Cross-sectional study of posterior tooth root fractures in 2015 and 2019 in a Chinese population.

OBJECTIVES: This study aimed to compare posterior tooth root fractures in endodontically treated teeth versus nonendodontically treated teeth in the Chinese population. MATERIALS AND METHODS: We investigated 500 root fractured posterior teeth in 461 Chinese patients. The clinical information (age, sex of patients, tooth type) were recorded. The fractured teeth were divided into endodontically treated root fractured (ETRF) teeth and nonendodontically treated root fractured (NETRF) teeth. The morphology of the fractured root (circular, oval, other), the orientation of fracture lines (vertical and non-vertical), the restorations performed (crown, filling, non-filling), and the position of the teeth in the dental arch (normal, misaligned) were evaluated based on cone-beam computed tomography images. These data were compared between 2015 and 2019. ETRF% was calculated as ETRF/ETRF + NETRF. Vertical% was calculated as vertical/vertical + non-vertical. RESULTS: There were 177 ETRF teeth and 323 NETRF teeth in this population. The total ETRF% was 29.3% in 2015 and 37.6% in 2019 (P = 0.087). The proportion of vertical root fracture in the ETRF group increased significantly in 2019 compared with that in 2015 (46.2% vs. 80.2%, P = 0.000). The ETRF% in female patients increased by 16.8%, but increased by only 1.2% in male patients in 2019 compared with that in 2015. The ETRF% of mandibular and maxillary premolars increased by 48.5% and 29.3%, respectively. The proportion of crown restoration increased by 2.4% in 2019 compared with that in 2015 in the ETRF group. CONCLUSIONS: The proportion of NETRF teeth and non-vertical root fractures in posterior teeth is high in this Chinese population. The number of vertical root fractures in endodontically treated teeth increased significantly from 2015 to 2019. CLINICAL RELEVANCE: More attention should be paid to endodontic treatment factors in the occurrence of root fractures, especially as female patients and premolars are more susceptible.

Evaluation of Fracture Resistance of Reattached Fractured Tooth Fragment Stored in Different Storage Media: An In Vitro Study.

AIM: To evaluate the fracture resistance of coronal fractured tooth fragments stored in five different storage media when reattached with nanohybrid flowable composite. MATERIALS AND METHODS: The crown portion of 50 extracted human permanent maxillary central incisors were divided into three equal parts (incisal third, middle third and cervical third) and then marked incisal third were cut with the diamond disk. These were divided into five equal groups according to the type of storage media used i.e. dry storage, fresh tender coconut water, HBSS, milk, and propolis for 2 hours. Coronal fractured part with their respective apical parts were then reattached with flowable composite (G-aenial Universal Flo, GC India), then after thermocycling process samples were subjected to universal testing machine for testing fracture resistance. The collected data were subjected to statistical analysis using one way ANOVA and Post-hoc Tukey test. RESULTS: The obtained results revealed that large amount of force is required to fracture the reattached teeth which were stored in milk and fresh tender coconut water as compared to those which were stored in dry environment, HBSS and propolis. CONCLUSION: In this study, maximum fracture resistance was seen in teeth stored in milk and fresh tender coconut water. Therefore, these two were considered as better storage media. CLINICAL SIGNIFICANCE: Due to increased interest towards the use of tooth colored restoration, recently, fractured teeth reattachment treatment procedure gaining attention by preserving life like translucency of treated tooth.

CAD/CAM ceramic fragments in anterior teeth: A clinical report.

OBJECTIVE: The treatment of fractured teeth has become a great opportunity to investigate new approaches in the field of restorative dentistry. Restoring teeth with ceramic fragments is a great challenge, however, the computer aided design/computer aided manufacturing (CAD/CAM) technology allows the fabrication of both laminate veneers and ceramic fragments. MATERIALS AND METHODS: Thus, the aim of this article was to report a clinical case where anterior teeth, fractured due to a sport practice, were restored with CAD/CAM ceramic fragments. CONCLUSIONS: It was observed that with this kind of restoration optimum esthetic results might be achieved when treating anterior fractured teeth. CLINICAL SIGNIFICANCE: Ceramic fragments using CAD/CAM systems are a viable clinical alternative to composites for the reconstruction of fractured teeth. Function and esthetics can be restored with the use of this treatment quickly and efficiently.

