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Mahale VD, Solete P, Priscilla Antony D, Adimulapu HS, M H, Sambandam V. Analyzing the Impact of Different Bonding Protocol Strategies to Improve the Fracture Resistance of Uncomplicated Crown Fractures on Tooth Fracture Reattachment in Permanent Anterior Teeth: An In-vitro Study. Cureus 2024; 16:e56127. [PMID: 38618357 PMCID: PMC11015062 DOI: 10.7759/cureus.56127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 03/13/2024] [Indexed: 04/16/2024] Open
Abstract
Objective This study aims to analyze three different bonding protocol strategies in determining the fracture resistance on the reattachment of fragments in permanent anterior teeth. Methodology This study evaluated the ability of three bonding methods (Group A, total-etch technique; Group B, selective-etch technique; and Group C, self-etch technique) to enhance the fracture resistance of reattached tooth fragments. Sixty permanent maxillary central incisors were chosen, segmented at 3 mm from the incisal edge, and randomly distributed among the three groups. Tooth fragments were stored for 24 hours in GC Tooth Mousse (GC Corporation, Tokyo, Japan), and then reattachment was done using respective bonding techniques. Fracture resistance was gauged using a universal testing machine. Results The mean fracture resistance values were as follows: total-etch (419.5995 N), selective-etch (359.1448 N), and self-etch (192.0887 N). One-way analysis of variance (ANOVA) and post hoc Tukey tests revealed a statistically significant difference between the groups. It was inferred that the total-etch technique exhibited the highest fracture resistance, while the self-etch technique resulted in the lowest fracture resistance (P < 0.05). Conclusions The choice of bonding technique for reattaching tooth fragments should be made based on clinical context and patient needs. Total-etch provided the highest fracture resistance, but selective etch can be preferred for anterior teeth with lower occlusal loads to prevent sensitivity. The self-etch technique may not provide sufficient strength and should be used cautiously. More clinical studies are required to validate these findings and guide clinical decision-making in traumatic dental injury management.
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Affiliation(s)
- Vivek D Mahale
- Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Pradeep Solete
- Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Delphine Priscilla Antony
- Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Hima Sandeep Adimulapu
- Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Hema M
- Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
| | - Vigneshwar Sambandam
- Conservative Dentistry and Endodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS) Saveetha University, Chennai, IND
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Jhunjhunwala G, Tewari N, Atif M, Morankar R, Mathur VP, Bansal K. Comparative evaluation of three materials used for fragment reattachment in uncomplicated crown fracture-An in vitro study using bovine teeth. Dent Traumatol 2024; 40:5-10. [PMID: 37731287 DOI: 10.1111/edt.12888] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/31/2023] [Accepted: 09/01/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND/AIMS The recommended treatment for uncomplicated crown fractures is bonding the fractured fragment or the fragment reattachment. A paucity was identified regarding the studies comparing the efficacy of micro-hybrid and nanohybrid composites in fragment reattachment. Hence, the present study aimed to evaluate and compare three materials for bonding of fragments rehydrated by humidification in teeth with uncomplicated crown fractures. MATERIAL AND METHODS Eighty mandibular bovine incisors with similar dimensions and free of any structural deformities were fractured similar to the technique followed in previous studies. Fracture was simulated, fragments, and stumps were coded, stumps were stored in artificial saliva and the fragments were dehydrated at room temperature and pressure. They were randomly assigned to Group-1 (no rehydration), Group-2 (rehydrated and bonded by flowable nanohybrid composite-3M Filtek Supreme Syringe Flowable Composite Resin-A2, Sao Paulo, Brazil), Group-3 (rehydrated and bonded by flowable micro-hybrid composite- Ruby Flow, InciDental, England, United Kingdom), and Group-4 (rehydrated and bonded by light-cured Glass-Ionomer-Cement-Voco Ionoseal, Cuxhaven, Germany). The samples were subjected to a universal testing machine to evaluate the force required to fracture the bonded fragments. RESULTS The highest median value of the force required to fracture was recorded for Group 2 (208.4 N) followed by Group 3 (195.2). The force required to fracture the bonded fragments was lowest in Group 4 (67.2 N) which was lower than the negative control (131.4 N). The differences between the observations in Groups 2 and 3 were not found to be statistically significant. CONCLUSION The nano and micro-hybrid composites showed greater force required to fracture than fragments bonded by LC-GIC. Dehydrated fragments bonded using nanocomposites performed better than rehydrated fragments bonded by using LC-GIC.
