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At least 217 records · Page 12Linked to original sources
PubMed2004

Reattachment of a fractured maxillary tooth: a case report.

A 14-year-old male patient reported with a horizontal fracture of almost the entire crown of a maxillary incisor, extending subgingivally at the palatal side. After root canal therapy and electrosurgery, the tooth fragment was reattached using a total-etch dentin-bonding system and a hybrid composite. Due to enamel cracks and the necessity for more retention, the labial surfaces of the teeth were veneered with a micro-filled composite. The clinical situation of the reattached teeth was confirmed successful by radiographic and photographic assessment after 1, 3, 6, and 12 months. The restoration of an anterior tooth with original tooth fragment in young patients has advantages over conventional composite or prosthetic restorations. However, reattached teeth with fracture extending subgingivally, require long-term follow-up.

Adolescent↗
PubMed2006

The effect of 2 different diameter cast posts on tooth root fracture resistance in vitro.

Prosthetic treatment frequently involves the restoration of endodontically treated teeth (ETT), which in turn implies that there has been a reduction of the crown due to previous restorative treatment, trauma and/or endodontic manipulations. The prognosis of a restored ETT is very much dependent on pre-endodontic status of the tooth, the quality of the endodontic treatment, the amount remaining tooth structure and the bone support. The aim of this study is to measure fracture resistance of extracted premolar teeth restored with 2 different diameter posts. Extracted premolars were collected and stored in physiologic solution at 5 degrees C. The teeth were examined for fractures by direct and transillumination observation and 40 premolars were accepted for the study. The PC were modelled using the appropriate diameter plastic pattern for the post and Pattern Resin (GC) was used to model the core part of the PC. The PC patterns were invested and cast in cobalt chromium alloy and then cemented using zinc phosphate cement. Fracture resistances of the samples were tested in an "Instron 4301" (Instron Series IX Automated Material Testing System Version 5) with a loading speed of 0.5 mm/min. The data for each sample was recorded graphically. Both groups were analyzed using the t-test (p<0.01) in relationship to the mean value of that group. Post and cores significantly reduce the fracture resistance of the tooth and should be used only to secure retention and resistance form for full coverage crowns. Teeth with a larger diameter post have a reduced fracture resistance than teeth with a smaller diameter.

Bicuspid↗
PubMed1989

[Vertical root fracture--case report and clinical evaluation].

It is observed at the Dental OPD that some of the patients suffer from toothache are due to tooth fracture. Of the various types of tooth fracture, it is noted that vertical root fracture of molars which have never undergone endodontic treatment has rarely been reported. It is suggested that x-ray examination is the best diagnostic tool as it would show a certain section of the abnormally large root canal. This will indicate a fracture in the root. As the fractured root is mostly very poor in prognosis, the tooth in question should be extracted or it can be treated with root amputation or hemisection to eradicate the fractured root. Three cases of vertical root fracture are reported. The intent of this paper is to probe such cases, the means of diagnosis, and their treatments in clinical practices. Dental colleagues are thus advised to take into consideration the possibility of vertical root fracture whenever patients complain about toothache without any apparent cause.

Adult↗
PubMed2004

Effects of crowding in the lower anterior segment--a risk evaluation depending upon the degree of crowding.

