Fracture resistance of tooth fragment reattachment: effects of different preparation techniques and adhesive materials. Effect of dehydration and rehydration intervals on fracture resistance of reattached tooth fragments using a multimode adhesive Evaluation of the fracture resistance of reattached incisal fragments using different materials and techniques. Shear bond strengths of tooth fragments reattached or restored. Effect of fractured or sectioned fragments on the fracture strength of different reattachment techniques. Comparison of the fracture resistance of reattached incisor tooth fragments using 4 different materials. Influence of Different Bonding Agents and Composite Resins on Fracture Resistance of Reattached Incisal Tooth Fragment Fracture resistance of reattached incisor fragments with mini fibre-reinforced composite anchors. Re-attachment of anterior fractured teeth: fracture strength using different techniques. Preservation of ridge dimensions following grafting with coral granules of 48 post-traumatic and post-extraction dento-alveolar defects. Ridge preservation with acellular dermal matrix and anorganic bone matrix cell-binding peptide P-15 after tooth extraction in humans. A bone regenerative approach to alveolar ridge maintenance following tooth extraction. Report of 10 cases. Experimental zirconia abutments for implant-supported single-tooth restorations in esthetically demanding regions: 4-year results of a prospective clinical study. Three-year clinical comparison of survival of endodontically treated teeth restored with either full cast coverage or with direct composite restoration. Four-year clinical evaluation of posterior resin-based composite restorations placed using the total-etch technique. Clinical trial assessing light enhancement of in-office tooth whitening. Survival characteristics of composite restorations in primary teeth Restoration of endodontically treated teeth with carbon fibre posts--a prospective study. Comparison of intraoral radiography and cone-beam computed tomography for the detection of horizontal root fractures: an in vitro study Evaluation of the efficacy of LED-laser treatment and control of tooth sensitivity during in-office bleaching procedures. Comparison of Resilon and Gutta-Percha Filling Materials on Root Canal Fracture Resistance Following Restoring with Quartz Fiber Posts In vitro Comparison of Impact of Different Bleaching Agents on the Microhardness of Enamel. Long-term survival of endodontically treated, maxillary anterior teeth restored with either tapered or parallel-sided glass-fiber posts and full-ceramic crown coverage.
The purpose of this study was to evaluate and compare the bond strengths of experimentally fractured human tooth fragments reattached with different adhesive material s and retentive techniques in vitro . Uncomplicated crown fractures were obtained on intact human m and ibular permanent incisors by applying perpendicular load to the buccal aspect of tooth crowns . Fractured teeth were r and omly assigned into one of three reattachment protocol s : ( i ) Simple reattachment , ( ii ) Overcontour preparation , and ( iii ) Internal dentin groove . The first and second groups were divided into 10 subgroups , and the third group into five subgroups ( n = 10 per group ) with respect to five different adhesive systems ( Prime&Bond NT , Adper Single Bond II , Adper Prompt L-Pop , Clearfil S(3 ) Bond , G Bond ) used with or without a hybrid resin composite ( Z250 ) . Restored teeth were subjected to thermal cycling , and subsequently to the same loading protocol used for fracturing intact teeth . Fracture strength after reattachment procedures was recorded as a percentage of the original fracture strength . Both type of adhesive material and placement of an intermediate layer of resin composite affected the fracture resistance ( P < 0.05 ) . The highest fracture strength recovery was obtained using the internal dentin groove technique ( 54 + /- 0.58 % , P < 0.05 ) , followed by the overcontour and simple reattachment protocol s ( 49 + /- 0.58 % and 32 + /- 0.82 % , respectively , P < 0.05 ) . Ultramorphological evaluation of bonded specimens revealed voids and microcracks along the adhesive interface , which might contribute to postadhesive failure BACKGROUND / AIMS The tooth fragment bonding technique , frequently used to restore traumatized teeth , may be affected by dehydration/rehydration periods . The aim of this study was to evaluate the effects of different dry and wet storage intervals on multimode adhesive bonding between reattached fragments and teeth . MATERIAL S AND METHODS Eighty-four bovine incisors were fractured and r and omized into groups ( n=12 ) . After teeth fracturing , each specimen was assigned to one of the following groups : G0 : control