot grooves; group D, bonding only; and group E, intact tooth. It was lesser in group B than in groups C and E (p = 0.007 and p = 0.006, resp.) and lesser in group D than in groups A, C, and E (p = 0.002, p < 0.001, and p < 0.001, resp.). Within the limitations of this in vitro study, it can be concluded that methods employing palatinal laminate and small grooves are clinically feasible for the reattachment of tooth fragments to incisors.

Fracture resistance of microhybrid composite, nano composite and fibre-reinforced composite used for incisal edge restoration

Traumatized anterior teeth need quick, aesthetic and functional repair. Along with aesthetics, the physical properties of restorative material should also be considered for long-lasting restoration. Fibre reinforcement has been tried as a newer technique to improve the physical properties of composite materials. Hence, this study was carried out to evaluate the fracture resistance of microhybrid composite, nano composite and fibre-reinforced composite used for restoration of incisal edge of fractured maxillary central incisors. Extracted permanent maxillary central incisors were randomly divided into four groups of 10 samples each: control group with intact teeth (Group A), microhybrid composite (Esthet X; Dentsply/Caulk, Milford, DE, USA) (group B), nano composite (Ceram X; Dentsply/Caulk) (group C) and microhybrid composite reinforced with polyethylene fibre - flowable composite unit [(Ribbond THM; Ribbond Inc., Seattle, WA, USA; Esthet X flow; Dentsply/Caulk)] (group D). The fracture resistance was measured under universal testing machine at a speed of 1mmmin(-1) with the loading tip of 2mm diameter. The samples were further evaluated for mode of fracture under stereomicroscope at 3.5× magnification. The data were analysed using one-way anova and Tukey's test for fracture resistance. Group A and group D exhibited significantly higher fracture resistance than group B and group C. No significant difference was found between group B and group C as well as between group A and group D. Fisher's exact test for the mode of fracture revealed no statistical significance. It was concluded that fibre reinforcement of composite could be an alternative technique for restoration of fractured anterior teeth for better aesthetics and longevity of the restoration.