Fractured Anterior Teeth Research Articles

Prevalence of Traumatic Dental Injury in Arab Israeli Community

Traumatic dental injury (TDI) in school children has become a serious dental public health problem in developing and developed countries. Worldwide research clearly shows that the prevalence of TDI is increasing. Objective: The purpose of this study is to clinical compare without use radiograph film in comparing between groups of boys and girls which complain of traumatic fracture of anterior permanent teeth in enamel and dentine reigns with or with out Pulp rom records of patients aged 9-12years. Design: A descriptive cross-sectional survey in Arab Israeli schoolchildren between 2003-2015. Subjects: A sample of 4262 ,Arab Israeli schoolchildren (2344(55%)) males and 1918(45%)) females) aged 9-12years ,were interviewed and examined between 2003-2015in different dental private clinics in Israel. Results: Among the 4262 schoolchildren examined, 520(12,2%) had experienced traumatic dental injuries (TDIs). Males had experienced a significantly higher prevalence of trauma 340(8%) than females 180(4,2%) . Conclusion: Overall traumatised permanent incisors were found to occur fairly frequently with males having experienced significantly more TDIs than females. Theprevalence of TDIs in Arab Israeli schoolchildren was 12,2%; enamel fractures were the most frequently observed injury and falls were the leading cause of trauma.

Pin Retained Restoration: A Case Report

Pin retained amalgam restoration are a type of amalgam or resin restoration of a complex nature requiring the placement of one or more pins in the dentin to provide adequate retention and resistance forms. The pin-retained amalgam is a valuable treatment aid in the restoration of teeth with extensive carious lesions or fractures. The pins help in binding the amalgam/composite to the tooth structure. The case report given in this article presents the recovery of fractured anterior teeth with dentinal pins and composite restoration.

No-Prep Rehabilitation of Fractured Maxillary Incisors with Partial Veneers.

Therapeutic options for dental trauma depend on the injuries' features. For patients with uncomplicated tooth fractures, adhesive materials and composite partial veneers may be a therapeutic solution that completely preserves healthy tooth structure. An ultra-conservative approach, using indirect composite partial veneers to restore fractured anterior teeth is described in these case reports. Despite the position of the finish line in the middle of the clinical crown, this solution offers functional and esthetic outcomes using an indirect composite technique, and appears to be a suitable alternative to direct composite restorations or less conservative indirect veneers. Indirect composite partial veneers present considerable advantages, such as ultra-minimally invasive properties and excellent esthetic appearances. The success seems to depend on a combination of sound adhesive principles, adequate design of the restoration, laboratory experience, and cementation techniques. (J Esthet Restor Dent 28:351-358, 2016).

A simplified restorative technique of fractured maxillary anterior teeth

Fractures of the anterior teeth consists of a clinical condition that generates not only aesthetic and psychological problems, but may also cause dental pain. Thus, the affected teeth should be treated as urgencies in dental offices and their resolution whenever possible should be in a single session. Direct resin composite restorations should wherever possible be preferred due to the speed and possibility of obtaining good results. Objective: The objective of this case report is to describe the clinical sequence for restoration of a maxillary central incisor that presented a crown fracture using an immediate insert technique for resin composite (a "free hand" technique) with a modification to obtain dentin layer. Case report: A patient sought treatment after she fractured tooth #21. The restoration was performed with resin composite using the immediate technique. To facilitate the layering technique, the immediate insertion technique was changed for making the dentin lobes with the aid of a Teflon tape and the support with the index finger. Conclusion: The restoration of fractured anterior teeth can be performed quickly with the use of resin composites of different opacities and the use of the technique of immediate insertion proposed in this case report.