group ( sound tooth ) ; GA1 and GA2 : 1-h dehydration and a 15-min or 24-hours rewetting period , respectively ; GB1 and GB2 : 24-hours dehydration and a 15-minutes or 24-hours rewetting period , respectively ; and GC : 1-hour ( GC1 ) or 24-hours ( GC2 ) dehydration period only . Tooth fragments were then reattached using a multimode adhesive in a self-mode technique with a flowable resin composite . The fracture resistance was evaluated in a universal testing machine under a compressive load ( 1 mm/min-1 ) . Data were su bmi tted to two-way analysis of variance and post hoc Tukey test ( 5 % ) . RESULTS No significant interaction between dehydration and rehydration intervals was observed ( P>.05 ) . Only the step of rehydration significantly affected the reattachment strength when compared to the groups su bmi tted only to dehydration , regardless of the interval ( 15 minutes or 24 hours ) . CONCLUSION Rehydrating a tooth fragment for 15 minutes before bonding with a multimode adhesive maintained sufficient moisture to increase reattachment strength OBJECTIVES When coronal fracture occurs in anterior teeth , fragment reattachment can be a valid alternative to a direct restoration . The aim of this study was to evaluate the influence of the material and the technique used to reattach the fragment . MATERIAL S AND METHODS Eighty sound maxillary and m and ibular incisors were selected and r and omly divided into eight groups ( n = 10 ) . The incisal third of each tooth was removed using a saw machine . The fragments in groups 1 - 4 were reattached using resin-based material s : group 1 adhesive , group 2 flow , group 3 composite , group 4 cement ; in groups 5 - 8 , the same material s mentioned before were used but a bevel was also performed on both labial and lingual surfaces . Shear bond strength ( SBS ) was calculated by applying a load incisal to the reattachment line . A two-way Anova was used to evaluate the influence of material s and techniques on the SBS . RESULTS The technique used was statistically significant ( P < 0.001 ) , while the material was not ( P = 0.793 ) . CONCLUSIONS The choice of material seems to have no influence on the SBS , whereas a bevel performed on the labial and lingual surfaces can significantly improve the SBS of the reattached fragment This study investigated the shear bond strengths of sectioned human m and ibular incisor edge fragments reattached using  luting cements , bonding agents or restored with composite resins . Seventy teeth were r and omly distributed among six experimental groups and a control group . Leaving half of the anatomic crowns exposed , the teeth were embedded in self-cure acrylic resins with the exposed part then sectioned . The fragments in groups 1 - 4 were bonded to their respective teeth using Clearfil Liner Bond 2V , Scotch Bond Multi Purpose Plus , Panavia-F and 3 M Opal Luting cement . The 5th and 6th groups were restored with composite resins ( Silux 3 M and Clearfil AP-X ) using their bonding agents ( Single Bond and Clearfil SE Bond ) . The results indicated that reattachment of fractured incisal fragments by using new generation bonding agents was effective against shear stresses , comparable with the intact teeth . Instead of restoration with composite resins therefore reattachment of a fractured fragment might be more preferable in cases of dental trauma This study evaluated the effect of fractured or sectioned fragments on the fracture strength recovery of four techniques used for reattachment and resin composite buildups . Ninety-one sound , permanent lower central incisors were used . Half the teeth were fractured in the incisal-proximal edge ; the other half had the incisal-proximal edge sectioned by a diamond saw . Teeth from each half were r and omly divided into five techniques : 1 ) bonded only ; 2 ) chamfer ; 3 ) over-contour ; 4 ) internal dentinal groove and 5 ) resin composite buildup . An adhesive system and dual cure resin cement were employed for the reattachment . Restored teeth were subjected to load in a specific point on the buccal surface . Based on the fracture strength of sound teeth , a fracture strength recovery was calculated for each tooth . A one-way ANOVA and Tukey 's test ( alpha=0.05 ) were used to evaluate differences between the techniques for each method of obtaining fragments . The fracture strength recovery of similar techniques was evaluated by a Student t-test ( alpha=0.05 ) . No differences could be detected among reattachment techniques when fragments were obtained by sectioning . In groups where the fragments were fractured , Techniques 3 and 4 showed the highest fracture strength recovery . The resin composite buildup provided fracture strength recovery similar to intact teeth regardless the way fragments were obtained AIM To