Ten-Year Follow-Up of a Fragment Reattachment to an Anterior Tooth: A Conservative Approach

Abstract

This report describes the 10-year follow-up data of a patient who underwent fragment reattachment to the maxillary central incisor after coronal fracture with pulp exposure as well as the procedures followed for functional and esthetic adjustments. A 9-year-old female patient presented at the clinic of dentistry at the State University of Rio de Janeiro with a coronal fracture and pulp exposure of the right maxillary central incisor that had occurred immediately after an accident. The intact tooth fragment was recovered at the accident site and stored in milk. The treatment plan followed was to perform direct pulp capping and tooth fragment reattachment. When the patient was 14 years old, adhesion between fragment and remaining tooth was lost, and fragment reattachment was performed. Five years later, the same tooth presented clinical discoloration and absence of sensitivity during pulp vitality tests. Subsequently, a new treatment plan was formulated, which included endodontic treatment, followed by nonvital tooth bleaching and light-cured composite resin restoration. An esthetic and natural-looking restoration was achieved. Tooth fragment reattachment is not a temporary restorative technique and requires functional and esthetic adjustments over time to maintain the biomimetic characteristics of traumatized anterior teeth and predictable outcomes.

Long‐term results of crown fragment reattachment techniques for fractured anterior teeth: A retrospective case‐control study

“…The successful rate of the patients treated with biological approach was 88.9%. The results obtained are in agreement with the literature data, which describes the successful results of fragment restoration, [26][27][28] and indicate that fragment reattachment is a good alternative to placement of conventional resin-composite restorations. 2,6 Based on the conducted pairwise comparisons, it is plausible to conclude that both methods (fragment reattachment and composite restoration) provide similar results over the 60 months of observation.…”

“…The successful rate of the patients treated with biological approach was 88.9%. The results obtained are in agreement with the literature data, which describes the successful results of fragment restoration, and indicate that fragment reattachment is a good alternative to placement of conventional resin‐composite restorations …”

Fracture tooth reattachment

“…The resulted space will be overfilled with a composite resin resulting in slightly over contoured buccal surface of the repaired tooth (Abdulkhayum et al 2014). This technique is more destructive to the tooth structure than external chamfer technique but a marked increase in fracture resistance is observed (Abdulkhayum et al 2014, Mendes et al 2017. It is advocated to use this technique when there is a minor discrepancy between the fractured piece and the remainder of the tooth (Wiegand et al 2005).…”

“…These aspects include discoloration, mobility, periodontal status, and the vitality of the tooth (Vishwanath et al 2013). Follow up of the reattached fracture piece has been done for various periods, starting from three months up to ten years Another study found discoloration of the repaired tooth due to pulpal degeneration with periapical radiolucency after 10 years (Mendes et al 2017). However the popularity acceptance of this technique, the fracture resistance of the restored teeth is still lower than that of sound ones (Davari & Sadeghi 2014).…”

“…Perfect adaptation and accurate fit is mandatory for the success of fracture reattachment procedure (Goenka et al 2012). The material used to preserve the fractured piece till the time of reattachment plays an important role in the success of this treatment (Mendes et al 2017). The lesser the dehydration period the better will be the prognosis (Shetty et al 2012).…”