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Affiliation(s)
- Garima Jhunjhunwala
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Nitesh Tewari
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Mohammad Atif
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Morankar
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Prakash Mathur
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Kalpana Bansal
- Division of Pediatric and Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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Patil M, Hegde V, Khan M, Kharbe N, Ghunawat D. Holistic management of complicated crown fracture: A case series. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2023; 26:719-723. [PMID: 38292735 PMCID: PMC10823977 DOI: 10.4103/jcde.jcde_2_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/24/2023] [Accepted: 09/23/2023] [Indexed: 02/01/2024]
Abstract
Coronal fractures of the anterior teeth give an agonizing experience for a young individual due to the physical disfigurement, and the psychological impact that is imposed on them. One of the options for managing complicated/uncomplicated crown fractures when the tooth fragment is available, and there is no or minimal violation of the biological width is the rebonding of the fractured segment. This treatment approach is promising, providing good and long-lasting esthetics as it helps in maintaining the tooth's original anatomic form, hue, and surface texture. This article describes three case reports of successful reattachment of fractured tooth fragments. Following the root canal treatment procedures, prefabricated posts were cemented as intraradicular splint to reattach the fractured segments.
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Affiliation(s)
- Madhuri Patil
- Department of Conservative Dentistry and Endodontics, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Vivek Hegde
- Department of Conservative Dentistry and Endodontics, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Mehrosh Khan
- Department of Conservative Dentistry and Endodontics, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Nain Kharbe
- Department of Conservative Dentistry and Endodontics, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
| | - Dhananjay Ghunawat
- Department of Conservative Dentistry and Endodontics, M. A. Rangoonwala College of Dental Sciences and Research Centre, Pune, Maharashtra, India
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Rajnekar R, Mankar N, Nikhade P, Chandak M, Burde K. Conservative Management of Complicated Crown-Root Fracture: An Immediate Esthetic Rehabilitation. Cureus 2022; 14:e25627. [PMID: 35785013 PMCID: PMC9249066 DOI: 10.7759/cureus.25627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2022] [Indexed: 11/24/2022] Open
Abstract
Among the various types of dental trauma, crown-root fractures are one of the most challenging to treat and require a multidisciplinary approach. This paper reports a case of a complicated crown-root fracture of maxillary left central incisor with esthetic, functional complications. An 18-year-old male patient presented to the department immediately after suffering trauma with a complicated crown-root fracture on tooth 21. As per the treatment, the patient had undergone endodontic therapy followed by flap reflection. Post flap reflection, a glass fiber post was luted, and the fractured fragment was reattached. By this approach, in the same appointment, the cervical margin can be exposed with appropriate isolation followed by a reattachment procedure. Reattaching the fragment is a viable option as it can be done immediately, provides better esthetics, restores function, and is less complicated than the conventional approach. A good prognosis is dependent on patient cooperation with the understanding of the treatment limitations. The article discusses a successful case of complicated crown-root fracture treated with the reattachment of a tooth fragment. Eighteen months of clinical and radiographic evaluation revealed that the clinical protocol was effective, as the tooth was functional, asymptomatic, and esthetic.