evaluate and compare the fracture resistance of reattached teeth using four different material s. MATERIAL S AND METHODS 150 extracted human permanent maxillary incisors were r and omly divided into five groups of 30 teeth each of one control and four experimental groups . Teeth in experimental groups were sectioned 2.5 mm from incisal edge and reattached using four different material s. The reattached teeth were subjected to evaluate fracture resistance . RESULTS The mean fracture resistance of reattached teeth using resin modified glass ionomer cement , compomer , composite resin and dual curing resin cement was 8.10 ± 2.34 , 11.15 ± 3.36 , 17.11 ± 3.99 and 14.13 ± 3.71 kg respectively . Results showed highly significant difference between the groups ( P < 0.001 ) . CONCLUSION Fracture resistance of reattached teeth in the different groups varied from 24 - 51 % of that for an intact tooth . Reattachment with composite resin provides highest fracture resistance ( P < 0.05 ) . Reattachment with resin-modified glass ionomer cement was the weakest ( P < 0.05 ) Statement of Problem : Reattachment of the fractured tooth fragment should be considered as a conservative treatment and valid alternative to a composite restoration . Purpose : This in vitro study was to evaluate the influence of different adhesives and composite resins on fracture resistance of dental fragment reattached to the sectioned incisal edges . Material s and Method : 120 sound human maxillary central incisors were selected under st and ard conditions and r and omly divided into 3 groups , 12 sound teeth were used as a control group and the remaining teeth were assigned to 3 groups ( n=36 ) and each group into three subgroups ( n=12 ) . The incisal third of the sample s was sectioned using a diamond disk and the respective fragments were then reattached utilizing different intermediate restorative material s , namely : i ) adhesive material s alone ( OptiBond S or OptiBond XTR or OptiBond All-in-One ; ii ) Premise flowable composite and iii ) Point 4 composite in the one of the mentioned adhesive interface . After storage for two weeks at 37 ° C and 100 % humidity and then thermocycling ; shear bond strength ( SBS ) was recorded in kilogram force ( kgf ) by applying a load in the middle incisal third with a Zwick Universal Testing Machine at a cross-head speed of 1 mm/min . Data was analyzed with one-way ANOVA and Tukey HSD ( p < 0.05 ) . Results : The control group had a significantly higher SBS than other groups ( p= 0.001 ) ; the highest SBS values were obtained using the Premise flowable composite and OptiBond S adhesive ( 112.44±30.46 MPa ) ; and the lowest with OptiBond All-in-One alone ( 33.97± 15.63 MPa ) . Conclusion : Although , none of the tested material s provided fracture resistance similar to that found with the intact maxillary central incisors ; utilizing the Premise flowable composite and OptiBond S adhesive improved the SBS of the reattached fragment than other material OBJECTIVES Fractured coronal fragments of incisors can be adhered to the remaining tooth with resin composite , but are prone to failure . This study explores whether mini fibre-reinforced composite ( FRC ) anchors increase fracture resistance of reattached fragments . METHODS Forty-five extracted incisors were r and omly divided into three groups . In Groups A and B coronal fragments were reattached to the remaining tooth , with additionally two anchors placed in Group B. In Group C resin composite buildups were made . Specimens were statically loaded until failure occurred . Failure modes were characterized as intact remaining tooth substrate ( adhesive or cohesive failure of coronal fragment ) or fractured remaining tooth substrate ( fracture limited to enamel or extending into dentin ) . RESULTS Mean fracture loads were 255N ( SD=108N ) for Group A , 599N ( SD=465N ) for Group B and 786N ( SD=197N ) for Group C ( values significantly different , all p values < 0.05 ) . Group A showed purely adhesive failures , while Groups B and C showed 73 and 53 % fractures of remaining tooth substrate ( p<0.05 ) . CONCLUSIONS Mini FRC anchors increase fracture resistance of reattached coronal fragments , but induce more remaining tooth substrate fractures Fracture of anterior teeth by trauma is a common problem in children and teenagers .  