Survival analysis of adhesive reattachments in permanent teeth with crown fractures after dental trauma.

Abstract

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. 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. 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 608.2days (±983.1days). The data further suggest that in the case of a detachment, repeated reattachment might be a valuable restoration strategy. Adhesive reattachment is a good first-choice treatment option in cases of crown fractures when the fractured fragment has been saved.