Endodontic Microbiome of Fractured Non-vital Teeth in Dogs Determined by 16S rRNA Gene Sequencing.

Dental fractures resulting in pulp exposure will lead to an endodontic infection with microbes from the oral cavity. However, data on the endodontic microbial composition in veterinary dentistry is lacking. The aim of this study was to examine the microbiome of naturally occurring primary endodontic infections in client-owned dogs. The endodontic microbiome of 10 non-vital teeth with exposed pulp cavities was assessed using a 16S rRNA gene sequencing approach. The results were compared to the microbiome of the subgingival plaque of the same teeth. Analysis revealed an abundant mixed microflora of a comparable richness and diversity and with mostly the same phyla obtained from sulcal and endodontic samples. However, further analysis revealed significant differences between sulcal and endodontic samples in the relative abundance of the most abundant phyla and genera, with the relative abundance of Bacteriodetes being significantly higher in endodontic samples. Although each sample presented a particular profile regarding the genera identified, Bacteroides was the most abundant genus in the endodontic samples. Snowella was also significantly more abundant in endodontic samples, while Porphyromonas and Fusobacterium were significantly more abundant in sulcal samples. We confirmed that the microbiome of the diseased endodontic system is comparably abundant with microorganisms to the healthy subgingival plaque indicating that previous culture-based studies of primary endodontic infections in dogs underestimated the richness and diversity of the endodontic microbiota.

A Preliminary Investigation into the Dietary and Oral Practices Associated with Fractured Teeth and Prostheses in a Trinidadian Population.

OBJECTIVES: This preliminary study seeks to determine the relationship between fractured teeth, restorations, prostheses, and specific dietary practices. METHODOLOGY: Anonymous questionnaires were randomly distributed to a convenience sample of Trinidadian adults at various locations around the country, after gaining consent. Data were analyzed using the software; Statistical Package for the Social Sciences for significant associations between various types of food and broken teeth or prosthesis using odds ratios. RESULTS: Three hundred questionnaires were completed. Seventy-five percent of the patients preferred crunchy or hard foods and 51% of the respondents liked crushing bones, mostly chicken bones. It was observed that respondents with a dietary preference for fried whole chana, split chana, crab, and sugarcane were significantly associated with broken dentures. Respondents eating whole chana also had a significant association with broken teeth and broken dentures. Associations were found between some dietary preferences, ethnicities, and age groups. CONCLUSIONS: Significant associations between age, ethnicity, sex, and certain dietary practices and habits were found. There also appears to be a significant relationship between patients with fractured teeth, restorations, and prostheses with certain dietary preferences.

Método de extrusión dentaria unitaria con fines protésicos: caso clínico / Single tooth extrusion method for prosthetic purposes: a clinical case

La pérdida de estructura dentaria por debajo del margen gingival y de la cresta ósea alveolar, ya sea por caries, fracturas traumáticas, desgaste, reabsorción radicular o perforaciones iatrogénicas, dificulta el tratamiento protésico y requiere un abordaje multidisciplinario para conseguir resultados óptimos y estables a largo plazo. Se presenta el caso de una paciente adulta que acude a consulta con la pieza 2.3, que no permite una adecuada restauración protésica sin invadir el espacio biológico. Dentro del abanico de posibilidades terapéuticas se selecciona la extrusión dentaria unitaria guiada, para poder exponer un remanente dentario adecuado supragingival, y conseguir un adecuado efecto ferrule para la posterior rehabilitación protésica. La técnica presentada es eficaz, simple, cómoda, higiénica y útil en pacientes que no desean realizarse tratamiento de ortodoncia en ambas arcadas (AU)

Reattachment of fractured teeth fragments in mandibular incisors: a case report.

The majority of dental trauma involves anterior teeth, especially the maxillary central incisors. A mandibular incisor fracture with or without pulp tissue involvement is considerably less common. Different approaches for treating these fractured teeth have been reported in the literature. The type of treatment rendered depends mainly on the extent of fracture, pulp involvement, radicular fracture, biologic width infringement or violation, and presence of the fractured piece. This case report illustrates reattachment of fractured fragments on two mandibular incisors without pulp exposure using a new proposed reattachment method using a combination of two different types of composite materials together with an orthodontic lingual retention wire. An 8-year-old female patient presented with fractured mandibular left incisors (Ellis class II fracture). Broken pieces were saved and brought in a closed container in water. Periapical radiographs revealed no evidence of pulpal involvement in either tooth and no periapical radiolucency was noticed. Fractured fragments and the broken teeth were prepared with circumferential bevels. Reattachment of the fractured fragments were done using two types of composite resin materials and a lingual orthodontic retention wire was also used. The patient was recalled after 8 months to follow up both teeth. Clinical examination revealed excellent composite restorations covering the fracture lines.