Esthetic Rehabilitation of Crown Fracture Utilizing Orthodontic Extrusion and Restorative Modality

INTRODUCTION: Complicated crown fractures involve enamel, dentine and the pulp, whereby the most commonly affected tooth is the maxillary central incisor. Fractures of anterior teeth cause not only esthetic and functional, but also psychological problems. Various treatment modalities are available depending upon the clinical, physiological and radiographic status of the involved tooth. In complex cases, a combination of endodontic, periodontal, orthodontic and restorative procedures may be required. CASE DISCUSSION: This case report describes the management of a crown fracture of maxillary left central incisor. A complex procedure was designed to manage this case including orthodontic extrusion to move the fracture line above the alveolar bone and surgical recontouring of the altered gingival margin. Finally, the tooth was restored prosthodontically. Prosthodontic treatment was based on performing post and core and all ceramic crown on the extruded tooth. CONCLUSION: The treatment resulted in good esthetics and secured periodontal health. This case report demonstrates that a multidisciplinary treatment approach is a reliable and predictable option to save a tooth.

Multi-Disciplinary Approach for the Treatment of Maxillary Anterior Teeth with Luxation Injuries and Complicated Crown Fractures: A Case Report

Anterior tooth fractures are commonly seen types of dental injury. In the treatment of complicated crown fractures, two treatment options as extraction and root canal treatment could be considered due to the remaining tooth structure. Endodontic treatment is vital in order to maintain function and provides better aesthetics and reliefs the patient's pain. The aim of this case report is to present a 17-years-old female patient’s treatment and five-years follow-up radiographs and photographs.

Reattachment of an Incompletely Fractured Anterior Tooth by a Conservative Approach

The major objectives of restoration dentistry are to restore teeth in a way that allies conservation of healthy dental tissue, esthetics, function, and durability. The ideal would be to attain restorations that are as strong as the natural teeth, which seems unnoticeable even to dentists and more demanding patients.3 Thus, in many clinical situations, the best option for fractured anterior teeth is reattachment of the tooth fragment because of the following reasons: • It reinstates the natural shape, contour, surface texture, and occlusal alignment. • Original color and brightness of the tooth are maintained. • Incisal edge of the tooth fragment wears at a similar rate to the adjacent teeth, whereas a composite restoration will likely wear more rapidly. • Less chair-side time is required so the reattachment is much more economical. Attachment of a tooth fragment can be achieved with good esthetic and functional results, even in more complex situations where pulp and/or the biologic width are involved.4-10 With the evolution of adhesive systems, offering excellent bonding to dentin,11,12 reattachment of dental fragment has been a noninvasive treatment offering good results,4,5,7,13-17 even when performed under challenging conditions.9 Bevels, chamfers, grooves, and undercuts apparently make no difference in the prognosis.9,18

Post Traumatic Biological Restoration: A Report of Two Cases

Introduction: Anterior tooth fracture is the most frequent squeal of traumatic injuries, which dental practitioners have to deal with. Proper reconstruction of extensively damaged teeth, both aesthetically and functionally, is the main goal to be achieved. A new approach of fragment reattachment procedure known as “Biological Restoration” can be an alternative to achieve this goal. Case Series: This case series presents two such cases wherein the aesthetic and functional recovery of extensively damaged central maxillary incisors through preparation and adhesive cementation of “Biological Posts and Crowns” was performed. Both biological crowns, post and dental fragments, were obtained from natural, extracted teeth of another individual. Conclusion: The technique of “Biological Restoration” presents a low-cost option and alternative technique for the morpho-functional recovery.

Management of anterior tooth trauma: Two case reports

Various treatment options may be employed for coronal fracture of anterior teeth and root, depending on the level of fracture. The following case reports highlight the anterior tooth trauma managed with reattachment of fractured segments using post and cores. In the first case, an easy and ultraconservative technique without any tooth preparation is used which involves intraradicular support, i.e., fiber post and core. In the second case, an interdisciplinary approach is used to treat the root fracture where biological width was encroached. The flap was raised to expose the fractured root with a small amount of osteoplasty so that the segments could be checked for exact fit and bonding can be done with proper isolation of the operating field. Successful esthetics and function were restored by conservative and economical means, and 6 months follow-up showed no failure of bonding or postoperative pain, indicating crown, and horizontal root fracture after trauma should not go for extraction.

