Fragment Reattachment Research Articles

Global Trends and Perspectives on Dental Fragment Reattachment (1988-2024): A Bibliometric and Altmetric Review.

Fragment reattachment in traumatic injuries is notable for its excellent esthetic, morphological, and functional results. The aim of this study was to investigate the scientific history and trends in publications on dental fragment reattachment through a bibliometric and altmetric analysis. The search was conducted in October 2024 using Web of Science. Two researchers selected articles and extracted key study characteristics. Collaborative networks were generated using VOSviewer software. Dimensions was consulted to measure altmetric data. The Spearman correlation was used. A total of 129 articles were included. The most cited article received 160 citations. Studies were published between 1988 and 2024. The leading journal was Dental Traumatology (n = 55). Case reports (n = 63) were the most frequent study design. The majority of studies aimed at clinical case follow-up (n = 71), with coronal fractures being most commonly reported (n = 96). Young patients were most affected in the selected studies (n = 49). Tewari N stood out (n = 8). The All India Institute of Medical Sciences was prominent with seven articles. Brazil was the most prevalent country (n = 29), and Asia was the most frequent continent (n = 57). Vosviewer demonstrated collaborations among authors. According to Dimensions, significant mentions were identified on Mendeley, followed by X users. This bibliometric analysis provides a comprehensive description of the technique of fragments reattachment in traumatized teeth, which has been studied for over 36 years. Studies on this technique primarily rely on case reports describing follow-up in young patients. Intervention studies and systematic reviews are recommended. Additionally, more studies in Africa, Oceania, and North America are encouraged.

Aesthetic rehabilitation of a complex crown-root fracture by fragment reattachment with a fiber-reinforced post: A case report

Complex crown-root fractures are characterized by the involvement of both crown and root with pulp exposure. They pose aesthetic, functional, and psychological problems for the patient. Furthermore, they can pose technical difficulties for the practitioner. The purpose of this case report is to describe the management of a complex crown-root fracture of the right upper central incisor with subgingival limit by reattaching the tooth fragment with fiber-reinforced post. We considered a coronal elongation (gingivectomy and osteoplasty) to recreate the biological space and to expose the limit of the fracture line to guarantee the quality of the bond.

Treatment Modalities of Uncomplicated Crown Fracture in Anterior Maxillary Permanent Teeth: A Systematic Review.

Several treatment modalities have been used to restore crown fractures in case of uncomplicated crown fractures. Although many treatment modalities have been reported, there is no consensus on which one has the best results in terms of success and durability. This systematic review of treatment modalities in uncomplicated crown fractures aims to provide the most common and successful treatment modality for each patient's unique needs, balancing conservation, aesthetics, and long-term durability. Three electronic databases (PubMed, Scopus, and Google Scholar) were searched for articles regarding treatment modalities in uncomplicated crown fractures in anterior maxillary teeth. Following the application of the inclusion and exclusion criteria, 10 case reports, four case series, and two retrospective studies were selected for the review. These studies reported on fragment reattachment, direct composite resin, and veneers for the management of uncomplicated crown fractures. Fragment reattachment was the most preferred treatment modality, with milk, water, or sterile saline used as storage mediums. Direct composite restoration was preferred for missing or bad-shaped fragments or longevity. Veneers were given for aesthetic consideration and fracture resistance when the crown structure was majorly affected by the fracture. Fragment reattachment was favored in 63% of the articles included in the review followed by direct composite restoration in 26% of the articles. Venners were used in about 11% of the articles. Composites depicted a higher survival rate and a better outcome than fragment reattachment. Follow-up periods ranged from 1 week to 4 years, and all articles successfully re-established function and aesthetics, except for one tooth that required root canal treatment. Fragment reattachment, direct composite restoration, and veneers are successful treatment modalities in uncomplicated crown fractures of anterior teeth. The choice of treatment depends on various factors like availability of fragments, age, and financial condition of the patient. PROSPERO Registration ID: CRD42020153091.