Application of Dahl concept on fractured teeth using direct composite resin restorations: A case report

@#Traumatic dental injuries are frequent problems among teenagers, affecting aesthetics, functionality and quality of life. With regards to the present case, there was an inadequate restorative space for anterior restorations due to the dentoalveolar compensation two years after a traumatic event and was particularly challenging. The use of the Dahl concept to create restorative space is well documented particularly in patients with localized tooth wear. However, there are no evidence to justify the feasibility of Dahl concept application on the fractured teeth. The purpose of this article is to provide a detailed description regarding this technique to create the necessary restorative space of the fractured teeth.

Force eruption of mandibular second incisor in an 11- year old boy: a technical report.

There is a great challenge in the treatment of deeply fractured and un-restorable teeth among dentists. Orthodontic force eruption is a method of treatment for these teeth to preserve natural root system and periodontal structures. This technical report is a new modification of this procedure presented in an 11- year old boy with deeply fractured left second mandibular incisor. The fractured teeth were treated with root canal therapy and a file #80 was modified to become a hook cemented into the fractured tooth. Anterior teeth were splinted and used as anchorage to help the root extrusion. 1-year follow up of the tooth showed the convenience of the treatment. This simple and low-cost method can be an acceptable alternative to the current high cost techniques, achieving the same results.

A Preliminary Investigation into the Dietary and Oral Practices Associated with Fractured Teeth and Prostheses in a Trinidadian Population

Objectives: This preliminary study seeks to determine the relationship between fractured teeth, restorations, prostheses, and specific dietary practices. Methodology: Anonymous questionnaires were randomly distributed to a convenience sample of Trinidadian adults at various locations around the country, after gaining consent. Data were analyzed using the software; Statistical Package for the Social Sciences for significant associations between various types of food and broken teeth or prosthesis using odds ratios. Results: Three hundred questionnaires were completed. Seventy­five percent of the patients preferred crunchy or hard foods and 51% of the respondents liked crushing bones, mostly chicken bones. It was observed that respondents with a dietary preference for fried whole chana, split chana, crab, and sugarcane were significantly associated with broken dentures. Respondents eating whole chana also had a significant association with broken teeth and broken dentures. Associations were found between some dietary preferences, ethnicities, and age groups. Conclusions: Significant associations between age, ethnicity, sex, and certain dietary practices and habits were found. There also appears to be a significant relationship between patients with fractured teeth, restorations, and prostheses with certain dietary preferences.

Informative promotional outcome on school teachers' knowledge about emergency management of dental trauma.

AIM: To assess awareness of school teachers concerning the emergency management of traumatized teeth. MATERIALS AND METHODS: This is a prospective intervention study conducted with 1000 teachers (500 urban, 500 rural) randomly selected from the entire government and private, primary (elementary) as well as secondary (high) schools of Nellore district of Andhra Pradesh, India. Study was carried out in three phases; the first phase being an initial survey conducted to assess the existing knowledge of teachers on management of traumatic injuries by using self-administered questionnaire. This was followed by a comprehensive informative promotion regarding the initial management of the traumatic dental injuries for the teachers. A post-promotion follow-up review was conducted 3 months later to evaluate the effect of the informative promotion, using the same set of questionnaires. Study was completed over a period of 9 months. STATISTICAL METHODS: Data analysis was done using SPSS software version 14.0, and Chi-square test was used to compare the knowledge of teachers prior to and after the informative promotion. The level of significance was set at P ≤ 0.05. RESULTS: The teachers' overall knowledge with respect to the emergency management of the traumatic injuries was deficient and significant differences were found in the knowledge of teachers before and after the informative promotion. CONCLUSION: Informative promotion programs to improve the knowledge and awareness of this group of community, who are generally the first line of assistance in case of dental trauma in schools, are mandatory.