Fragment reattachment of a complicated crown-root fracture in primary maxillary central Incisor and 1 year follow-up

Coronal fracture of anterior teeth is a common form of dental trauma that affects children and adolescents. It is a tragic experience, which requires immediate attention and quick functional and esthetic repair. The major challenge for the clinician for managing such type of dental injuries is to re-establish the natural esthetics of the traumatized anterior tooth. Traditionally, such injuries have been restored with composite resins. They have the primary disadvantage of color mismatch and variable wear. Therefore, if a broken fragment is available, the restoration of the tooth using its own fragment should be the first treatment of choice. This clinical report describes reattachment of tooth fragment of complicated crown-root fracture of a deciduous maxillary central incisor in a 4-year-old child following trauma.

Effect of storage media on fracture resistance of reattached tooth fragments using G-aenial Universal Flo.

Background:Over a period of the past few years’ episodes of dental trauma more commonly coronal fractures of anterior teeth are being increasingly reported in children. Fragment reattachment can be considered as a valid treatment option in such situations. However, ideal medium for storage of fragments before reattachment needs to be explored.Aim:To compare the fracture resistance of incisor tooth fragments stored in four storage media: Dry air, milk, coconut water, or egg white before reattaching them with G-aenial Universal Flo.Materials and Methods:Forty-eight freshly extracted maxillary incisors were divided into four groups. Teeth were then sectioned, and fragments were stored in dry air (Group I), milk (Group II), coconut water (Group III), and egg white (Group IV). The fragments were reattached using simple reattachment technique and tested on the Universal Testing Machine. Statistical analysis was performed using one-way analysis of variance and post hoc Tukey's test.Results:There was statistically significant difference (P < 0.05) in fracture resistance values between the groups. The highest fracture resistance value was demonstrated by Group II, whereas least fracture resistance values were observed in Group IV.Conclusion:Along with milk, coconut water being tested for the first time can be considered a viable alternative.

Conservative approach for natural restoration of fractured anterior teeth: A review and case series

Coronal tooth fractures are most common in anterior teeth, especially in maxillary teeth due to their anatomical position. They create serious esthetic and psychological problems for the patient. Esthetical rehabilitation of fractured anterior teeth is one of the greatest challenges to a dentist. Traditionally, such traumatized teeth are restored with composite resins, but the main disadvantage is variable wear and color mismatch. Reattachment of fractured fragments provides faster natural esthetics, positive psychological response, economical and is the relatively simple procedure. In the recent years, number of techniques and materials are evolved for reattaching the fractured fragments such as flowable composites, dual cure resin cements, fiber posts with self-etch adhesive cement. In this review and case series, different approaches for re-bonding the permanent incisors have been described. All the advantages are mentioned in the literature are summarized to provide a good clinical approach for this innovative procedure. Clinical Relevance to Interdisciplinary Dentistry Reattaching the fractured tooth fragments gives a viable conservative option for the clinician because it restores tooth function and esthetics with the use of a very conservative and cost-effective approach.

Mini fiberglass post for composite resin restorations: A clinical report

Threaded metal pins have been used to create additional retention for large composite resin restorations. However, their dark appearance may compromise esthetic outcome. The use of small fiberglass posts has been advocated as an alternative. This clinical report describes a mini fiberglass post (MFP) used to provide additional retention in a fractured anterior tooth that received a composite resin restoration. The MFP represents a promising option for creating additional retention for large composite resin restorations.

Trans-operative reattachment of crown-root fragment: fundamentals of the technique and a case report

The functional and aesthetic restoration of crown-root fractured anterior teeth with biological width involvement represents a challenge to the clinician, because it requires a multidisciplinary approach. The trans-operative fragment reattachment technique is a feasible and advantageous alternative since it makes it possible to reestablish the original aesthetics and function of the fractured tooth in a single appointment. This work presents the fundamentals of this technique, highlighting its advantages, indications and limitations. The applications of the surgical and restorative procedures are demonstrated by way of a case report.

