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


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.


CONCLUSIONS
Fragment reattachment can be used to treat fractured teeth successfully in children and adolescents.
Yilmaz
Yucel
Y
Department of Pedodontics, Ataturk University, Erzurum, Turkey. yyilmaz25@atauni.edu.tr
Guler
Cigdem
C
Sahin
Hakan
H
Eyuboglu
Ozge
O
D000134:Acid Etching, Dental; D000293:Adolescent; D002126:Calcium Hydroxide / Q000627:therapeutic use; D002648:Child; D003116:Color; D003188:Composite Resins / Q000737:chemistry; D003785:Dental Pulp Capping; D003789:Dental Pulp Exposure / Q000628:therapy; D003793:Dental Restoration, Permanent / Q000379:methods*; D003801:Dental Veneers; D003804:Dentin / Q000293:injuries / Q000473:pathology; D017220:Dentin-Bonding Agents / Q000737:chemistry; D003890:Desiccation; D005500:Follow-Up Studies; D006801:Humans; D007180:Incisor / Q000293:injuries / Q000473:pathology; D019188:Organ Preservation Solutions / Q000627:therapeutic use; D011109:Polymethacrylic Acids / Q000737:chemistry; D011446:Prospective Studies; D011672:Pulpotomy; D011859:Radiography; D012965:Sodium Chloride / Q000627:therapeutic use; D019227:Tooth Apex / Q000000981:diagnostic imaging; D019228:Tooth Crown / Q000293:injuries / Q000473:pathology; D014082:Tooth Fractures / Q000628:therapy*; D014092:Tooth Root / Q000000981:diagnostic imaging; D016896:Treatment Outcome; D014867:Water
D003188:Composite Resins; D017220:Dentin-Bonding Agents; D019188:Organ Preservation Solutions; D011109:Polymethacrylic Acids; C425843:Prime and Bond NT; C452226:tetric flow composite resin; C112192:valux plus; D014867:Water; D012965:Sodium Chloride; D002126:Calcium Hydroxide