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Khurana D, Prasad AB, Raisingani D, Srivastava H, Mital P, Somani N. Comparison of Ribbond and Everstick Post in Reinforcing the Re-attached Maxillary Incisors Having Two Oblique Fracture Patterns: An In Vitro Study. Int J Clin Pediatr Dent 2021; 14:689-692. [PMID: 34934284 PMCID: PMC8645633 DOI: 10.5005/jp-journals-10005-2035] [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] [Indexed: 11/23/2022] Open
Abstract
Aim and objective This study aims to compare the resistance to fracture in maxillary incisors which were fractured in two different oblique patterns and then were re-attached and reinforced using anatomic fiber-reinforced composite (FRC) post. Materials and methods Sixty extracted and intact human maxillary incisors were obtained and divided into two groups (A and B; n = 30). “Labiopalatal” and “palatolabial” fractures were induced in group A and group B, respectively. These two groups were further subdivided into two subgroups (n = 15). In subgroup I Ribbond fiber (Ribbond Inc., Seattle, WA, USA) and in subgroup II Everstick post (everStick Post™, GC Corporation, Tokyo, Japan) were used. Fractured fragments were re-attached using resin and tested for fracture resistance in universal testing machine. Statistical analysis was done with ANOVA one-way test and post hoc test. Results The labiopalatal fracture pattern of group A showed significantly increased resistance to fracture than the palatolabial fracture pattern of group B in both the subgroups. Similarly, subgroup II with Everstick post exhibited significantly higher fracture resistance than subgroup I with Ribbond in both groups A and B (p value < 0.05). Clinical significance The study simulates a clinical scenario of coronal fracture of a tooth and focuses on the techniques and materials which can be used for successful management of such cases. How to cite this article Khurana D, Prasad AB, Raisingani D, et al. Comparison of Ribbond and Everstick Post in Reinforcing the Re-attached Maxillary Incisors Having Two Oblique Fracture Patterns: An In Vitro Study. Int J Clin Pediatr Dent 2021;14(5):689–692.
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Affiliation(s)
- Deeksha Khurana
- Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Ashwini B Prasad
- Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Deepak Raisingani
- Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Harshit Srivastava
- Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Prachi Mital
- Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Dental College and Hospital, Jaipur, Rajasthan, India
| | - Namita Somani
- Department of Conservative Dentistry and Endodontics, Darshan Dental College and Hospital, Jaipur, Rajasthan, India
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Suresh M, Mallikarjun SB, Babu G, Zareena MA. Fracture Resistance of Reattached Hydrated Fragment of Fractured Incisors. Int J Clin Pediatr Dent 2021; 13:476-480. [PMID: 33623332 PMCID: PMC7887173 DOI: 10.5005/jp-journals-10005-1819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and objectives Fragment reattachment procedure provides conservative treatment option when an intact fractured fragment is available. Rewetting of fractured fragment before reattaching has shown better bond strength of attached fragment. Therefore, fracture resistance of reattached fractured fragment with hydration and without hydration was evaluated and compared. Materials and methods Ellis class II fracture was induced in selected and coded 60 extracted maxillary central incisors using a custom-made-wise and assigned into group I and group II (without hydration and with hydration) and both the groups were further divided into two groups (1 week and 3 months). In group I, fractured fragments were reattached after bench-drying for 24 hours. In group II, fractured fragments were reattached after hydrating for 1 hour following bench-drying for 24 hours. Composite (Filtek Z350 XT, Universal Restorative, 3M ESPE) was used to reattach the fractured fragments. Reattached fractured fragments were stored in artificial saliva for 1 week and 3 months and subjected to fracture resistance test using Universal Testing Machine. The data obtained were tabulated and statistically analyzed. Results Fracture resistance in hydration samples was higher than without hydration at the end of 1 week and 3 months statistically. Fracture resistance of fractured fragment at the end of 3 months was higher in both with hydration and without hydration but was not significant with hydration. Conclusion Hydration of fractured fragment before reattachment procedure has shown better fracture resistance and improved further after storing in artificial saliva for 3 months. How to cite this article Suresh M, Mallikarjun SB, Babu G, et al. Fracture Resistance of Reattached Hydrated Fragment of Fractured Incisors. Int J Clin Pediatr Dent 2020;13(5):476-480.