AIM: The aim of this study was to investigate the extent to which the anterior segment is at risk of developing disease under the influence of different types of anterior crowding and whether the degree of crowding correlates with a potential risk. PATIENTS AND METHOD: A clinical examination and cast analysis taking special account of the age and gender of 125 adult patients (63 women, 62 men) were used to determine the clinical degree of abrasion and the individual incidence of tooth infractions, tooth fractures, caries, gingivitis, periodontitis and gingival recessions (WHO-OHS method), with any correlation between the incidence of disease and the respectively calculated crowding being recorded. The diagnosis of crowding was based on the segmented arch analysis proposed by Lundström [29]. Besides evaluating the total collective, a separate evaluation was performed for the age groups 18-34 years (n = 63) and > or = 35 years (n = 62). RESULTS: No gender-related differences in crowding were determined. Patients > or = 35 years showed significantly more crowding. An age-related increase in disease was recorded. The degree of abrasion and the individual incidence of caries did not correlate with the degree of crowding. By contrast, differences in the degree of crowding were determined in the total collective for tooth infractions (p < 0.001), tooth fractures (p = 0.004), gingival bleeding (p = 0.022), shallow periodontal pockets (p < 0.001), and gingival recessions > 3.5 mm (p < 0.001). The degree of crowding was found to correlate in the younger patients with tooth infractions (p < 0.017) and tooth fractures (p = 0.036), and in the older patients with shallow periodontal pockets (p < 0.001) and gingival recessions > 3.5 mm (p < 0.001). The incidences of disease in virtually physiologic cases of crowding (crowding < or = 2 mm, n = 31) were compared with those recorded in extreme cases of crowding (crowding > or = 5 mm, n = 30). All cases of crowding > or = 5 mm were subject to gingivitis and tooth infractions, and shallow periodontal pockets occurred three times more often and gingival recession > 3.5 mm twelve times more often. The presence of deep periodontal pockets could not be attributed to the degree of crowding. CONCLUSION: With respect to the multifactorial etiology underlying the risk of disease of the dental hard tissue and the periodontal tissues, anterior crowding > 3 mm (threshold value) as an individual "host factor" represents a cumulative risk potential for chronic inflammatory processes whose consequences are manifest only at a higher age. This gives rise to a medical treatment indication within the framework of preventive treatment strategies.

Adolescent↗
PubMed1978

Endodontic-orthodontic management of fractured anterior teeth.

A case history is presented of a 10-year-old patient, who accidentally injured her maxillary central incisor. The fracture of the crown extended 2 mm below the crest of the alveolar bone. After a pulpotomy was done as a temporary measure, orthodontic appliances were placed by bonding brackets on the maxillary anterior teeth and fitting a sectional arch wire to extrude the fractured tooth. After successful extrusion, the fracture line was brought above the level of alveolar bone where successful restoration of the tooth by the acid-etch method could be accomplished.

Child↗
PubMed2001

The relationship between radiologic interpretation and root tip fracture during tooth extraction performed by junior clinicians.

OBJECTIVES: The purpose of this study was to analyze the relationship between root tip fracture and radiologic interpretation of root morphology on periapical radiographs during third molar extraction performed by junior clinicians. METHODS: Before tooth extraction, periapical radiographs of 107 patients with 116 third molars were evaluated by junior clinicians, all with less than 5 years of clinical experience. Radiologic interpretations of root morphology-including number, curvature, fusion, and accessory root-were recorded before each extraction. The clinicians were also asked to estimate the possibility of root fracture on a Visual Analogue Scale before the procedure. The exact morphology of the extracted teeth was recorded after the extraction for the purpose of comparison. RESULTS: Twenty-nine of 116 teeth extracted were not correctly interpreted in at least 1 of the morphologic categories surveyed. The average expected fracture rate of nonfractured teeth was 23.1%, whereas the average expected fracture rate of fractured teeth was a significantly higher 50.3%. Misinterpretation of root morphology on radiographs decreased with increased clinical experience. Senior residents had the lowest misinterpretation and fracture rate. Logistic regression analysis showed that fracture is most closely related to the estimated fracture rate (4.95) and is also significantly related to underestimation of root curvature (0.95; 24.56 with 2 df of chi-square, P = .0001). CONCLUSIONS: Misinterpretation of root morphology on radiographs occurred in 25% of the teeth. Root curvature was the most misinterpreted item studied. Fracture was most closely related to the estimated fracture rate. Junior clinicians in this study expected that only 50% of the fractured teeth would fracture, reflecting a general underestimation of root tip fracture. Further study should be performed to evaluate how to increase the accuracy of root curvature interpretation.

Clinical Competence↗
PubMed2002

Incompletely fractured teeth associated with diffuse longstanding orofacial pain: diagnosis and treatment outcome.

