Knowledge, awareness and perception amongst dental practitioners towards natural tooth fragment reattachment procedures in clinical practice—A cross‐sectional survey

Abstract

Background/Aim: Reattachment of a tooth fragment is a viable alternative to restore a fractured tooth. The aim of this study was to assess the knowledge, awareness and perception of dental practitioners towards tooth fragment reattachment procedures. Material and Methods:The cross-sectional study was conducted during 2019 and comprised dental practitioners working as general dentists or dental specialists. The subjects were asked to fill out a self-administered questionnaire. Questions related to knowledge and practice regarding fragment reattachment procedures were asked, and the responses were recorded. SPSS version 20.0 and the chi-square test were selected as the statistical tools for data analysis with significance level established at p < .05.Results: Eight hundred and fifty-seven subjects participated in the study. Of them, 404 (47%) were general dentists and 453 (53%) were specialist dentists. Out of the 857 subjects, 231 (27%) had clinical experience of less than 5 years, 268 (31.3%) between 5 and 10 years, 190 (22%) between 10 and 20 years and 168 (19.6%) had experience of over 20 years. Of the 857 subjects, 673 (78.5%) had some knowledge about the reattachment procedure and 292 (34.1%) had performed reattachment in clinical practice. The most common storage medium used for the fractured fragment was saline. The bonding material used for reattachment was lightcured composite resin. A subsequent fracture of the reattached fragment was encountered by more than 62% of the subjects.Conclusions: Lack of availability of the fragment and lack of clinical training were the major reasons for clinicians not performing the procedure routinely. The attachment procedure was most often performed by both general dentists and specialist dentists with 5-10 years of clinical experience. Furthermore, the majority of the participants did not have any familiarity with the concept of biological restorations. Cross contamination was a major clinical concern for the limited clinical application of biological restorations.

Biological restorations: Literature review with proposed definition & classification

“…Cross contamination appears to be one of the major clinical concerns towards the use of extracted tooth for biological restorations. 6 OSHA (Occupational Safety and Health Administration) has considered the human tooth as potential source of blood borne pathogens. 22,23 The best possible way to eliminate the biosecurity risk is to properly sterilize the extracted tooth.…”

“…According to a survey published in 2021, clinicians do have knowledge about procedures like fragment reattachments but they were unfamiliar with the basic concept of biological restorations. 6 Therefore, current review provides insight into clinical applications and aspects related to biological restorations and also attempts to propose a definition and classification based on clinical implications.…”