Complex metal-ceramic crowns with considerable loss of remaining sound structure are no longer necessary due to adhesive techniques , such as composite restorations and re-attachment techniques . This study compared the fracture strength of sound and restored anterior teeth using a resin composite and four re-attachment techniques . A " one bottle " adhesive system ( One-Step , BISCO ) and a dual cure resin cement ( Duo-Link , BISCO ) were applied . Thirty-five sound permanent lower central incisors were fractured by an axial load applied to the buccal area and r and omly divided into five groups . The teeth were restored as follows : 1 ) bonded only = just bonding the fragment ; 2 ) chamfer-group = after bonding , a chamfer was prepared on the enamel at the bonding line and filled with composite ; 3 ) overcontour group = after bonding , a thin composite overcontour was applied on the buccal surface around the fracture line ; 4 ) internal dentinal groove = before bonding , an internal groove was made and filled with a resin composite ; 5 ) resin composite group = after a bevel preparation on the enamel edge , the adhesive system was applied and the fractured part of the teeth rebuilt by resin composite . Restored teeth were subjected to the same loading in the same buccal area . Fracture strength after restorative procedure was expressed as a percentage of the original fracture strength and the results analyzed by Kruskal-Wallis statistical analysis . The mean percentages of fracture strength were : Group 1 : 37.09 % , Group 2 : 60.62 % , Group 3 : 97.2 % , Group 4 : 90.54 % and Group 5 : 95.8 % . It was concluded that the re-attachment techniques used in Groups 3 and 4 , as well as the composite restored group ( Group 5 ) , were statistically similar and reached the highest fracture resistance , similar to the fracture resistance of sound teeth This prospect i ve clinical analysis reports on the use of coral granules in alveolar ridge preservation procedures in a population of young , growing patients . The sample consisted of 21 patients , 12 females and 9 males , with a mean age of 13.6 years . These 21 patients had 48 dento-alveolar defects suitable for augmentation with coral granules  , and were followed clinical ly and radiographically for 3 - 7 years after augmentation . There were two areas of augmentation : 17 defects in the anterior maxilla result ed from traumatic tooth loss , and 31 defects in the posterior maxilla and m and ible result ed from the extraction of ankylosed retained primary molars with no permanent succedaneous teeth . Between 1 - 2 ml of coral granules were implanted into the alveolar bone defects left by the extraction of teeth in both the areas . This was in order to preserve the remaining edentulous ridge from further alveolar ridge resorption . The goal of the procedure was to preserve the alveolus so that in the future , a dental implant could be placed to replace the missing tooth , after jaw growth had stopped , without the need for a bone graft . The coral granules appeared to be totally replaced by the host bone on follow-up clinical and radiographic examinations . The two areas of the jaws behaved quite differently . In the anterior maxilla , where tooth loss was secondary to trauma , the coral granules  restored the alveolar ridges temporarily . However , over the years of follow-up in this study , the coral granules failed to provide sufficient bone to support the placement of a dental implant without using a bone graft in 14 of the 17 defects or 82.4 % of sites . In the posterior maxilla and m and ible , where tooth loss was due to the elective removal of ankylosed primary molars , 29 of the 31 defects or 93.5 % of sites were successful as they were able to support the placement of an osseo-integrated dental implant without the use of a bone graft . The alveolar sparing technique was more successful in maintaining an alveolar ridge sufficient for the placement of a dental implant without bone grafting in the posterior maxilla and m and ible , where tooth loss was secondary to the elective removal of ankylosed deciduous molars than in the anterior maxilla , where tooth loss was secondary to trauma . Coral granules seem to be more suitable in the posterior maxilla and m and ible where there were ankylosed deciduous teeth and congenitally absent permanent teeth than in the traumatized anterior maxilla . In successful sites , coral granules can spare the alveolus from residual ridge atrophy or resorption , obviating the need for a bone graft . This reduces patient morbidity , as a second surgical donor site is avoided because bone graft harvesting is made unnecessary BACKGROUND Preventing ridge collapse with the extraction of maxillary anterior teeth is vital to an esthetic restorative result . Several regenerative techniques are available and are used for socket preservation . The aim of this study is to analyze by clinical parameters the use of acellular dermal matrix ( ADM ) and anorganic bovine bone matrix ( ABM ) with synthetic cell-binding peptide P-15 to preserve alveolar bone after tooth extraction . METHODS Eighteen patients in need of extraction of maxillary anterior teeth were selected and r and omly assigned to the test group ( ADM plus ABM/P-15 ) or