Rehabilitation to crown–root fracture by fragment reattachment with resin‐modified glass ionomer cement and composite resin restoration

Abstract

Tooth fragment reattachment in cases of enamel/dentin fracture is based on adhesive protocols and is indicated because of its technique simplicity. Complex cases of root fracture or extensive coronal damage demand the integration of biological properties with the mechanical characteristics of the restorative materials. This paper is a report from one patient with a favourable result that addresses the clinical procedures involved in the association of resin-modified glass ionomer cement and composite resin for cases of coronal fracture of anterior teeth with invasion of the periodontal biological space and/or proximity with the pulp tissue. The research-based background for establishment of the treatment plan is discussed and a case of crown fracture with root involvement in a maxillary central incisor illustrates the operative technique of tooth fragment reattachment. After 1 year of follow up, the clinical and radiographic findings demonstrate that the adopted clinical protocol was successful and yielded an excellent pulp and periodontal response as well as maintenance of function and aesthetics.

Long‐term results of crown fragment reattachment techniques for fractured anterior teeth: A retrospective case‐control study

“…Possibly, this fact could be explained by the lesser resistance of the rebonding of the fractured tooth fragment than the direct composite restoration, although fracture strength of the reattached teeth is the most important factor determining its longevity. 14 However, according to the literature, the resistance of the tooth fragment rebonding varies greatly from the techniques used, [29][30][31][32][33] whereas the only direct comparison of the resistance of dental restoration was made between the fragment reattachment and the use of ceramic veneers. 34 With that, as the limitation of the study, which could affect the results we should note that the patients were not randomly assigned to the two groups.…”

Management of crown‐related fractures in children: an update review

“…In this approach, gingival healing is facilitated presumably through formation of a long junctional epithelium, which is followed by restoration of the coronal part . The restoration could be performed by reattachment of original fragment (especially in young patients with still developing teeth), resin composite restoration with adhesives, and full crown coverage .…”

Conservative Treatment of a Complicated Crown-root Fracture Using Adhesive Fragment Reattachment and Composite Resin Restoration: Two Year Follow-up

“…The prominent and open position of the upper teeth in the face is responsible for their more frequent involvement in fractures than the lower teeth. [1][2][3][4]13 Crown fracture restorations localized in the superior incisor area need to be evaluated from several perspectives, including the topography, tissues involved, quality and the quantity of the remaining tooth structures, adaptation of the fragment to the Figure 9. Perfect fragment adaptation to the remaining dental structure.…”

“…[1][2][3] Traumatic injury to teeth and their supporting structures usually occurs in young people, and maxillary central incisors are the most commonly affected teeth in either permanent or primary dentition because of their exposed position in the dental arch. 4 A crown-root fracture is a type of dental trauma, usually resulting from horizontal impact, that involves enamel, dentin, and cementum, occurs below the gingival margin, and may be classified as complicated or uncomplicated, depending on whether pulpal involvement is present or absent. [5][6][7] The prognosis of traumatic injuries depends on early intervention to injured teeth and the extension of the intervention.…”