Tooth fragment reattachment using cyanoacrylate tissue adhesive and flowable composite: An in vitro study

ABSTRACT Aim: Crown fractures in anterior teeth represent 18%–22% of dental hard tissue injuries. Immediate reattachment of the fragment using composite resin is the preferred treatment option. However, the reattached fragments are prone to fracture. The use of topical cyanoacrylate tissue adhesive has been reported for managing painful fractured molar teeth and maxillary incisors. Rural population of India does not have access to basic health care; hence, over-the-counter availability of cyanoacrylate may prove beneficial for reattaching the tooth fragment until a patient receives professional care. The present study aimed to evaluate and compare the methods of fractured fragment reattachment using isoamyl 2-cyanoacrylate tissue adhesive and flowable composite. Methods: Eighty intact human permanent maxillary central incisors were randomly divided into four groups (n = 20). Except for the control Group D, other teeth were cut through the middle third of the crown horizontally. Fragments were reattached using flowable composite in Group A, cyanoacrylate tissue adhesive in Group B, and in Group C fragments were attached using cyanoacrylate tissue adhesive, and filling flowable composite circumferentially in chamfer placed along the fracture line. Fracture resistance was tested using a universal testing machine by applying load to each tooth perpendicular to the line of reattachment from labial to lingual direction. The force required to fracture the tooth was recorded in Newtons, and data were statistically analyzed. Results: The highest fracture resistance was exhibited by Group D, followed by Group A, Group C, and Group B, respectively. There was no statistically significant difference between Groups A and C. Conclusion: Composite remains most efficacious in reattaching fractured fragments to the tooth. However, the use of isoamyl 2-cyanoacrylate followed by composite restoration in chamfer offers comparable bonding. The experimental over-the-counter available isoamyl 2-cyanoacrylate may be useful for reattaching uncomplicated fractured teeth when emergency dental care is inaccessible, and needs to be clinically and esthetically evaluated by a professional. However, this in vitro experiment needs to be evaluated clinically for long-term bond strength and under various intraoral forces.

Single- versus multi-visit approach for fragment reattachment in complicated crown-root fractures: a cohort study

BackgroundComplicated crown-root fractures are a type of tooth fracture that involves the enamel, dentin, and cementum and accompanied by pulp exposure. The treatment of a complicated crown-root fracture is always challenging due to the difficulties in achieving a hermetic seal and a stable restoration with a fracture level close to the crestale bone level. This study aimed to evaluate and compare the efficacy of single-visit and multi-visit approaches for fragment reattachment in complicated crown-root fractures of anterior teeth.MethodsTwo cohort consist of 10 adolescent patients in each group at both genders, who suffered from permanent anterior tooth complicated crown-root fracture were included. Fragment reattachment with root canal treatment was performed with either single or multiple-visit approach. Single visit fragment attachement combined with root cannel therapy was conducted in single-visit approach group immediately after injury. Fragment attachment, root cananel therapy and post resoration were performed during three times ‘ clinical visit in multi-visit approach group.ResultsAll the patients in both groups achieved satisfactory aesthetic results one year after fragment reattachment. Patients who underwent a multi-visit approach had a significantly shorter operative duration, less intra-operative pain and fatigue, slightly better periodontal health at an early stage, and a decreased incidence of temporomandibular joint disorders compared to those who underwent a single-visit approach. However, multiple visits approach may increase the risk of fragment detachment postoperatively.ConclusionFragment reattachment a reliable but temporary technique for adolescent patients who have suffered from complicated crown-root fractures. Multi-visit approach showed similar effecacy to single-visit approach but with slightly less complications. The choose of these two merhos should depend on the specific patient situation and patient compliance.Trial registrationThis prospective cohort study was retrospectively registered in Chinese Clinical Trial Registry (ChiCTR2300076811) on 19/10/2023.

Management of complicated crown fracture in maxillary incisor using fragment reattachment - 5-year follow-up

Complicated crown-root fractures of maxillary incisors are a relatively common occurrence in cases of trauma to the facial region. Patients with such fractures are in acute pain and usually require emergency care on their first clinical visit. Pain management and restoration of function, esthetics, and phonetics should be the prime objective in handling such patients. The reattachment of fractured tooth fragments is a relatively simple procedure that provides natural esthetics and conservation of tooth structure. This case report describes such a reattachment procedure in a complicated crown-root fracture and its success at 5 years of follow-up.

Management of Complicated Crown Root Fracture Using Chamfer Reattachment Technique

Abstract The reattachment of the tooth fragment is one of the viable treatment options if the original intact tooth fragment is available following dental trauma. The reattachment of the remaining fractured tooth can provide better aesthetics, improved function and generate a positive psychological response amongst patients. This case report consists of three cases of crown root fracture that was successfully treated using tooth fragment reattachment technique.

Fragment Reattachment of Maxillary Anterior Tooth- A Case Report

Dental trauma often results in fracture of the tooth. Reattaching the fractured fragment is one among the treatment modalities in the management of fractured tooth. The procedure is simple and relatively inexpensive. However, understanding the limitations of the procedure is essential. Also, patient cooperation is essential for long term success of the treatment. The case report highlights the management of fractured maxillary anterior tooth in a elderly patient.

