Reattachment of Fractured Anterior Teeth—Determining Fracture Strength using Different Techniques: An in vitro Study

Abstract

Aim:The aim of this in vitro study was to evaluate and compare the shear bond strength of teeth reattached with sixth generation dentin bonding agent: Xeno III and microhybrid resin composite: Esthet-X, using three different techniques: (1) Simple reattachment, (2) overcontour and (3) internal dentinal groove. Methodology:A total of 70 human maxillary central incisors were selected and divided into four groups as follows. Group I: Control group comprised of 10 samples. Group II: Simple reattachment, group III: Overcontour and group IV: Internal dentinal groove. Groups II, III and IV comprised of 20 samples each. The teeth in three study groups were sectioned using a diamond disk and the fragment was reattached with Esthet-X and Xeno III using three different techniques. Specimens were stored in tap water for 24 hours and shear bond strength was determined using universal testing machine using a knifeedge chisel (0.5 mm in cross-section) at a crosshead speed of 1 mm/minute. Results:The results of this study showed following mean value of fracture strength in Kgf: Group I: Control-27.71; group II: Simple reattachment-9.78; group III: Overcontour-24.41; group IV: Internal dentinal groove-23.83. Conclusion:The overcontour technique had the highest strength recovery while the simple reattachment had the lowest. Clinical significance:The overcontour technique provided strength recovery almost similar to intact teeth emphasizing that tooth preparation influenced fracture resistance.

Tooth Fragment Reattachment: Interim or a Permanent Solution?

“…24 Overcontour: This technique involves preparation of a groove along the fracture line extending coronally and apically after reattaching the fragment. Srilatha et al 25 have reported a fracture strength recovery of 91.4% compared to a sound tooth, highest among all the above-mentioned techniques. Likewise, Reis et al 12 have reported the highest fracture strength recovery of 97.2% compared to sound tooth with composite overcontouring.…”

“…23 It has been shown that reattachment without any additional preparation recovers only 50% of the fracture resistance as compared to a sound tooth. 24 Srilatha et al 25 have reported a fracture strength recovery of around 36.6% compared to a sound tooth in simple reattachment technique which suggests that this technique results in a fracture strength of even less than 50% of a sound tooth. On the contrary, Worthington et al 26 reported no difference in the bond strength in teeth reattached with simple technique compared to those with additional preparation.…”

“…Since the preparation is done before reattachment, loss of fit of fractured fragment may still be seen. Internal dentine groove: It involves preparation of a dentinal groove (1 mm deep × 1 mm wide) in the fractured fragment and tooth before reattachment. Srilatha et al, 25 in a study comparing 4 different reattachment techniques, have reported that internal dentine groove has shown to attain a fracture strength recovery of 89.2% in relation to a sound tooth. The superior fracture resistance is attributed to the increased area of adhesion and the additional resin infiltration in the groove which acts as an opposing force to the compression load.…”

Reattachment of Fractured Tooth: A Comprehensive Review

“…Studies have revealed that, in comparison to a healthy tooth, reattachment restores 50% of fracture resistance [ 15 ]. Srilatha et al conducted a study on fragment reattachment and found that a simple fragment reattachment procedure recovers fracture strength by nearly 36.6% compared to a sound tooth [ 16 ]. Worthington et al, on the other hand, employed a straightforward reattachment method and discovered no variation in the bonding strength between teeth that were reattached without further preparation [ 17 ].…”

“…According to Diangelis and Jungbluth, inhibition of eventual darkening because of dentine devitalization in the fragment and an increase in bond strength are provided by an internal dentine groove preparation [ 23 ]. In a study comparing four different reattachment techniques, Srilatha et al found that, in comparison to a sound tooth, the internal dentine groove can regain fracture strength by 89.2% [ 16 ]. According to Kulkarni et al, labial double chamfer with lingual overcontouring (54.49%), labial and lingual double chamfer (51.31%), and simple reattachment (28.27%) showed the maximum recovery of fracture resistance.…”