Fragment Reattachment Research Articles

Direct fragment reattachment of a complicated crown root fracture of maxillary lateral incisor: A case report

Direct fragment reattachment of a complicated crown root fracture of maxillary lateral incisor: A case report

Naturalistic Approach for Management of Fractured Anterior Teeth – A Case Report

Dental trauma accounts for about 5% of all injuries in children and adolescents. Anterior teeth are most frequently affected by trauma, especially the maxillary incisors. Various treatment options are available like light cure composite resin restoration, fragment reattachment, and ceramic crowns, laminate veneers. Among those, fragment reattachment is a conservative method. The procedure is simple and economic and needs less chair-side time and also provide good aesthetics, because of the maintenance of original morphology, color, and surface texture. It also allows to restore the tooth with minimal loss of the remaining tooth structure, which in turn maintains the integrity of the teeth. The success of fragment reattachment also depends on patient and parent cooperation, adequate recall and follow up of the patient to monitor the pulp vitality. This clinical case reports the management of two coronal tooth fracture cases that were successfully treated using tooth fragment reattachment using flowable composite.

Tooth Fragment Reattachment: Interim or a Permanent Solution?

One of the most commonly encountered situations in clinical practice is dental trauma. Children and adolescents frequently report with uncomplicated/complicated crown fracture that requires immediate consideration. Clinicians should be prompt in treating such injuries and must be aware of the various treatment options available. With the advent of newer adhesive systems, reattachment has become the treatment of choice when the fragment is properly stored, and luxation injury is not associated with the fracture. This article aims to review the various techniques available for reattachment of fractured fragment and the recent advances in the adhesive systems.

Endo-Aesthetic rehabilitation of complicated crown-root fracture of maxillary lateral incisor by fragment reattachment: A case report

In case of traumatic injuries to the anterior teeth, fragment reattachment is considered a minimally invasive technique. Re-attaching the same tooth fragment, possesses the advantage, of biomimicry by complete restoration of form, function, texture, lustre, and translucency. Due to advancements in adhesive dentistry, simple re-attachment to complex fragment rehabilitation have become predictable and reliable. Various techniques have been proposed for fragment reattachment based on the extent of injury, type of injury, condition of the fragment, and time- lapse. This case report demonstrates the endo-aesthetic rehabilitation of a complicated crown root fracture using a fiber post on lateral incisor with fracture line on the cervical 1/3of the labial aspect, running obliquely and apically towards the palatal surface after 1 year follow-up.

Comparative evaluation of fracture strength recovery of anterior tooth fragment reattachment using different methods and bonding systems: An in vitro study

PurposeTo compare and evaluate the fracture strength recovery of fractured teeth using the combination of reattachment techniques (simple reattachment, over contour and internal dentinal groove) and bonding adhesives (Super-Bond C & B and Calibra Universal). Materials and methodsSeventy human central incisors gathered from dental clinics in Ranchi and Hazaribag, Jharkhand, India, were randomly divided into 3 groups (G-I to G-III); G-I (n = 10) being the control group, only the test groups G-II and G-III (n = 30 each) were fractured using diamond disc and bonded with Super-Bond C & B and Calibra Universal respectively. These two groups were further sub-grouped into 3 each based on the reattachment techniques used. Post reattachment, the specimens were tested for fracture strength recovery and the data obtained was evaluated using One-way Analysis of Variance (ANOVA) and multiple comparison tests. ResultsThere was statistically significant difference of fracture strength recovery between control (G-I) and the experimental groups (G-II and G-III), P<0.0001. Comparison between the experimental groups revealed the fractured teeth reattached with Super Bond C&B showed highest fracture strength recovery compared to Calibra Universal. Among the different preparation techniques applied, the over contour technique combined with Super-Bond C & B showed the maximum fracture strength recovery attaining 92% fracture resistance as that of the control specimens. ConclusionThough none of the combinations of adhesives and techniques have achieved the fracture strength recovery as that of the intact teeth, Super-Bond C & B showed better performance compared with Calibra Universal in combination with the techniques used in the current study. Further, Super-Bond C & B combined with over contour technique showed the highest fracture strength recovery.

