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Shokri A, Jamalpour M, Jafariyeh B, Poorolajal J, Sabet NK. Comparison of Ultrasonography, Magnetic Resonance Imaging and Cone Beam Computed Tomography for Detection of Foreign Bodies in Maxillofacial Region. J Clin Diagn Res 2017; 11:TC15-TC19. [PMID: 28571230 DOI: 10.7860/jcdr/2017/24523.9736] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 01/03/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Foreign Bodies (FBs) entrapped in the maxillofacial region have a high prevalence due to trauma and accidents. Accurate localization of FBs and verifying their type and size are critical to assist the surgeon in their fast retrieval with minimal tissue damage. AIM To assess and compare the imaging modalities including MRI, ultrasonography and Cone Beam Computed Tomography (CBCT) for detection of different types of FBs. MATERIALS AND METHODS In this study, four types of FBs including pieces of normal glass, barium glass, wood and pebbles with equal sizes were placed randomly in two sheep heads in different locations such as upper lip, maxillary sinus and body of mandible as FBs and subjected to MRI, ultrasound and CBCT. The images were interpreted by expert observers and the data was analysed using the stata 11 software, kappa test and chi-square test. RESULTS Sensitivity of CBCT, MRI and ultrasound for detecting foreign bodies was 79.19%, 20.83% and 33.33%, respectively. None of the imaging modalities could clearly visualize wooden FBs. Among different FBs, pebbles and barium glass were detected more accurately by radiographic imaging technique. The sensitivity of CBCT, ultrasound and MRI for pebbles was 100%, 33.33% and 16.67%, respectively. The sensitivity of CBCT, ultrasound and MRI for barium glass was 100%, 33.33% and 41.69%, respectively. The sensitivity of CBCT, ultrasound and MRI for wood was 33.33%, 33.33% and 16.67%, respectively. Specificity of all three imaging modalities was 100%. Diagnostic accuracy of all three imaging modalities was higher for detection of FBs in the upper lip than those in the body of mandible, and FBs in the latter location had higher detection accuracy than those in the maxillary sinus. CONCLUSION Among the three imaging modalities, CBCT had the highest diagnostic sensitivity for the examined FBs. The highest diagnostic sensitivity was noted for pebbles and barium glass.
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Affiliation(s)
- Abbas Shokri
- Assistant Professor, Dental Research Center, Department of Oral and Maxillofacial Radiology, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammadreza Jamalpour
- Associate Professor, Dental Research Center, Department of Oral and Maxillofacial Surgery, Dental School, Hamadan University of Medical Sciences, Hamadan, Iran
| | | | - Jalal Poorolajal
- Associate Professor, Modeling of Noncommunicable Diseases Research Center, Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Negar Kanouni Sabet
- Postgraduate Student, Department of Periodontics, Dental School, Isfahan University of Medical Sciences, Isfahan, Iran
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2
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Affiliation(s)
- L Lim
- Consultant Oral and Maxillofacial Surgeon; Westmead Hospital; Westmead New South Wales Australia
| | - P Sirichai
- Department of Oral and Maxillofacial Surgery; Westmead Hospital; Westmead New South Wales Australia
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3
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Importance of Imaging Examinations to Planning the Removal of a Foreign Body From the Tongue. J Craniofac Surg 2016; 27:e223-5. [PMID: 26872277 DOI: 10.1097/scs.0000000000002398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Marwaha M, Bansal K, Srivastava A, Maheshwari N. Surgical Retrieval of Tooth Fragment from Lower Lip and Reattachment after 6 Months of Trauma. Int J Clin Pediatr Dent 2015; 8:145-8. [PMID: 26379385 PMCID: PMC4562050 DOI: 10.5005/jp-journals-10005-1302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 01/16/2015] [Indexed: 11/23/2022] Open
Abstract
Dental traumas are one of the most frequent facial traumas especially in children. Maxillary incisors are the most frequently involved teeth. Here we present, a report of a child who sustained a crown fracture with lost portion of tooth embedded in her lower lip for 6 months. The fragment was surgically retrieved and successfully reattached to the fractured 21 using acid-etch resin technique. How to cite this article: Marwaha M, Bansal K, Srivastava A, Maheshwari N. Surgical Retrieval of Tooth Fragment from Lower Lip and Reattachment after 6 Months of Trauma. Int J Clin Pediatr Dent 2015;8(2):145-148.