AIM: To evaluate the diagnostic value of different clinical findings, and analyse the symptoms experienced from teeth with incomplete dentinal fractures in patients with diffuse orofacial pain. Secondly, to present the outcome of different treatment modalities in these patients. METHODOLOGY: Thirty-two patients, referred to the teaching clinic at the Faculty of Dentistry, University of Bergen, with poorly localized orofacial pain, were finally diagnosed with 46 incompletely fractured teeth. The distribution and pattern of pain was thoroughly recorded for each patient. The final diagnosis, incompletely fractured tooth, was obtained after removal of fillings and direct inspection of possible fracture lines. RESULTS: Many of the patients had suffered diffuse orofacial pain for more than 1 year, and had earlier consulted dental and medical expertise. Direct inspection of fracture lines, combined with staining solution and transillumination proved to be the best diagnostic tools. The longer the duration of pain before the diagnosis of an incompletely fractured tooth was established, the more diffuse was the distribution of pain. Endodontic or restorative treatment relieved the symptoms in 90% of the patients, whilst persisting symptoms in 10% were considered part of an orofacial pain complex of obscure aetiology. CONCLUSION: This study shows that the diagnosis of the incompletely fractured teeth in patients with longstanding diffuse orofacial pain symptoms are time consuming and represent a diagnostic problem. With appropriate endodontic and/or restorative treatment, symptoms were relieved in the majority of cases.

Bite Force↗
PubMed1996

Clinical evaluation of gallium alloy as a posterior restorative material.

This study evaluated 30 gallium alloy (Gallium alloy GF) and 31 amalgam (Dispersalloy) restorations over a period of 8 months in both Class I and Class II cavity preparations in 28 human subjects. At baseline, all gallium alloy and amalgam restorations were considered acceptable (Alfa) in terms of caries, anatomic form, marginal adaptation, surface texture, and bulk fracture. Postoperative sensitivity was reported in 67% of the gallium alloy restorations and in 29% of the amalgam restorations. At 8 months, 61% of the gallium alloy restorations were rated Beta for marginal adaptation, and all restorations exhibited tarnish and corrosion. With a few exceptions, the amalgam restorations were rated Alfa for those criteria. Three gallium alloy restorations had to be replaced during the evaluation period because of severe postoperative sensitivity and 39% of gallium restorations still presented some sensitivity at 8 months. Additional problems exhibited by gallium restorations were tooth fractures, tooth cracks, and marginal whitening.

Alloys↗
PubMed2004

Laser Doppler flow investigation of fractured permanent maxillary incisors.

Laser Doppler flowmetry (LDF) is a non-invasive method to assess pulpal blood-flow (PBF). Dental injury has been associated with losses of pulpal sensibility. The purpose of this study was to assess the outcome of splint therapy on tooth fracture type-related PBF values. In 15 trauma patients, a single maxillary incisor treated by repositioning and splinting was investigated by LDF to assess local PBF values. Perfusion units were taken in four sessions, on the day of splint removel, and 12, 24 and 36 weeks after splint removal. Analysis of the tooth fracture type-related PBF measurements revealed root fractures to be associated with a significant decrease (P < 0.05) and uncomplicated crown fractures to be associated with a significant increase in PBF values (P < 0.05), while complicated crown fractures showed no significant difference between the session-related values (P > 0.05). The main findings of this study suggest splint therapy of root fractures of the central maxillary incisor to be associated with a short- and long-term decrease in PBF values. The LDF may become useful in the detection of transient ischaemic episodes and the identification of teeth at risk for adverse sequelae such as avascular necrosis and tissue loss.

Adolescent↗
PubMed2001

Tongue piercing: a restorative perspective.

The implication of a traumatic injury to a permanent molar tooth as a complication by tongue piercing with ornamental jewelry is reported. An appropriate restorative management of the fractured tooth is described. The dentist's role in prevention and treatment of unfavorable complications is outlined. The rationales for selection of specific treatment modalities, in view of the degree of damage to hard dental tissues, are discussed. The range of hard tissue injuries resulting from tongue jewelry varies from a simple crack propagating into the enamel to a fractured tooth. A variety of factors must be considered before employing the available restorative methods.