Asexual propagation of Asparagopsis armata gametophytes: fragmentation, regrowth and attachment mechanisms for sea-based cultivation

The red algal genus Asparagopsis produces secondary metabolites that when fed to ruminants reduce methane production by up to 98%. However, cultivation methods for Asparagopsis are nascent and fundamental information on reproduction, which is essential for large-scale cultivation, is lacking. In this study we examined asexual propagation in Asparagopsis armata, the regrowth of fragments and mechanisms of attachment to assess the potential for fragments to be used in sea-based cultivation. Asparagopsis armata gametophytes grow specialised structures, barbs, that hook fragments onto substrata. Surveys revealed barbs were abundant occurring at ~ 1 barb every 3–4 cm on gametophyte branches. Barbs did not regrow, but fronds did, either when attached to a barb or on their own. In contrast, fronds doubled in size with most developing barbs within 4 weeks. Barbs were, however, critical for the reattachment of fragments: barbs attached to substrata at four times the rate of frond fragments without barbs and they also attached in higher proportions to mussel rope than polypropylene rope, and two types of net. Utilising fragmentation for the propagation of A. armata gametophytes in sea-based cultivation requires that fragments can attach to a substratum and regrow once attached. We have shown that A. armata fragments in Tasmania require barbs for attachment and frond tissue for growth, which has implications for cultivation. Optimising fragmentation, attachment and out-planting methods are important future steps in establishing fragmentation as a method for sea-based cultivation in A. armata.

Immediate restorative rehabilitation of fractured tooth by fragment reattachment

Dental trauma commonly leads to fracture of anterior teeth which affects the aesthetics and even has a psychological impact on the patient. Management of crown fractures depends on multiple factors like extent, pattern and the restorability of fracture to maintain the occlusion, aesthetics, and prognosis. If the fractured fragment is available, re-attachment is the most feasible option which is simple and economic providing good and long-lasting aesthetics, maintaining the original morphology and colour. This case report shows management of complex coronal tooth fracture by tooth fragment reattachment using metal post.

Immediate autogenous reattachment of fractured tooth fragment post trauma: A case report

Fractures of the anterior teeth are one of the most common forms of dental injury that occur during trauma to the head and neck region. These complications can be managed conservatively and immediately through autogenous reattachment procedures. Reattachment procedures are an immediate solution in the management of coronal fractures in which the patient’s own fractured tooth fragment is bonded back onto the remaining portion of the tooth after endodontic therapy. This technique restores proper form, function, and aesthetics of the tooth in a short duration of time and also significantly impacts the post traumatic psychological rehabilitation of the patient. The recent advances in bondable dental materials have made these reattachment procedures much more predictable. This paper describes a case report of a patient who reported with a fractured tooth post trauma to the face and was treated using endodontic therapy followed by reattachment of the fractured tooth fragment using anchorage from a fiber post.

AESTHETICS WITH NATURAL TOOTH VENEER: A CASE REPORT

Among the various treatment options, reattachment of a crown fragment is a conservative treatment that can be considered for crown fractures of anterior teeth. The procedure is simple, economic, conserves tooth structure and needs less chair-side time as compared to conventional methods. This procedure is an interim type of treatment for immediate restoration of aesthetics till a more permanent treatment is planned. Advantages of the fragment reattachment is that all the alternative methods such as direct adhesive resin reconstruction, veneers and crowns can be performed in case of failure. This clinical case report describes the management of a permanent maxillary central incisor which had undergone partial crown fracture during endodontic treatment.

Management of complicated and uncomplicated crown-root fractures: A case series

Crown fractures are the most common consequences of traumatic injuries that mainly occur in the anterior permanent dentition. The choice of the esthetic restorative treatment of fractured anterior teeth remains the biggest challenge for the dentist. These fractures can be located either supra-gingivally or sub-gingivally. The treatment of these fractures is also based upon the involvement of the pulpal tissue. This case series highlights two different techniques of tooth fragment re-attachment, depending on the extent of the fracture as well as involvement of the pulp.

Reattachment of fractured tooth fragments using modified over contour technique: 2- case report

Özellikle ön bölgede yer alan dişlerin kuron kırıkları dental travmalardan sonra sık karşılaşılan bir durumdur. Dental travma sonrası kırık diş parçası mevcutsa, parçanın kalan dişe yeniden yapıştırılması, doğal dişin optik özelliklerinin ve şeklinin korunmasının yanı sıra, hastayı psikolojik olarak rahatlatan, nispeten kısa tedavi süresi, öngörülebilir tedavi sonucu ve düşük maliyet sunan konservatif bir tedavi seçeneğidir. Bu vaka raporunda, travma sonucu kırılmış iki üst santral dişin kırık parçalarının rezin kompozit ve modifiye edilmiş over-kontur tekniği kullanılarak başarılı bir şekilde yeniden yapıştırılması özetlenmiştir.