Prevalence of permanent anterior tooth fracture due to trauma in South Indian population

Abstract Aim: The aim of the study is to determine the prevalence of permanent anterior teeth fracture due to trauma in South Indian population. Materials and Methods: After formal consent, study was conducted on 2000 patients reporting for treatment in A B Shetty Memorial Institute of Dental Sciences and Rural Satellite Centers from June to December 2013. They were examined under good illumination using sterilized mouth mirror, explorer and cotton rolls. Results were evaluated using Pearson Chi-square test. Results: Of 2000 patients, overall prevalence of anterior teeth fracture due to trauma was 14.85%, 53.9% cases were noticed in the age group of 15-30 years, 20.2% cases in an age group of 12-15 years. Of 14.85% (297) cases, 53.9% males and 46.1% females had anterior teeth fracture, 88.67% cases were with respect to maxillary arch and 11.33% cases were with respect to mandibular arch. 43.9% patients had enamel and dentin fracture, only enamel fracture was seen in 31.6% patients and the least was 6.01% which showed displacement of tooth without crown or root fracture, 67% were because of falls and rest of the 33% of patients had anterior tooth fracture because of violence, sports and traffic accidents, 71.42% cases had fracture with maxillary central incisor. Furthermore, 59.6% cases were seen with Class II Division I malocclusion. Conclusions: In the present study we noticed that fall was the most frequent cause and are seen more in males with an increased prevalence in 15-30 years of age. Furthermore, fracture of maxillary central incisor was most common and among all, fractures involving enamel and dentin were most common.

Biological Post: A Reconstructive Approach to Achieve Aesthetics

Traumatic injuries lead to fracture of anterior teeth, frequently occurs in dentistry and the prevalence rate of fractured anterior teeth, as a result of traumatic injuries, occurs 8.1 in 1000. The fracture of a tooth is itself a traumatic incident for young patients which leads to functional, aesthetic, psychological problems and reduces patient's quality of life. Various materials are available to restore these types of traumatic injuries, but till date there is no material that has been proved to be as effective as natural structure considering mechanical and biological properties. This case report represents the management of traumatized fractured mandibular anterior teeth with biological posts and coronal restorations with composite.

Multidisciplinary approach for management of complicated crown-root fracture: A report of two cases

Fracture of anterior teeth after trauma adversely affects the emotional well-being of a person in addition to the discomfort and pain. Complexity and extension of fracture along with the associated injury to the tooth influence the restorative design. Crown-root fracture of anterior teeth cause concomitant periodontal injury and there will be concern about appearance, and aesthetics. Clinical considerations for the management of crown-root fractures include extent and pattern of fracture, restorability of remaining tooth, availability of fractured fragment, and damage to the attachment apparatus. Sub-gingival extension of fracture raises concern about biological width violation. This report of two cases described the clinical procedures involved in the treatment of a complicated crown-root fracture in the maxillary anterior teeth.

Biological Restoration: A Natural Replacement for a Fractured Tooth

Fractured anterior teeth due to traumatic injuries are a common occurrence in dental practice. The role of operative dentistry in such cases is to restore proper tooth form, function, and esthetics. Achieving this by bonding sterile dental fragments to teeth with large coronal destruction is expressed as biological restoration. This approach provides excellent esthetics as compared to composites or cast restorations, especially in terms of translucency and is also a cost-effective alternative to the same. This paper reports the case of a 22-year-old male in whom biological restoration was considered as a biofunctional and esthetic replacement of the fractured central incisor (Ellis Class III tooth fracture) with more than 40% loss of tooth material. Following clinical and radiographic evaluation, endodontic treatment of the fractured tooth was carried out. Post space was prepared to receive the biological restoration. Extracted teeth were then used to fabricate a biological post and biological crown; which was then sterilized in accordance with biosecurity standards and later cemented. According to the available literature and clinical evidence, biological restorations can be considered as an efficient option for management of fractured anterior teeth.