Fragment Reattachment For Complicated Crown Root Fracture – A Case Report

Complicated crown-root fractures are challenging dental injuries that involve both enamel and dentin structures and extend into the root. They often necessitate a multifaceted approach to achieve successful reattachment and functional restoration. This case report describes the management and outcomes of a complicated crown-root fracture using a reattachment technique

Esthetic Management of Maxillary Anteriors with Complicated and Uncomplicated F and Uncomplicated Fractures Using Diff es Using Different Fragment Reattachment Approaches

Esthetic Management of Maxillary Anteriors with Complicated and Uncomplicated F and Uncomplicated Fractures Using Diff es Using Different Fragment Reattachment Approaches

Materials and Techniques for Pediatric Restorative Dentistry: A Review of the Latest Trends

Dental caries remains a significant oral health problem affecting children worldwide. Restoring carious lesions in the pediatric dentition requires materials and techniques that are effective, efficient, esthetic, and minimally invasive. This review provides an overview of the latest trends in pediatric restorative dentistry, focusing on restorative materials, esthetic crowns, biological restorations, prosthetic rehabilitation, and alternative techniques for improving esthetics. Advancements in glass ionomer cements, composite resins, and nanofilled composites have improved physical properties and esthetics. Esthetic crowns like zirconia, cerec, and preveneered stainless steel offer durable and natural-looking solutions. Biological restorations (fragment reattachment, natural tooth pontics) and prosthetic techniques (modified appliances, fiber-reinforced space maintainers) enable conservative approaches. Alternative techniques such as bleaching, veneers, lasers, and cosmetic contouring further enhance esthetics. As the field continues evolving, future research should focus on developing biocompatible, minimally invasive, and long-lasting materials and techniques that improve patient compliance and satisfaction while addressing the unique challenges of treating pediatric patients.

Reattachment of Fractured Tooth Segment in Minimally Invasive Way - A Case Report

Dental trauma frequently results in coronal fractures of the front teeth. Root canal therapy followed by reattaching the fractured segment with fiber post reinforcement is a viable alternative in cases of complex fractures where the fractured segment is present and there is close approximation of the segment to the intact tooth. Reattaching a fractured piece is a quicker, less involved process that offers immediate relief, better aesthetics, and function restoration. The present case report is of a 11-year-old boy with an uncomplicated crown fracture of permanent maxillary right central incisor and a palatal uncomplicated crown–root fracture of his permanent maxillary left central incisor . The fractured fragment was reattached using nano-filled dual-cure composite resin and tooth restored with composite resin. The fragment showed opaque discoloration that reduced over time but still persisted after 1 year. During the follow-up period, no unfavorable radiographic changes were seen. The prognosis of the teeth was favorable with good esthetic results. Keywords: Fragment reattachment, Fragment rehydration, Periodontal health, Root fracture, Uncomplicated crown.

Minimal intervention treatment of a complicated crown fracture in a maxillary lateral incisor by partial pulpotomy and fragment reattachment: A case report with a 10‑year follow‑up

Minimal intervention treatment of a complicated crown fracture in a maxillary lateral incisor by partial pulpotomy and fragment reattachment: A case report with a 10‑year follow‑up

An assessment of Brazilian dentists' knowledge about tooth fragment reattachment: A cross-sectional study.

Crown fractures are common traumatic dental injuries and tooth fragment reattachment is a viable option for restoring a fractured tooth. The aim of this study was to assess the knowledge and experience of dentists in the Federal District regarding the tooth fragment reattachment technique for enamel and dentin fractures. For the cross-sectional observational study, an electronic form was designed with objective and self-report questions for dentists. The data were analyzed using descriptive statistics, with their absolute and relative frequencies. For the analysis of categorical variables, the nonparametric chi-squared or Fisher exact association tests were used in the statistical software R (version 4.2.1). A total of 416 dentists participated in the study (58.9% female and 41.1% male). Of these, 70% declared they knew about fragment reattachment, but only 42.3% reported previous experience with this procedure. The most common storage medium used for the fractured fragment was milk (78.1%), and the bonding material used for reattachment was light-cured composite resin (86.3%). A majority (66.3%) reported that for a patient with enamel and dentin fracture, with the crown fragment in good condition, they would choose to do the reattachment. Dentists demonstrated that they had adequate knowledge about the tooth fragment technique, although many did not have previous experience with this procedure.

The risk of bonded fragment loss in crown-fractured anterior teeth managed by fragment reattachment: a systematic review and meta-analysis.