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Affiliation(s)
- Mohita Marwaha
- Associate Professor,Department of Pedodontics and Preventive Dentistry, SGT Dental College and Research Institute, Gurgaon, Haryana India
| | - Kalpana Bansal
- Professor and Head, Department of Pedodontics and Preventive Dentistry, SGT Dental College and Research Institute, Gurgaon, Haryana India
| | - Ankit Srivastava
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry, SGT Dental College and Research Institute, Gurgaon, Haryana India
| | - Neha Maheshwari
- Postgraduate Student, Department of Pedodontics and Preventive Dentistry, SGT Dental College and Research Institute, Gurgaon, Haryana India
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5
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Traumatic displacement of maxillary permanent canine into the vestibule of the mouth. Case Rep Dent 2015; 2015:360160. [PMID: 26000177 PMCID: PMC4426822 DOI: 10.1155/2015/360160] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/10/2015] [Indexed: 11/18/2022] Open
Abstract
Dentoalveolar injuries are common and are caused by many factors. Dental trauma requires special consideration when a missing tooth or tooth fracture accompanies soft tissue laceration. A tooth or its fragment occasionally penetrates into soft tissue and may cause severe complications. This report presents a case of delayed diagnosis and management of a displaced tooth in the vestibule of the mouth following dentoalveolar injury. This report suggests that radiography can lead to an early diagnosis and surgical removal of an embedded tooth in the soft tissue.
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Nagaveni NB, Umashankara KV. Tooth fragment embedded in the lower lip for 10 months following dentoalveolar trauma: A case report with literature review. BURNS & TRAUMA 2014; 2:141-5. [PMID: 27602375 PMCID: PMC5012040 DOI: 10.4103/2321-3868.135652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 03/19/2014] [Accepted: 05/27/2014] [Indexed: 12/02/2022]
Abstract
Traumatic injuries to maxillary anterior teeth are a common finding in children because of falls while playing. Sequelae of trauma to dental hard tissue include broken, lost, aspirated and swallowed teeth. One additional hazard is the embedding of fractured tooth fragments in the soft tissues, particularly in the lip. A 10-year-old male patient complained of pain in the lower lip. There was a history of trauma to the upper anterior tooth 10 months previously. Clinical examination showed scarring and discoloration over the lower lip, and the presence of a hard mass was felt on palpation. Intraoral examination revealed an Ellis and Davey class II fracture of number 11. A radiograph of the lip was taken, which showed a radiopaque structure similar to the shape of the missing tooth fragment. Under local anesthesia, the tooth fragment was removed successfully, and the class II fracture was restored with composite. Therefore, proper clinical and complete radiographic examination of both hard and soft tissues following dental trauma is essential to rule out such occurrences.
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Affiliation(s)
- N B Nagaveni
- Department of Pedodontics and Preventive Dentistry, College of Dental Sciences, Davangere 577002, Karnataka, India
| | - K V Umashankara
- Department of Oral and Maxillofacial Surgery, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Avinash A, Dubey A, Singh RK, Prasad S. Surgical removal of coronal fragment of tooth embedded in lower lip and esthetic management of fractured crown segment. Int J Clin Pediatr Dent 2014; 7:65-8. [PMID: 25206243 PMCID: PMC4144052 DOI: 10.5005/jp-journals-10005-1238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Accepted: 09/02/2013] [Indexed: 11/23/2022] Open
Abstract
Dental fractures of the permanent maxillary anterior teeth are relatively frequent accidents during childhood. The Efficient diagnosis and treatment of dental injury are important elements in clinical dentistry. This article describes a case of trauma in permanent right central maxillary incisors with tooth fragments embedded in the lower lip. Thorough clinical examination followed by soft tissue radiographs confirmed the presence of a fractured incisal fragment, which was surgically retrieved under local anesthesia. Direct composite restoration was placed. After finishing and polishing, an esthetic and natural-looking restoration was achieved; this completely satisfied the functional and esthetic expectation of the patient and dental team. How to cite this article: Avinash A, Dubey A, Singh RK, Prasad S. Surgical Removal of Coronal Fragment of Tooth Embedded in Lower Lip and Esthetic Management of Fractured Crown Segment. Int J Clin Pediatr Dent 2014;7(1):65-68.