Adult↗
PubMed2006

Multidisciplinary approach to the rehabilitation of a crown-root fracture with original fragment for immediate esthetics: a case report with 4-year follow-up.

Dental practitioners frequently encounter dentoalveolar traumas. According to the severity of the trauma, a large spectrum of complications such as isolated tooth fracture, dentoalveolar fracture or fracture at maxillofacial region may occur. If the isolated tooth fracture occurs particularly at anterior region, the rehabilitation should satisfy both esthetic and functional problems. An unrestorable tooth should be extracted and this leads to more complex treatments such as implant or conventional prosthetic rehabilitations, which will restore the function, but impair the esthetics. Recently, powerful new generation dual-cured resin composites have been produced for reattachment of original fractured fragments. In this case, we presented treatment of oblique crown-root fracture of a maxillary central tooth from enamel-cement junction by the reattachment technique. We used dual cured resin composite (Panavia F) and a self-tapping screw-post (Dentatus) for reattaching the crown fragment. Orthodontic treatment was applied for intruding and leveling the tooth. Four years after treatment, the tooth exhibited good esthetics, good periodontal health and normal function. However, minimal relapse occurred in spite of orthodontic treatment. In conclusion, the reattachment technique is an alternative method, which offers satisfactory esthetic and functional rehabilitation of the fractured teeth.

Adult↗
PubMed1979

In vitro comparison of intact endodontically treated teeth with and without endo-post reinforcement.

In an in vitro experiment, the failure loads of 59 intact endodontically treated teeth with and without Kerr Endo-Post reinforcement were compared. Fifty-eight teeth fractured below the cementoenamel junction. One tooth fractured through the pulp chamber with a chisel fracture involving both the crown and root. Teeth without posts fractured through the middle or coronal one third of the root. Teeth with posts fractured through the body of the post. No statistically significant reinforcement was demonstrated by cementing a Kerr Endo-Post No. 100 into a sound endodontically treated tooth.

Crowns↗
PubMed1996

2-year clinical evaluation of a gallium restorative alloy.

PURPOSE: To assess the clinical performance of 2-year old gallium alloy restorations. Parameters evaluated include: (1) fracture at the margins, (2) tarnish, (3) surface roughness, (4) tooth fracture, (5) fracture through the body of the restoration, and (6) any medical or dental conditions arising during the study. MATERIALS AND METHODS: Nine patients received 30 Class I restorations of Galloy gallium alloy. These were placed as conservatively as possible under a rubber dam. Fifteen of the preparations were lined with a Bis-GMA resin to seal the restoration from moisture. The other 15 preparations were sealed with Amalgambond. After placement of the gallium alloy, the exposed surfaces of all restorations were sealed with the Bis-GMA resin, and the occlusion was checked. The restorations were examined at 2 weeks, 3 months, 6 months, 1 year and 2 years. RESULTS: At the 2-year recall, all restorations were intact with the exception of one tooth fracture (cause unknown). Forty-five percent of the restorations exhibited tarnish and 60% had a rough surface. The fracture at the margins of these restorations was minimal, and no significant difference could be found between those using Amalgambond and those sealed with the resin system. No medical problems were reported by the patients, and postoperative sensitivity was minimal.

Bisphenol A-Glycidyl Methacrylate↗
PubMed1998

Combined endodontic-orthodontic and prosthodontic treatment of fractured teeth. Case report.

A case history of a 10 year old patient who accidentally injured his maxillary left central incisor is presented. The fracture of the crown extended about 4 mm below the crest of the alveolar bone. After pulpectomy and root canal therapy, a screw was cemented into the canal of the incisor. By means of a removable orthodontic appliance, the fractured tooth was extruded and the fracture line was brought above the level of the alveolar bone. The tooth was then restored with a veneer crown over a post core. A tooth that would have been extracted routinely was thus saved and restored through the use of a collaborative approach.

Accidental Falls↗