Reattachment of anterior fractured teeth: effect of materials and techniques on impact strength.

BACKGROUND/AIM The reattachment of dental fragments, as a conservative treatment, should be the first choice to restore fractured teeth. Therefore, the aim of this study was to evaluate the effect of different materials and reattachment techniques on impact strength of bovine incisors. MATERIAL AND METHODS Standardized fragments were obtained when 80 crowns were sectioned 12 mm from the incisal edge. Teeth were mounted in PVC rings, embedded in acrylic resin and polyether to simulate bone support and periodontal ligament. Specimens were distributed in nine groups (n = 10), according to the reattachment technique (Direct bonding or Circumferential chamfer); the adhesive system (Single Bond or Clearfil SE Bond); and the intermediated material (Filtek Z350 Flow or Rely X CRA). Sound teeth composed the control group. Circumferential chamfer was prepared after the bonding of the fragment by means of a spherical point and filled with the composite Filtek Z250. The impact strength was evaluated in a universal testing machine Instron. A compressive load was applied at a crosshead speed of 500 mm min(-1) on the buccal surface, 2 mm from the incisal edge. Data were submitted to anova and Ryan-Einot-Gabriel-Welsch Multiple Range test (5%). RESULTS Mean value of impact strength for control group was 64.8 Kgf. The fragment reattachment using Circumferential chamfer was significantly superior to Direct Bonding. The use of Single Bond significantly increased the impact strength when compared to the use of Clearfil SE. There was no significant difference among Rely X and Filtek X350 Flow. CONCLUSION No technique or material, when individually considered, was capable of achieving the mechanical strength of the sound teeth; however, the association of reattachment technique Circumferential chamfer with bonding system Single Bond could approximate the immediate impact strength of the restored teeth to that observed in the sound teeth.

[1]  N. Altay,et al.  Fracture resistance of tooth fragment reattachment: effects of different preparation techniques and adhesive materials. , 2010, Dental traumatology : official publication of International Association for Dental Traumatology.

[2]  R. Tamaki,et al.  Reattachment of rehydrated dental fragment using two techniques. , 2009, Dental traumatology : official publication of International Association for Dental Traumatology.

[3]  W. Geurtsen,et al.  Shear bond strength of self-etch adhesives to enamel with additional phosphoric acid etching. , 2008, Operative dentistry.

[4]  L. Baratieri,et al.  Effects of phosphoric acid pretreatment and substitution of bonding resin on bonding effectiveness of self-etching systems to enamel. , 2007, The journal of adhesive dentistry.

[5]  Kirzioğlu Zuhal,et al.  Traumatic injuries of the permanent incisors in children in southern Turkey: a retrospective study. , 2005, Dental traumatology : official publication of International Association for Dental Traumatology.

[6]  M. A. Sinhoreti,et al.  SEM evaluation of contemporary self-etching primers applied to ground and unground enamel. , 2005, The journal of adhesive dentistry.

[7]  C. Soares,et al.  Influence of root embedment material and periodontal ligament simulation on fracture resistance tests. , 2005, Brazilian oral research.

[8]  C. Feldens,et al.  Prevalence of crown fractures in 8-10 years old schoolchildren in Canoas, Brazil. , 2004, Dental traumatology : official publication of International Association for Dental Traumatology.

[9]  F. Demarco,et al.  Fracture resistance of re-attached coronal fragments--influence of different adhesive materials and bevel preparation. , 2004, Dental traumatology : official publication of International Association for Dental Traumatology.

[10]  A. Reis,et al.  Effect of fractured or sectioned fragments on the fracture strength of different reattachment techniques. , 2004, Operative dentistry.

[11]  E. Matson,et al.  Reattachment of fractured teeth: a review of literature regarding techniques and materials. , 2004, Operative dentistry.

[12]  Simonides Consani,et al.  Effect of sodium hypochlorite on dentin bonding in primary teeth. , 2004, The journal of adhesive dentistry.

[13]  L. Baratieri,et al.  Tooth fragment reattachment: fundamentals of the technique and two case reports. , 2003, Quintessence international.

[14]  F. Ozer,et al.  Shear bond strengths of tooth fragments reattached or restored. , 2003, Journal of oral rehabilitation.

[15]  S. Kreiborg,et al.  Fractured teeth bonded with dentin adhesives with and without unfilled resin. , 2002, Dental traumatology : official publication of International Association for Dental Traumatology.

[16]  P. Lambrechts,et al.  Adhesives and cements to promote preservation dentistry , 2001 .

[17]  L. Nicolais,et al.  Mechanical strength of tooth fragment reattachment. , 2001, Journal of biomedical materials research.

[18]  A. Loguercio,et al.  Re-attachment of anterior fractured teeth: fracture strength using different techniques. , 2001, Operative dentistry.

[19]  J. Andreasen,et al.  Impact strength of teeth restored by fragment-bonding. , 2000, Endodontics & dental traumatology.

[20]  V. Górecka,et al.  Direct pulp capping with a dentin adhesive resin system in children's permanent teeth after traumatic injuries: case reports. , 2000, Quintessence International.

[21]  M. Campese,et al.  Crown fractures: effectiveness of current enamel-dentin adhesives in reattachment of fractured fragments. , 2000, Quintessence international.

[22]  Murchison Df,et al.  Incisal edge reattachment: the effect of preparation utilization and design. , 1999 .

[23]  M. Hannig,et al.  Self-etching primer vs phosphoric acid: an alternative concept for composite-to-enamel bonding. , 1999, Operative dentistry.

[24]  E. Munksgaard,et al.  Fracture strength of intact and fragment-bonded teeth at various velocities of the applied force. , 1999, European journal of oral sciences.

[25]  S. Kreiborg,et al.  Adhesive bonding of fractured anterior teeth: effect of wet technique and rewetting agent. , 1998, American journal of dentistry.

[26]  J. Astbäck,et al.  A retrospective study of 236 patients with teeth restored by carbon fiber-reinforced epoxy resin posts. , 1998, The Journal of prosthetic dentistry.

[27]  S. Kreiborg,et al.  Adhesive bonding of fragmented anterior teeth. , 1998, Endodontics & dental traumatology.

[28]  Kanca J rd Replacement of a fractured incisor fragment over pulpal exposure: a long-term case report. , 1996 .

[29]  M. Walker Fractured-tooth fragment reattachment. , 1996, General dentistry.

[30]  Vissichelli Vp Restoration of a fractured maxillary central incisor by using the original tooth fragment. , 1996 .

[31]  J. Andreasen,et al.  Long-term survival of fragment bonding in the treatment of fractured crowns: a multicenter clinical study. , 1995, Quintessence international.

[32]  S. Karlsson,et al.  Survival rate and failure characteristics for two post designs. , 1995, The Journal of prosthetic dentistry.

[33]  W. G. Matthews,et al.  Nanoleakage: leakage within the hybrid layer. , 1995, Operative dentistry.

[34]  D. Pashley,et al.  Comparative SEM and TEM observations of nanoleakage within the hybrid layer. , 1995, Operative dentistry.

[35]  H. Sano,et al.  Microporous dentin zone beneath resin-impregnated layer. , 1994, Operative dentistry.

[36]  E. Munksgaard,et al.  Reinforcement of bonded crown fractured incisors with porcelain veneers. , 1991, Endodontics & dental traumatology.

[37]  R. Simonsen Restoration of a fractured central incisor using original tooth fragment. , 1982, Journal of the American Dental Association.

[38]  R. Simonsen Traumatic fracture restoration: an alternative use of the acid etch technique. , 1979, Quintessence international, dental digest.