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Affiliation(s)
- Alok Avinash
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry Rungta College of Dental Sciences and Research, Bhilai Chhattisgarh, India
| | - Alok Dubey
- Reader, Department of Pedodontics and Preventive Dentistry Rungta College of Dental Sciences and Research, Bhilai Chhattisgarh, India
| | - Rajeev Kumar Singh
- Assistant Professor, Department of Pediatric and Preventive Dentistry, Faculty of Dental Sciences, King George's Medical University, Lucknow Uttar Pradesh, India
| | - Swati Prasad
- Postgraduate Student, Department of Oral Medicine, Rungta College of Dental Sciences and Research, Bhilai, Chhattisgarh, India
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Lauritano D, Petruzzi M, Sacco G, Campus G, Carinci F, Milillo L. Dental fragment embedded in the lower lip after facial trauma: Brief review literature and report of a case. Dent Res J (Isfahan) 2013; 9:S237-41. [PMID: 23814592 PMCID: PMC3692182 DOI: 10.4103/1735-3327.109769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Upper incisors are the most frequently involved teeth in traumatic dental injuries. Soft tissues (lips and/or oral mucosa) adjacent to incisal edge can receive direct and/or indirect traumas. Laceration of the lower lip is a not rare eventuality and teeth fragments could be embedded in labial soft tissue. The reattachment of these fragments, if possible, is the elective treatment choice, thanks to the modern adhesive and restorative techniques. The authors present a case of a white Caucasian 10-year-old child, who attended the dental clinic for the treatment of both upper central incisors’ crown fractures. The fragment of the left incisor was retrieved embedded in the lower lip. It was successfully surgically removed and reattached using a composite adhesive technique. A careful clinical and radiographic examination with the surgical removal of tooth fragments could prevent undesirable foreign body reaction, infection and scarring. The authors also reviewed the most relevant literature concerning tooth fragment reattachment after removal from oral soft tissues.
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Affiliation(s)
- Dorina Lauritano
- Department of Dentistry, University of Milano Bicocca, Milan, Italy
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Lips A, da Silva LP, Tannure PN, Farinhas JA, Primo LG, de Araújo Castro GF. Autogenous bonding of tooth fragment retained in lower lip after trauma. Contemp Clin Dent 2013; 3:481-3. [PMID: 23633815 PMCID: PMC3636835 DOI: 10.4103/0976-237x.107448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
In cases of trauma, dental fragments occasionally penetrate into the soft-tissues and may cause severe complications, if neglected. Clinical and radiographic examinations can provide a diagnosis and help in the surgical removal of any dental fragment embedded in soft-tissue. This case report concerns an 8-year-old boy who was diagnosed with a fragment of a fractured permanent central incisor crown located in the lower lip. The patient was seen initially at a general hospital, where the dental fragment went unnoticed. After 2 days, the patient was seen at the pediatric dentistry clinic, where a fragment embedded in the lower lip, causing a large swelling, was diagnosed. The fragment was removed surgically and bonded to the fractured tooth. A mouth guard was prescribed for sports. The importance of soft-tissue exploration even post-trauma was highlighted in this paper.
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Affiliation(s)
- Andrea Lips
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Brazil
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Barua P, Chaudhary S, Kaur H, Mallikarjuna R. Treatment imprudence leading to missed tooth fragment. BMJ Case Rep 2013; 2013:bcr-2013-009154. [PMID: 23606390 DOI: 10.1136/bcr-2013-009154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Traumatic dental injuries (TDI) represent one of the most common oral health problems in children and adolescents. Dental trauma requires a special consideration when it accompanies soft tissue lacerations. Tooth fragments occasionally penetrate into soft tissues and may cause severe complications. This article describes the case of a 12-year-old girl with a fractured tooth fragment embedded in the lower lip for 4 months, which went unnoticed at her primary health centre. This report highlights the importance of proper radiographic diagnosis along with clinical examination after trauma in order to prevent any future complications.
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Affiliation(s)
- Pranamee Barua
- Department of Pediatric Dentistry, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India.
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de Santana Santos T, Melo AR, Pinheiro RTA, Antunes AA, de Carvalho RWF, Dourado E. Tooth embedded in tongue following firearm trauma: report of two cases. Dent Traumatol 2011; 27:309-13. [PMID: 21645242 DOI: 10.1111/j.1600-9657.2011.00994.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Injuries caused by projectiles from firearms involve diverse patterns of dentoalveolar trauma due to the different types of wound and extent of tissue damage. This article reports two cases in which tooth fragments were embedded in the tongue following aggression from a firearm projectile in the facial region. Radiographs confirmed the presence of foreign bodies, which were surgically removed under local anesthesia. When dentoalveolar trauma occurs in facial injuries, both hard and soft tissues must be carefully examined to avoid overlooking embedded tooth fragments not located immediately in the soft tissue.
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Affiliation(s)
- Thiago de Santana Santos
- Oral and Maxillofacial Surgery, Post-Graduate Program of Pernambuco Dentistry College, Camaragibe, Pernambuco, Brazil.