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Affiliation(s)
- Minu Suresh
- Department of Pediatric Dentistry, Coorg Institute of Dental Sciences, KK Campus, Karnataka, India
| | - Shanthala B Mallikarjun
- Department of Pediatric Dentistry, Coorg Institute of Dental Sciences, KK Campus, Karnataka, India
| | - George Babu
- Department of Pediatric Dentistry, Coorg Institute of Dental Sciences, KK Campus, Karnataka, India
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CAN E, DİKİCİ B, ÇAKAR G. A multidisciplinary approach for the restoration of a crown-root fracture with the involvement of supracrestal attached tissues: a case report with 7 year follow up. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.796047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Bissinger R, Müller DD, Hickel R, Kühnisch J. Survival analysis of adhesive reattachments in permanent teeth with crown fractures after dental trauma. Dent Traumatol 2020; 37:208-214. [PMID: 33180986 DOI: 10.1111/edt.12613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM When patients have saved tooth fragments in case of crown fractures, reattachment is considered as the treatment of choice. With respect to the need to provide clinical outcome data regarding adhesively reattached fragments, the aim of this practice-based clinical study was to evaluate the survival of reattached fragments after crown fractures in permanent teeth. MATERIALS AND METHODS Records from patients treated at Ludwig-Maximilians-University between 2004 and 2017 were analyzed to collect clinical and radiographic data regarding the management of fractured teeth that were treated with an adhesive reattachment. The study population consisted of 109 patients comprising 135 reattached fragments divided into uncomplicated (N = 84/135) and complicated (N = 51/135) crown fractures. The Kaplan-Meier Survival estimator was used to estimate the survival probability of primary reattachments after uncomplicated and complicated crown fractures. RESULTS Overall, 77.4% (N = 65/84) and 66.6% (N = 34/51) of the primarily applied reattachments in uncomplicated fractured teeth and complicated fractured teeth, respectively, survived over the period of observation. The survival rate for adhesive reattachment in all teeth was 84.4% (N = 114/135) after 608.2 days (±983.1 days). The data further suggest that in the case of a detachment, repeated reattachment might be a valuable restoration strategy. CONCLUSIONS Adhesive reattachment is a good first-choice treatment option in cases of crown fractures when the fractured fragment has been saved.
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Affiliation(s)
- Ricarda Bissinger
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Daniel David Müller
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Jan Kühnisch
- Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
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Mello I, Michaud PL, Tanner N. Resistance to fracture of extracted teeth used for pre-clinical endodontic procedures: Influence of storage conditions. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:272-275. [PMID: 31925845 DOI: 10.1111/eje.12494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 12/12/2019] [Accepted: 01/07/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES The purpose of this in vitro study was to determine whether different storage conditions used during endodontic procedures affect the fracture resistance of extracted teeth used for pre-clinical dental education. METHODS Freshly extracted mandibular incisors and canines were sterilised in an autoclave for 40 minutes at 24°F under a pressure of 20 psi and then stored in distilled water at 4°C until use. Specimens were randomly assigned to two groups based on the storage method used whilst undergoing endodontic procedures. Between endodontic sessions, teeth in the Wet Group (n = 16 incisors; n = 4 canines) were stored in distilled water and teeth in the Dry Group (n = 16 incisors; n = 4 canines) were stored in a dry container. All specimens were kept at room temperature and away from sunlight. Endodontic treatments were performed in 3 sessions over a 3-week period. The specimens were then brought to fracture under compressive forces along the long axis of the tooth in an Instron universal testing machine. The data were analysed using t tests (α = 0.05). RESULTS None of the teeth fractured during endodontic procedures. However, the compressive load required to fracture teeth stored under wet conditions was significantly higher than the load needed for teeth stored dry (P < .05). CONCLUSIONS Fracture resistance is affected by storage conditions; teeth stored in water have a higher resistance to fracture than teeth that are stored dry. Fracture resistance was, however, not reduced enough to lead to tooth fracture during pre-clinical endodontic procedures.
