![]() ![]() Then, based on the post obturation radiograph, no 2 HiRem quartz fiber post (Overfibers, Italy) was selected. ![]() Single visit root canal treatment was carried out with 11. The fractured fragment was removed and bleeding controlled. (a) Pre operative photograph, (b) Post obturation radiograph, (c) Palatal envelope flap raised, (d) Post and fractured fragment luted, (e) Sutures given, (f) Post cementation radiograph, (g) At 6 months follow-up Ĭlinical photograph and radiograph of case 2. The 4 years follow-up photograph shows satisfactory results. The patient was given oral hygiene instructions and was recalled for follow-up after 6 months. The fracture line was camouflaged with composite resin. The post and the fragment were luted using resin based luting cement, Calibra (Dentsply, U.K.). This adjustment was done to obtain a lock and key type of fit between the post and fragment in order to provide additional retention for the fractured fragment. The post and the fragment were adjusted until the fragment approximated in its original position. An arbitrary preparation was done on the pulpal aspect of the tooth fragment using round bur and straight fissure bur and hence that it would fit over the 2 mm of the post. After the seating of the post was checked, it was trimmed, leaving about 2 mm of post beyond the tooth. Post space preparation was done, retaining 6 mm of apical Gutta-percha. The post selected was HiRem post size 2 (Overfibers, Italy). The obturation radiograph was used to determine the size of the prefabricated fiber post. Single visit root canal treatment of 22 was carried out. The fragment was placed in normal saline. (a) Preoperative photograph and radiograph, (b) Fractured fragment, (c) Post obturation radiograph, (d) Post cementation radiograph, (e) Postoperative photograph, (f) 6 months follow-up, (g) 4 years follow-upĪs the patient was due for debonding, the brackets were removed from the maxillary arch. Reattachment of fragment offers following advantages:Ĭase 1. Subsequently, Starkey and Simonsen have reported similar cases. Tennery was the first to report the reattachment of a fractured fragment using the acid-etch technique. Tooth fragment reattachment has been shown to be an acceptable alternative to the restoration of the fractured tooth. The most common etiological factors of crown and crown root fractures in the permanent dentition are injuries caused by fall (about 40%), contact sports (about 20%), automobile accidents, and foreign body striking the teeth.Įarly techniques to restore the fractured crown include jacket crown, orthodontic bands, pin retained resin, porcelain bonded crown and composite resin. This is particularly true in case of young patients as it not only causes physiologic impairment, but also esthetic disfigurement leading to a psychological impact. Traumatized anterior teeth require quick functional and esthetic repair. Coronal fractures of permanent incisors represent 18-22% of all trauma to dental hard tissues, 28-44% being simple (enamel and dentin) and 11-15% complex (enamel, dentin, and pulp). ![]() Reattachment is the most economical, biologically acceptable and esthetic restorative option for dental trauma.ĭental fractures account for 26-76% of dental injuries in the permanent dentition. The second case with a subgingival fracture was treated by raising a flap. The first case showing a 4-year success was treated without raising a flap. This article presents 2 case reports of reattachment of fractured tooth fragments. In cases of fractures extending subgingivally, an envelope flap helps to achieve the desired isolation and visibility. However, fractures involving the pulp require reinforcement by quartz fiber posts and resin luting cement. Cases of enamel and dentin fractures not involving pulp are treated by reattaching the fragment with adhesives and composite resin. If in case of complex fractures the fractured tooth fragments are available to the dentist in a clean and hydrated state, reattachment of the tooth fragment is the most conservative and biological treatment option possible. Simple tooth fractures, which occur due to sharp blows, are widely seen in all age groups, especially in young adults. ![]() Dental hard tissue trauma is among the most common cases encountered in dental practice. ![]()
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