Prevalence of Anterior Tooth Fracture due to Trauma

ABSTRACT Aim To evaluate the prevalence of anterior tooth fracture due to trauma in 2000 patients randomly from the population of south Canara district. Materials and methods The present study was conducted on 2000 patients attending the Department of Conservative Dentistry and Endodontics, AB Shetty Dental College, Mangalore, and rural satellite centers of Nitte University. Each patient was examined for anterior tooth fracture due to trauma under dental chair in a good illumination of light using sterilized mouth mirror, explorer, tweezer and teeth are isolated by cotton roles. The patient who had anterior tooth fracture were questioned with a standard questionnaire from oral health survey WHO format 2013, to find its relation associated to age, gender, location, occupation, etiology, type of fracture and its relation to molar. Results According to the present study, prevalence of anterior tooth fracture due to trauma in south Canara population was low and found to be 18.8% with increase in prevalence in males (56.2%) between the age group of 36 and 45 years (33.2%), common etiological factor seen was falls (44.7%). The most common type of fracture was enamel-dentine fracture (44.7%) with class 1 molar relation (55.6%). Conclusion The prevalence of anterior tooth fracture due to trauma was most commonly seen in males with increased prevalence in age group between 36 and 45 years, common etiological factor being falls, type of fracture most commonly seen are cases with enamel-dentine fracture with class 1 molar relation. How to cite this article Hegde MN, Abootty S, Attavar S. Prevalence of Anterior Tooth Fracture due to Trauma. World J Dent 2015;6(2):77-81.

A Comparative Evaluation of the Effectiveness of Three Different Irrigating Solution on Microorganisms in the Root Canal: An Invivo Study

An infected root canal system either due to caries exposure or trauma cannot be eliminated by the host defense mechanisms alone or in combination with systemic antibiotic therapy. It can be treated through professional endodontic intervention using both chemical and mechanical procedures. To suggest triple antibiotic solution containing tetracycline, ornidazole and ciprofloxacin as a new endodontic irrigant that may possess superior antibacterial activity in comparison with chlorhexidine solution. This study was carried out on 60 teeth from 40 children with anterior tooth fracture, asymptomatic, non-vital and necrotic in nature. Patients were randomly divided into three groups of 20 teeth each depending upon the type of irrigant. After access opening microbial samples were obtained: a) Pre- irrigation i.e. sample after pulp extirpation and before irrigation, b) Post-irrigation i.e. sample after irrigation, stored in sterile containers and immediately transferred to microbiological laboratory. After incubation of samples aerobically at 37(0)C for 24 hours, the samples were streaked on blood agar culture media and incubated for 48 hours. After 48 hours, the colony forming units were counted using a colony counter. Statistical analysis was carried out using Kruskal-Wallis test, Wilcoxson signed rank test and Mann-Whitney test. On intra group comparison, highly significant differences in the colony forming units were found between pre-irrigation and post-irrigation sample for all the three groups. On inter group comparison, statistical difference was found between saline and chlorhexidine (p ≤ 0.001), saline and triple antibiotic paste (p< 0.001). The greatest percentage decrease was obtained in samples treated with Chlorhexidine solution (Group 2) i.e.73.91. The triple antibiotic irrigating solution group showed percentage decrease of 66.22 followed by Group 1 (Saline) 15.04. The difference found amongst the groups was statistically insignificant. It was concluded that triple antibiotic irrigating solution can be used as an irrigating solution. The antibacterial action of triple antibiotic irrigating solution is comparable with chlorhexidine. Although saline may not be effective in the antimicrobial action but its flushing action may be able to decrease some microbial load.