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Affiliation(s)
- Isabel Mello
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
| | - Pierre-Luc Michaud
- Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
| | - Nicole Tanner
- Dental Hygiene student, School of Dental Hygiene, Dalhousie University, Halifax, NS, Canada
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Demirel G, Baltacioglu IH, Kolsuz ME, Ocak M, Bilecenoglu B, Orhan K. Volumetric Cuspal Deflection of Premolars Restored With Different Paste-like Bulk-fill Resin Composites Evaluated by Microcomputed Tomography. Oper Dent 2019; 45:143-150. [PMID: 31283421 DOI: 10.2341/19-019-l] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to measure the volumetric cuspal deflection of premolars restored with different paste-like bulk-fill resin composites using microcomputed tomography (micro-CT). METHODS AND MATERIALS A total of 35 freshly extracted human maxillary second premolars were selected for this study. Standardized large MOD cavities were prepared in each premolar with a bucco-lingual width of 4 mm and a cavity depth of 4 mm measured from the palatal cusp tip. After cavity preparation, all samples were scanned immediately using a micro-CT system. After the initial micro-CT scanning, restorative procedures were performed. Four groups received different paste-like bulk-fill composites-Beautifil-Bulk Restorative (BBR), Admira Fusion x-tra (AFX), x-tra fill, and Sonic Fill-and the control group received a conventional universal composite and Clearfil Majesty Esthetic (CME). Immediately after the restorative procedure, each tooth was scanned by micro-CT in the same manner as the initial scanning. The buccal and palatal regions of each restoration were evaluated separately in terms of cuspal deflection. One-way analysis of variance was used to compare the effect of the composite resin, and multiple comparisons were performed by the Tukey test with a level of significance of α = 0.05. RESULTS AND DISCUSSION Multiple comparisons showed that teeth restored with the conventional paste-like composite and CME (control) had significantly different cuspal deflection from those filled with paste-like bulk-fill composites (p<0.05). Among the bulk-fill composites, a significant difference was observed between BBR and AFX (p<0.05). CONCLUSIONS Paste-like bulk-fill resin composites had significantly lower cuspal deflection than the conventional paste-like resin composite tested.
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Madhubala A, Tewari N, Mathur VP, Bansal K. Comparative evaluation of fracture resistance using two rehydration protocols for fragment reattachment in uncomplicated crown fractures. Dent Traumatol 2019; 35:199-203. [PMID: 30933418 DOI: 10.1111/edt.12473] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/28/2019] [Accepted: 03/29/2019] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Aripirala Madhubala
- Pedodontics & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Nitesh Tewari
- Pedodontics & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Prakash Mathur
- Pedodontics & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Kalpana Bansal
- Pedodontics & Preventive Dentistry, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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de Sousa APBR, França K, de Lucas Rezende LVM, do Nascimento Poubel DL, Almeida JCF, de Toledo IP, Garcia FCP. In vitro tooth reattachment techniques: A systematic review. Dent Traumatol 2018; 34:297-310. [DOI: 10.1111/edt.12414] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/06/2018] [Indexed: 01/18/2023]
Affiliation(s)
| | - Kamilla França
- Department of Dentistry; School of Health Sciences; University of Brasília; Brasília Brazil
| | | | | | | | - Isabela Porto de Toledo
- Histopathology Laboratory; School of Health Sciences; University of Brasília; Brasília Brazil
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Ramesh P, Mathew S, Murthy SBV, George JV, Hegde S, Premkumar R. Efficacy of Ribbond and a fibre post on the fracture resistance of reattached maxillary central incisors with two fracture patterns: a comparative in vitro study. Dent Traumatol 2015; 32:110-5. [PMID: 26361080 DOI: 10.1111/edt.12223] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2015] [Indexed: 11/26/2022]
Abstract
AIM To compare the fracture resistance of maxillary central incisor fragments having two different fracture patterns and re-attached using two different posts - fibre post and Ribbond. MATERIALS AND METHODS Sixty extracted human maxillary central incisors were randomly divided into two groups of thirty samples each. Group A consisted of samples with 'labio-palatal' fracture pattern and Group B with a 'palato-labial' fracture pattern. The crowns of all the samples were sectioned using safe-sided diamond discs. Following cleaning and shaping and sectional obturation, the samples were randomly subdivided into two subgroups of 15 samples each. Prefabricated fibre post (Reforpost, Angelus, Londrina, PR, Brazil) was placed in all samples of Subgroup I, and Ribbond (Ribbond Inc., Seattle, WA, USA) was placed in all samples of Subgroup II. The fragments were re-attached, fracture resistance was tested using Instron Universal Testing Machine, and the failure modes were assessed using a stereomicroscope. RESULTS Group A with a labio-palatal fracture pattern exhibited higher fracture resistance as compared to Group B (palato-labial) in both subgroups. The fibre post (Subgroup I) exhibited higher fracture resistance as compared to Ribbond (Subgroup II). The Ribbond group exhibited significantly more number of repairable failures as compared to fibre post group. CONCLUSION The labio-palatal pattern of fracture is a favourable type of fracture on palatal load application. The fragments re-attached using the fibre post (Reforpost) had a higher resistance to fracture. However, teeth restored with Ribbond posts exhibited 100% repairable failures upon load application. The fracture pattern had no influence on the failure modes.
