A biological approach to crown fracture: Fracture reattachment: A report of two cases

Comparison of Ribbond and Everstick Post in Reinforcing the Re-attached Maxillary Incisors Having Two Oblique Fracture Patterns: An In Vitro Study

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.

Fracture Resistance of Incisal Fragments Following Reattachment With Different Techniques in Simulated Crown Fractures

Introduction: The aim of the present study was to evaluate and compare the effect of acidetching and Er, Cr:YSGG laser treatment before the reattachment of incisal fragments in coronal fractures of permanent incisor teeth. Methods: Sixty-six sound human maxillary incisors were randomly divided into 3 groups (n=22). Teeth were embedded in self-cure acrylic resins by leaving one-third of the crowns out, and uncomplicated crown fractures were obtained using an Instron testing device. The fragments were reattached using 3 different procedures and a hybrid resin composite (Z250): Group I: Acid etching + Prime & Bond NT; Group II: Er,Cr:YSGG + Prime & Bond NT; Group III: Er,Cr:YSGG + Acid etching + Prime & Bond NT. The percentages of shear bond strengths were determined by comparing fracture strengths of sound and reattached teeth for 3 groups. All data were analyzed statistically with Kruskal-Wallis H test. Results: Mean fracture strengths of the reattached fragments were between 51.02% and 62.93% of that of the sound teeth in all groups. Group I had significantly higher percentages of shear bond strength values (P<0.05) when compared to group II and group III. No significant difference (P>0.05) was found between group II and group III. Conclusion: The findings of the present study show that Er,Cr:YSGG laser irradiation prior to the reattachment of incisal fragments has a negative effect on fracture strength.

Reestablishing Biology, Function, and Esthetics for Fractured, Immature Incisors

A seven-year-old boy with enamel-dentin fractures on both maxillary central incisors presented to the Piracicaba Dental School-UNICAMP seven days after the trauma. At the clinical evaluation, there were no clinical signs of pulp exposure, neither tooth was mobile, and both affected teeth presented a positive response to sensitivity tests and a negative response for percussion and palpation. The radiographic examination showed an undeveloped root and opened apex for both teeth. Indirect pulp capping was performed on the left maxillary central incisor, followed by a direct restoration. After one month, the patient complained of pain in the left central incisor, which responded negatively to sensitivity testing. Pulp revascularization was performed only on this tooth and was followed for 18 months. During this period, the left maxillary central incisor did not recover sensitivity, although radiographic examination showed apical closure, a slight increase in root length, and the formation of a mineralized barrier between the root canal and sealing material. The technique achieved its goal of restoring biological aspects, function, and esthetics of traumatized teeth when using this multidisciplinary approach.