Comparative evaluation of fragment reattachment protocols for the management of teeth with crown-root fractures.

A crown-root fracture is a fracture of both the crown and the root of a tooth. The International Association of Dental Traumatology (2020) guidelines recommended fragment reattachment and stabilization of loose fragments as an immediate management protocol for uncomplicated crown-root fractures. However, the lack of evidence and unpredictability make it a less popular treatment option. The aim of this study was to compare three protocols of fragment reattachment for the management of teeth with crown-root fractures. Eighty mandibular bovine incisors with similar dimensions and no structural deformities were selected and randomized into four groups: Group I (Control/sound teeth); Group II (no rehydration); Group III (rehydration in distilled water for 15min) and Group IV (rehydration in a humidification chamber for 15min). A fracture was simulated to extend from the labial side of the middle-third of the crown to the palatal side of the cervical-third of the root. Fragments were exposed to the environment under normal temperature and pressure. Fragments were later reattached as per the standard protocol following the rehydration as specified for each group. Samples were subjected to thermocycling, and the force required to fracture them was evaluated by using a universal testing machine. The highest mean force required to fracture was seen in Group IV (208.27±75.99N) followed by Group III (182.01±90.13N) and Group II (158.85±68.04N). These differences were statistically significant. Comparison of the mean difference of force required to fracture between pairs of groups revealed statistically significant mean differences only between the controls and each experimental group. The force required to fracture the reattached fragments in teeth with crown-root fractures was affected by rehydration of the fragments. The force was higher in fragments reattached after rehydration, and the highest force was required in the teeth that had been rehydrated in a humidification chamber.

Fracture Resistance of Incisal Tooth Fragment reattached with different Materials and Preparation

The purpose of this study is to analyze the fracture resistance of reattached tooth according to the resin materials and tooth preparation type under physiological conditions. Uncomplicated crown fracture in the oblique direction was reproduced on the extracted 64 anterior teeth. Depending on the composite resin material, reattachment was performed using a flowable resin and a packable resin. Depending on retentive forms, reattachment was performed using simple reattachment, 1.0 mm × 1.0 mm labial chamfer bevel, 1.0 mm × 1.0 mm lingual chamfer bevel and 1.0 mm × 1.0 mm circumferential bevel. A load was applied to the palatal surface of the tooth using a universal testing machine at an angle of 125 degree, which is the interincisal angle of normal children. Under the masticatory pressure condition, fracture resistance of lingual chamfer groups was 28.28 ± 7.41 MPa and 27.54 ± 4.45 MPa, which was significantly higher than those of simple reattachment groups, 17.21 ± 5.87 MPa and 20.10 ± 6.00 MPa, in both flowable and packable resin groups. When considering the lingual force similar to masticatory pressure, the fragment retention was significantly improved when the lingual chamfer was formed compared to the simple reattachment. Clinicians may consider the design of the lingual chamfer in order to improve fracture resistance to masticatory pressure during fragment reattachment.

Rehabilitation of the Breached Tooth, Fragment– A Minimal Invasive Cosmetic Approach: An Original Case Series

Tooth fractures are often reported as emergencies in dental practice. Coronal fractures of the anterior teeth are a prevalent cause of dental trauma in children and teenagers. It's a tragic situation that necessitates prompt care and quick functional and esthetic repair. The clinician's main difficulty when dealing with these types of dental injuries is to re-establish the natural esthetics of the traumatized anterior tooth. There are several therapeutic options for this condition, one of which is reattachment of the fractured component itself. Because of its simplicity, natural esthetics, and preservation of tooth structure, reattachment of a tooth fragment should be the first choice and a feasible alternative to conventional approaches. For a successful prognosis, the patient's cooperation and comprehension of the treatment's limitations is essential. This paper presents a report of two clinical cases on managing complicated crown fractures, where the restoration of the fractured anterior teeth using the residual tooth fragment was supported by fiber post system.&#x0D; Keywords: Complicated Crown Fracture, Fiber post, Fractured Tooth Fragment, Internal grooving.

