Conservative and esthetic approach in crown fracture of maxillay anterior tooth: tooth fragment reattachment

Crown fractures are the most frequent traumatic injuries to permanent teeth and mainly involve the maxillary incisors due to their exposed position in the dental arch. One option for managing crown fractures, when the tooth fragment is present and in good condition, is reattachment of the fragment to its original position. This paper reports on three crown fracture cases in which successful esthetic and functional results were achieved by reattachment of the tooth fragment.

Tooth fragment re-attachment in fracture with biological width violation: case

ABSTRACT: Dento-alveolar traumas are one of the most frequent injuries to teeth, mainly affecting the upper incisors due to their exposed position in the dental arch. In such cases, esthetics, function and phonetics of anterior teeth may be compromised. Furthermore, when there is involvement of the biological width, there is often a poor prognosis. This case report describes the multidisciplinary approach to tooth fragment re-attachment in a fracture with biological width violation. The patient presented with an oblique crown fracture in the maxillary right lateral incisor, extending from the buccal to palatal side, as well as a biological width invasion. The re-establishment of the biological width was obtained by periodontal surgery to achieve clinical-crown lengthening and tooth fragment re-attachment with a glass fiber post to increase retention. After 3 years of follow-up, the rehabilitated lateral incisor remains in good condition, with satisfactory esthetic and periodontal health.

Biological restorations as a treatment option for primary molars with extensive coronal destruction: report of two cases

This article reports the cases of two young children aged 4 and 5 years, in whom biological restorations using tooth fragments were placed in primary molars with severely damaged crowns due to extensive carious lesions. After radiographic and clinical evaluation, tooth fragments obtained from extracted teeth in stock were autoclaved, adjusted to the prepared cavity and bonded to the remaining tooth structure with either adhesive system (Case 1) or dual-cure resin-based cement (Case 2) over a calcium hydroxide layer and a glass ionomer cement base. Occlusal adjustment was performed and topical sodium fluoride was applied to tooth surface. Periodical clinical and radiographic controls were carried out and the restored teeth were followed up for 4 and 3 years, respectively, until exfoliation. In these two reports, the technical aspects are described and the benefits and disadvantages of biological restorations as an alternative treatment for rehabilitation of severely destroyed primary molars are discussed.

Este artigo descreve dois casos clínicos de reconstrução de molares decíduos com extensa destruição coronária por meio de restaurações biológicas, em crianças de 4 e 5 anos. Após avaliação clínica e radiográfica, os fragmentos dentais heterógenos foram submetidos à colagem ao remanescente dental preparado usando sistema adesivo (Caso 1) ou cimento resinoso de presa dual (Caso 2) sobre uma camada de hidróxido de cálcio e uma base de ionômero de vidro. Foi realizado ajuste oclusal e aplicação tópica de flúor sobre a superfície dentária. Controles clínico e radiográfico foram realizados periodicamente e os dentes restaurados foram acompanhados por 4 e 3 anos respectivamente, até a exfoliação. Por meio destes dois relatos, os autores discutem os aspectos técnicos, além das vantagens e desvantagens das restaurações biológicas como tratamento alternativo para restauração de molares decíduos.