Evaluation of tooth-fragment reattachment: a clinical and laboratory study.

PURPOSE: To evaluate the restoration of fractured teeth by reattaching tooth fragment to its tooth remnant in a group of children and adolescents, and to compare the results with those of a laboratory study. MATERIALS AND METHODS: The clinical study was conducted on 43 fractured incisors: 22 uncomplicated crown fractures (Group A) and 21 complicated crown fractures (Group B). The 43 incisal fragments: 23 were kept dry for 47 h and 20 were kept wet for 24 h by the patients before they were reattached. The fragments were kept in 0.9% saline solution for 30 min before reattachment. The fragments in Group A were reattached using a dentin bonding agent, a flowable and a hybrid resin composite, whereas the fragments in Group B were reattached to the tooth remnant after a pulpotomy was performed. The laboratory study was conducted on 56 extracted incisors. Teeth were divided equally into four groups: Group I - Uncomplicated crown fracture + wet medium; Group II - Uncomplicated crown fracture + dry medium; Group III - Complicated crown fracture + wet medium, and Group IV - Complicated crown fracture + dry medium. The fragments were then reattached in a manner that was similar to that used in the clinical study. The restored teeth were then re-fractured. All data were analyzed statistically. RESULTS: In the clinical study, the restored teeth were followed up for 2 years. Neither the type of trauma nor the storage medium had any significant effect on the survival, color, and bond strength of the restored teeth when assessed in the clinical and laboratory study. The color disharmony that was encountered initially in restored teeth resolved significantly on its own accord within 12 months after reattachment of the fragment. CONCLUSION: Fragment reattachment can be used to treat fractured teeth successfully in children and adolescents.

A 6-year investigation into types of dental trauma treated in a paediatric dentistry clinic in Eastern Anatolia region, Turkey.

The purpose of this study was to assess the frequency, the effective factors and the applied treatments for dental trauma among children aged 1-15 years from Eastern Anatolia in a 6-year period. The total frequency of trauma in this study was calculated as 4.9% during a 6-year period. The males were found to have more traumatic injury than females (P < 0.05). Also, the permanent teeth were more vulnerable to dental trauma than the primary teeth (P < 0.05). The highest frequency of traumas in the primary teeth was observed at the age of 5, whereas the rate for the permanent teeth was at the age of 10. The teeth mostly influenced by the traumas were the upper central incisors in both primary and permanent teeth. It was in October that traumas were mostly seen for the permanent teeth and in June for the primary teeth. The most frequent source of trauma in both genders and in both primary and permanent teeth were falls. The most common type of trauma in the primary teeth was lateral luxation, while it was enamel-dentin crown fracture in the permanent ones. Soft tissue injuries were observed in 143 of 653 dental traumatized children. The most common method of treatment was examination and follow up for the primary teeth, and only direct restoration for the permanent teeth without any endodontic treatment. 15% of the patients applied for treatment 1 year after injury event. Therefore, it was concluded that the patients, parents and teachers living in Eastern Anatolia should be informed about the necessity of early treatment of dental traumas and the consequence of a delay.

The repair of preveneered posterior stainless steel crowns.

PURPOSE: This study's purposes were to determine the shear bond strength (SBS) for and to perform dye penetration (microleakage) and scanning electron microscopy (SEM) evaluations of preveneered posterior stainless steel crowns (SSCs) that were repaired using 2 different materials. METHODS: Twenty-two crowns were used. They were stored in artificial saliva for 30 days and then thermocycled. A force was applied on the crowns' occlusal surfaces until the original veneer material appeared to be fractured. The fracture types and S8S values were recorded. The crowns were then repaired using Panavia opaque cement and Tetric Flow or Monoopaque and Tetric Flow. Twenty of the repaired crowns were subjected to dye penetration and SBS tests, and the remaining 2 were evaluated using SEM. RESULTS: Statistical analysis revealed no statistically significant differences in the results of either the S8S or the dye penetration test (P = .58 and P = 38, respectively). A statistically significant difference was found between original and repaired crowns regarding fracture extent (P = .02), but not failure type (P = .08). SEM evaluation showed that there was no observable gap at the interface of the original or repaired materials and the stainless steel base. CONCLUSION: Preveneered posterior stainless steel crowns may be repaired using either repair material types tested here.

Evaluation of success in the reattachment of coronal fractures.

The aim of this study was to evaluate clinically and radiographically the restored teeth using reattachment technique of fractured fragment to the remaining tooth. This study was conducted on 11 children (six girls and five boys; age range: 8-13 years). Before the treatment, the teeth were evaluated clinically and radiographically. The broken incisal part was directly reattached to the remaining tooth part with flowable resin composite. Thereafter, with the purpose of obtaining optimal esthetics and function, along the fracture line an external 'double chamfer' in the shape of a V was created and then covered with resin composite. During the follow-up (1-24 months) after the treatment, the teeth were evaluated clinically and/or radiographically with regard to periodontal, pulpal, coronal, color harmony of the fragments, and occlusion. In addition, the restored teeth were assessed in terms of parental-patient ratings of satisfaction. Both clinically and radiographically, no pathology was reported and all the restorations were successful. Moreover, the mean scores of parental-patient satisfaction were reported as 'satisfied, very-satisfied.'

A one-year clinical evaluation of a high-viscosity glass ionomer cement in primary molars.

In this study one-year clinical results of high-viscosity glass ionomer cement (GIC) (Fuji IX, A3, GC, Japan) were determined in class I and class II restorations in 68 primary molars with occlusal or approximal caries. Following caries removal and cavity preparation, the teeth were restored with Fuji IX. The restorations were evaluated according to the U.S. Public Health Service's (USPHS) criteria at the end of one year. Statistical analyses of the data obtained were analyzed using the X2 test. The evaluations showed no statistically significant difference between class I and class II restorations in terms of the color mismatch, anatomic form, marginal adaptation, and secondary caries (P>0.05), but they were statistically significant with regard to cavosurface marginal discoloration (P<0.05). At the end of one year, the success rate of the class I and class II restorations of the primary molars restored with Fuji IX was 94%.