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Cubukcu CE, Aydin U, Ozbek S, Kahveci R. Delayed removal of a primary incisor embedded in the upper lip after dental trauma: a case report about the importance of soft tissue examination. Dent Traumatol 2011; 27:314-7. [PMID: 21631725 DOI: 10.1111/j.1600-9657.2011.01000.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This article describes a child patient who initially had inadequate treatment and suffered concomitant soft tissue trauma involving complete displacement of a primary central incisor into the lip tissue. The primary tooth was subsequently removed by surgery under general anesthesia. Despite the delay in diagnosis, there was an excellent outcome following removal of the embedded tooth. This paper again emphasizes the importance of an accurate history, physical, and radiographic evaluation of these patients in the acute phase. The importance of soft tissue inspection even in cases that are presented late for dental trauma management is also highlighted. This case shows that educated emergency room staff preferably including an oral and maxillofacial surgeon is required for a proper emergency management in orofacial traumas.
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13
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Schwengber GFDS, Cardoso M, Vieira RDS. Bonding of fractured permanent central incisor crown following radiographic localization of the tooth fragment in the lower lip: a case report. Dent Traumatol 2010; 26:434-7. [PMID: 20738363 DOI: 10.1111/j.1600-9657.2010.00908.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study describes the case of an 8-year-old boy who fractured his left maxillary central incisor, exposing the pulp. The trauma also resulted in a cut on his mentum. Radiographic examination revealed the fractured tooth fragment embedded in the lower lip. The fractured tooth, with incomplete root formation, was treated endodontically and received a temporary restoration. After 15 days, the temporary restoration was removed and the fractured tooth fragment was etched with 37% phosphoric acid. A bonding system was then applied to the etched-fractured tooth surface without polymerization. The same bonding procedure was carried out on the tooth fragment. A layer of flowable resin composite was applied to the fragment, which was positioned on the remaining tooth. The resin composite was then polymerized, finished, and polished.
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14
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Gill P, Fleming K. Retained tooth fragment. Br Dent J 2010; 208:330. [DOI: 10.1038/sj.bdj.2010.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Subramanian K, Chogle SMA. Medical and orofacial considerations in traumatic dental injuries. Dent Clin North Am 2009; 53:617-v. [PMID: 19958901 DOI: 10.1016/j.cden.2009.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A complete medical and dental evaluation is imperative following traumatic dental injuries, which are emergent situations that need a quick assessment and appropriate management. The proper diagnosis and treatment rendered determines the prognosis of the case. Proper documentation is important for medicolegal reasons and for baseline reference regarding the traumatic injury. Future treatment modalities and outcomes can be better managed with accurate documentation at the initial assessment.
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Affiliation(s)
- Kumar Subramanian
- Department of Dentistry, Nationwide Children's Hospital, Columbus, Ohio, USA.
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Munerato MC, da Cunha FS, Tolotti A, Paiva RL. Tooth fragments lodged in the lower lip after traumatic dental injury: a case report. Dent Traumatol 2008; 24:487-9. [PMID: 18721355 DOI: 10.1111/j.1600-9657.2008.00565.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Dental fractures are common trauma complications in the oral cavity. The efficient diagnosis and treatment of dental injury are important elements in clinical dentistry. This article describes a case study of trauma in central maxillary incisors with tooth fragments lodged in the lower lip. Radiographs of the soft structures proved themselves as an important tool in the detection and identification of occult tooth fragments, and play an important role in the establishment of the treatment to be adopted. Also, case follow-up is of fundamental significance in the preservation and maintenance of compromised structures.
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Pektas ZO, Kircelli BH, Uslu H. Displacement of tooth fragments to the lower lip: a report of a case presenting an immediate diagnostic approach. Dent Traumatol 2007; 23:376-9. [PMID: 17991240 DOI: 10.1111/j.1600-9657.2006.00465.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Zafer Ozgür Pektas
- Department of Oral and Maxillofacial Surgery, Adana Teaching and Medical Research Center, Baskent University, Adana, Turkey.
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Abstract
The most common traumatic dental injury is the uncomplicated crown fracture of the maxillary central incisor. Various reports have been written about reattachment of the fragment, and literature reviews have cited this technique as the best way of treating these injuries if the fragment is available and properly stored. The case presented here is of a child who sustained an uncomplicated crown fracture with the lost portion of the tooth embedded in his lower lip. This was successfully reattached to the tooth using an acid-etch and enamel-bonding resin technique.
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