To identify the factors affecting the risk of bonded fragment loss in crown-fractured anterior teeth managed by fragment reattachment. The study protocol followed the best practices of evidence-based medicine and was registered in PROSPERO. A comprehensive literature search was performed electronically in six databases (PubMed, Embase, SCOPUS, Web-of-Science, Lilacs, and Cochrane) on 18-09-2023. It was saved in EndNote-online and duplicates were removed. Selection of articles was performed in two stages, followed by data-extraction, risk of bias assessment, data-analysis, and meta-analysis. The quality of evidence for the outcomes was assessed by the GRADE-approach. The study included six articles that had similar selection protocols with variations in duration from trauma to treatment and the observation period. Only one study employed pre-attachment fragment preparation and three performed post-attachment reinforcements. Overall loss of fragment was 20% (95%CI-13,30%). When the risk ratio for loss of restoration or fragment was compared, it was found to be 2.21 (95%CI-1.52,3.21) in uncomplicated crown fractures, 2.54 (95%CI-1.35,4.79) in complicated crown fractures. The risk of bias was found to be low in two and moderate in four studies. Grade of evidence for all the outcomes was very low. Fragment loss was lowest in uncomplicated crown fractures where reinforcement had been performed, and highest when bonding was done in complicated crown fractures without reinforcement. The risk of fragment loss was higher than the loss of composite restorations.

Reattachment of Fractured Tooth: A Comprehensive Review.

Dental trauma is one of the most prevalent problems encountered in clinical practice. Traumatic injuries involving fractures of the anterior tooth are one of the most common problems among children and adolescents. There is a physical and social impact on patients' quality of life due to traumatic dental injuries (TDIs). Children and adolescents frequently present with a crown fracture that necessitates immediate intervention. Clinicians need to be aware of various treatment modalities for TDIs and have to address these injuries immediately. Due to advances in adhesive technologies, fragment reattachment is the treatment of choice when the fragment is available and well stored. The purpose of this article is to cover various techniques for reattaching fractured fragments and the most current developments in adhesive systems for this purpose.

Repairing the Irredeemable Fragment Reattachment of a Complicated Crown-root Fracture with Fiber Post

Coronal fracture of the anterior teeth is a commonly occurring dental trauma often seen in young individuals. Such fractures can be conservatively managed with fragment reattachment procedure when the fragment is available and preserved in correct storage media. Due to advancements in adhesive dentistry, fragment reattachment is a simple, esthetic and fast treatment option. This article reports a case of fragment reattachment of a complicated crown root fracture using fibre post as an intraradicular splint.

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.

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.

Stronger Hurricanes and Climate Change in the Caribbean Sea: Threats to the Sustainability of Endangered Coral Species

An increasing sea surface temperature as a result of climate change has led to a higher frequency and strengthening of hurricanes across the northeastern Caribbean in recent decades, with increasing risks of impacts to endangered corals and to the sustainability of coral reefs. Category five Hurricanes Irma and María during 2017 caused unprecedented damage to coral reef ecosystems across northeastern Puerto Rico, including mechanical destruction, localized sediment bedload (horizontal sediment transport and abrasion), and burial by hurricane-generated rubble fields. Hurricanes inflicted significant site-, depth-, and life history trait-specific impacts to endangered corals, with substantial and widespread mechanical damage to branching species, moderate mechanical damage to foliose species, and moderate to high localized damage to small-sized encrusting and massive morphotypes due to sediment bedload and burial by rubble. There was a mean 35% decline in Acropora palmata live cover, 79% in A. cervicornis, 12% in Orbicella annularis, 7% in O. faveolata, 12% in O. franksi, and 96% in Dendrogyra cylindrus. Hurricane disturbances resulted in a major regime shift favoring dominance by macroalgae, algal turf, and cyanobacteria. Recovery from coral recruitment or fragment reattachment in A. palmata was significantly higher on more distant coral reefs, but there was none for massive endangered species. Stronger hurricanes under projected climate change may represent a major threat to the conservation of endangered coral species and reef sustainability which will require enhancing coral propagation and restoration strategies, and the integration of adaptive, ecosystem-based management approaches. Recommendations are discussed to enhance redundancy, rapid restoration responses, and conservation-oriented strategies.

Comparative Evaluation of Fracture Resistance and Microleakage of Tooth Fragment Reattachment with Different Pretreatment Conditions: An In Vitro Study

Comparative Evaluation of Fracture Resistance and Microleakage of Tooth Fragment Reattachment with Different Pretreatment Conditions: An In Vitro Study