Compared to a 30-minute period, a 24-hour rehydration of the tooth fragment before treatment seems to salvage enough moisture to result in an increase in reattachment strength.

Aim:The aim of this study was to examine various storage environments for storing fragments before being bonded to the remaining teeth and also estimate the required force to fracture the restored teeth.Materials and Methods:Sixty mandibular incisor teeth were fractured on the incisal one-third and were divided into five groups of 12 each to be stored in normal saline, water, milk, saliva and dry environments for 24 hours. All the fractured parts in each group were bonded to their relevant apical parts by an etch and rinse bonding system and a flowable composite resin. The fracture resistance was measured by a universal testing machine, and the results were analyzed using one-way ANOVA and Tukey statistical tests.Results:The results revealed that the difference among the five groups was statistically significant (P<0.001). Tukey tests showed that the force required for fracturing fragments kept in the milk and saliva environments were significantly higher than those for the normal saline, water and dry environments (P<0.05 ).Conclusions:It was concluded that keeping the fractured parts in milk and saliva environments can increase the required force for fracturing teeth more than the other environments.

Discharge against medical advice (AMA) depends on both patient population and hospital-related factors. No previous study has examined AMA discharges in Iran. The aim of this study was to determine the prevalence of AMA discharges and the associated factors in Iranian emergency department-admitted patients. In this prospective cross-sectional study, we studied 915 consecutive patients admitted to the emergency department of a major referral center in Iran. Patients were divided into two groups: those who left hospital AMA and those discharged with medical approval. Patients' characteristics in AMA and non-AMA groups along with reasons associated with AMA discharges were examined. Of 880 patients included, 178 (20.2%) were discharged AMA. Male sex, younger age, and a history of drug or alcohol abuse were not associated with AMA discharges. Lack of health insurance was found more frequently in patients discharged AMA (46.1 vs. 34.8%). Most AMA patients (63.0%) have been staying in hospital for less than 12 h. The most common reason stated by the patients for AMA discharge was dissatisfaction with care or diagnostic and therapeutic procedures (38.2%). This study identifies marked differences in prevalence and potential predictors of AMA discharges in Iran compared with what has been described in the literature. The high prevalence of AMA discharges after emergency admission in a developing country such as Iran calls for effective approaches to reduce the prevalence as well as further investigation into the responsible factors.

Background: Reattachment of the tooth fragment is a well-accepted treatment option in dealing with crown fractures. Hydration of the fragment is an important aspect in this treatment. The present study evaluated the effect of storing fragments in different storage media prior to reattachment. Methods: Sixty bovine incisors were randomly divided into five groups. The teeth were fractured and the fragments were dried for 48 hours and then immersed in one of the four experimental media (distilled water, milk, egg white, or 50% dextrose solution) for 2 hours. Tooth fragments in the control group were kept dry. The apical segments of the fractured teeth were stored in physiological saline. Fragments were reattached and force was applied on the labial side of the teeth at a 1 mm/min rate until failure. Results: One-way ANOVA indicated that the storage medium affects bond strength (p = 0.002). Multiple comparison tests showed that the teeth preserved in the 50% dextrose solution and the egg white exhibited significantly higher bond strengths compared to the control group (p < 0.05). Conclusions: Preservation of the fractured tooth fragment in egg white or hypertonic solutions results in a higher strength of the bond between the restoration and the tooth as compared to storage in water or dried conditions.