Fragment Reattachment of Complicated Maxillary Central Incisor Crown Fracture in 8-year-old Female Child - A Case Report

Fragment Reattachment of Complicated Maxillary Central Incisor Crown Fracture in 8-year-old Female Child - A Case Report

Management of Complicated Crown Fracture by Partial Pulpotomy &amp; Fragment Reattachment: A Case Report

The management of complicated crown fractures require immediate intervention as it affects the pulp health and has psychological impact on patients. Vital pulp therapy combined with fragment reattachment is the most conservative and minimally invasive treatment strategy for the management of these fractures if the fragment is available. This case report discusses the conservative technique for the management of complicated crown fracture of maxillary right central incisor by performing partial pulpotomy with MTA followed by fragment reattachment done within 24 hours of trauma. A six month follow up revealed healthy vital pulp and retained fragment with acceptable aesthetics and function.nbsp

Management of cracked maxillary first molar with erbium-doped yttrium aluminum garnet laser

Treatment and diagnosis of fractured teeth present a big challenge to dentists. Treatment of traumatized teeth can be done with reattachment of a dental fragment both in simple and complicated coronal fractures. A 28-year-old male patient came to our department with a traumatic crown fracture of the permanent, left maxillary molar. The patient complained of pain upon mastication, and on examination left maxillary second molar has a fracture line extending in a mesiodistal direction. Partial pulpotomy with the help of erbium-doped yttrium aluminum garnet (Er: YAG) laser was done to relieve symptoms and to reduce microleakage and increase strength, the fracture line was sealed with the help of Er: YAG laser. The cavity was then sealed with biodentin and composite. For these types of cases, Er: YAG laser is used for biostimulation of exposed pulp, and also to improve strength and reduce microleakage through sealing of fracture line.

Finite element analysis for fracture resistance of reattached human tooth fragment with different types of retentive preparation techniques.

Restoration of traumatized incisors by reattachment of the original tooth fragment appears to be the most conservative treatment approach. But the measurement of forces acting on natural tooth in-vivo poses many challenges. The advent of finite element analysis (FEA) has made it possible to demonstrate the propagation of stress through each part of a tooth and its restoration. The objective of this study was to evaluate and compare the fracture resistance of reattached human tooth fragment with different types of retentive preparation techniques using finite element analysis. An intact maxillary central incisor was obtained, scanned by laser and its Computer Assisted Device (CAD) model was generated and then converted to Finite Element Model(FEM). Mechanical properties of tooth specimen and materials were added on the generated mesh. These reattached fragments were then fractured with a force applied at 30°, 45°, 70° and 90° to the long axis of tooth. FEA Calculation was run with the setup. The highest fracture strength recovery was found with internal dentinal groove (64.97%) followed by labial double chamfer with lingual over-contour (54.49%), subsequently by labial and lingual double chamfer (51.31%) and least was with simple reattachment (28.27%). Fracture resistance varied with different retentive techniques and greatest strength was offered by internal dentinal groove preparation.

Conservative approach for managing complicated crown-root fracture in a 4-year-old child: A case with 12-month follow-up

Traumatic dental injuries (TDIs) are of great concern when it comes to a child. Crown-root fracture is the most complicated type as both crown and root are affected by trauma. Complicated crown-root fracture seldom occurs in deciduous dentition. It is a tragic experience and requires immediate attention and quick functional and esthetic repair. Appropriate and early diagnosis leads to successful treatment, for which knowledge on types of TDIs, classification, and management is necessary. Complete restoration of teeth affected with trauma will restore function and esthetics and preserve occlusal harmony. The objective of the present case report is to discuss the appropriate diagnosis and conservative treatment of this unusual and rare case of complicated crown-root fracture in a 4-year-old child using tooth fragment reattachment. This case will focus on the options to restore the uncommon trauma and normalize the function and esthetics of the patient, which will lead to improvement of speech, increase in self-confidence and protection of successors, and describe the treatment and aspects concerning follow-up of the patient.

Fragment Reattachment of Immature Permanent Incisors: Clinical Procedures and the Development of an Algorithm

Fragment Reattachment of Immature Permanent Incisors: Clinical Procedures and the Development of an Algorithm