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Affiliation(s)
- Poornima Ramesh
- Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, Bengaluru, India
| | - Sylvia Mathew
- Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, Bengaluru, India
| | - Sreenivasa B V Murthy
- Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, Bengaluru, India
| | - John V George
- Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, Bengaluru, India
| | - Swaroop Hegde
- Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, Bengaluru, India
| | - Remya Premkumar
- Department of Conservative Dentistry & Endodontics, Faculty of Dental Sciences, M.S.Ramaiah University of Applied Sciences, Bengaluru, India
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Taguchi CMC, Bernardon JK, Zimmermann G, Baratieri LN. Tooth fragment reattachment: a case report. Oper Dent 2014; 40:227-34. [PMID: 25535781 DOI: 10.2341/14-034-t] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this article is to present a case report for the multidisciplinary treatment of anterior tooth fractures with invasion of the biologic width and pulpectomy. Successful esthetic and functional results were achieved by bonding the crown fragment, without any form of preparation or the utilization of intracanal posts.
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15
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Reston EG, Reichert LA, Busato ALS, Bueno RPR, Zettermann J. 10-year Follow-up of Natural Crown Bonding After Tooth Fracture. Oper Dent 2014; 39:469-72. [DOI: 10.2341/13-294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
The aim of this article is to discuss relevant considerations about crown bonding and describe a clinical case in which a tooth fragment and direct composite resin were used to successfully restore a fractured anterior tooth. Clinical examinations showed good esthetics and periodontal health after 10 years of follow-up.
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Affiliation(s)
- EG Reston
- Eduardo G Reston, DDS, MSD, PhD, Lutheran University of Brazil, Department of Restorative Dentistry, School of Dentistry, Canoas, Brazil
| | - LA Reichert
- Leandro A Reichert, MD, Lutheran University of Brazil, School of Dentistry, Department of Restorative Dentistry, Porto Alegre, Brazil
| | - AL Stefanello Busato
- Adair L Stefanello Busato, DDS, MSD, PhD, Lutheran University of Brazil, School of Dentistry, Department of Restorative Dentistry, Canoas, Brazil
| | - RPR Bueno
- Renata PR Bueno, Lutheran University of Brazil, Dentistry, Esteio, Brazil
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16
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Shirani F, Sakhaei Manesh V, Malekipour MR. Preservation of coronal tooth fragments prior to reattachment. Aust Dent J 2013; 58:321-5. [PMID: 23981213 DOI: 10.1111/adj.12092] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND Reattachment of the tooth fragment is a well-accepted treatment option in dealing with crown fractures. Hydration of the fragment is an important aspect in this treatment. The present study evaluated the effect of storing fragments in different storage media prior to reattachment. METHODS Sixty bovine incisors were randomly divided into five groups. The teeth were fractured and the fragments were dried for 48 hours and then immersed in one of the four experimental media (distilled water, milk, egg white, or 50% dextrose solution) for 2 hours. Tooth fragments in the control group were kept dry. The apical segments of the fractured teeth were stored in physiological saline. Fragments were reattached and force was applied on the labial side of the teeth at a 1 mm/min rate until failure. RESULTS One-way ANOVA indicated that the storage medium affects bond strength (p = 0.002). Multiple comparison tests showed that the teeth preserved in the 50% dextrose solution and the egg white exhibited significantly higher bond strengths compared to the control group (p < 0.05). CONCLUSIONS Preservation of the fractured tooth fragment in egg white or hypertonic solutions results in a higher strength of the bond between the restoration and the tooth as compared to storage in water or dried conditions.
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Affiliation(s)
- F Shirani
- Dental Materials Research Center, Department of Operative Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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