the control group ( ADM only ) . Clinical measurements were recorded initially and at 6 months after ridge-preservation procedures . RESULTS In the clinical measurements ( external vertical palatal measurement [ EVPM ] , external vertical buccal measurement [ EVBM ] , and alveolar horizontal measurement [ AHM ] ) the statistical analysis showed no difference between test and control groups initially and at 6 months . The intragroup analysis , after 6 months , showed a statistically significant reduction in the measurements for both groups . In the comparison between the two groups , the differences in the test group were as follows : EVPM = 0.83 ± 1.53 mm ; EVBM = 1.20 ± 2.02 mm ; and AHM = 2.53 ± 1.81 mm . The differences in the control group were as follows : EVPM = 0.87 ± 1.13 mm ; EVBM = 1.50 ± 1.15 mm ; and AHM = 3.40 ± 1.39 mm . The differences in EVPM and EVBM were not statistically significant ; however , in horizontal measurement ( AHM ) , there was a statistically significant difference ( P<0.05 ) . CONCLUSION The results of this study show that ADM used as membrane associated with ABM/P-15 can be used to reduce buccal-palatal dimensions compared to ADM alone for preservation of the alveolar ridge after extraction of anterior maxillary teeth TEN PATIENTS WHO REQUIRED two or more anterior teeth extraction s were utilized in this study . Extraction procedures were carried out with a full thickness surgical flap approach . After flap reflection , teeth were removed with a minimum of trauma to the surrounding bone . Following extraction silicone-based impression techniques were used to produce a model of the alveolar process and small metal pins were placed in the alveolus to be used as fixed points to make measurements of ridge dimensions . One socket was covered with an exp and ed polytetrafluoroethylene ( ePTFE ) barrier membrane ( experimental site ) ; the other socket was a conventional control . The soft tissue flaps were then mobilized using periosteal releasing incision and the wound closed with ePTFE mattress sutures . Six months following extraction , patients were treated with flap surgery to expose both extraction s sites to remove the ePTFE membranes and to measure ridge dimensions using the pins as fixed points . Clinical and model measurements have shown statistically significant better ridge dimensions at experimental sites than at control ( P < or = 0.05 ) . Three patients with exposed membranes had similar dimensional changes as controls . Results from this study suggested that this improved technique offers a predictable alveolar ridge maintenance enhancing the bone quality for dental implant procedures and esthetic restorative dentistry PURPOSE This prospect i ve clinical study evaluated an experimental implant abutment made of densely sintered zirconia with respect to peri-implant hard and soft tissue reaction as well as fracture resistance over time . MATERIAL S AND METHODS Twenty-seven consecutively treated patients with 54 single-tooth implants were included .  Zirconia abutment ingots were individually shaped and set on the implants with gold screws . All-ceramic ( Empress I ) crowns were cemented using a composite cement . At the 1- and 4-year examinations , reconstructions were evaluated for technical problems ( fracture of abutment or crown , loosening of abutment screw ) . Modified Plaque and simplified Gingival Indices were recorded at implants and neighboring teeth , and peri-implant bone levels were radiographically determined . RESULTS All but 1 of the 27 patients with 53 restorations could be evaluated at 1 year , and 36 restorations in 18 patients were evaluated 4 years after abutment and crown insertion . The median observation period for the reconstructions was 49.2 months . No abutment fractures occurred . Abutment screw loosening was reported for 2 restorations at 8 months and 27 months , respectively . Mean Plaque Index was 0.4 ( SD 0.6 ) at abutments and 0.5 ( SD 0.6 ) at teeth ; mean Gingival Index was 0.7 ( SD 0.5 ) at abutments and 0.9 ( SD 0.5 ) at teeth . Mean marginal bone loss measured 1.2 mm ( SD 0.5 ) after 4 years of functional loading . CONCLUSION Zirconia abutments offered sufficient stability to support implant-supported single-tooth reconstructions in anterior and premolar regions . The soft and hard tissue reaction toward zirconia was favorable STATEMENT OF PROBLEM Little information exists regarding the outcome of crown build-ups on endodontically treated teeth restored with metal-ceramic crowns or with only a direct-placed composite . PURPOSE The aim of this study was to evaluate the clinical success rate of endodontically treated premolars restored with fiber posts and direct composite restorations and compare that treatment with a similar treatment of full-coverage with metal-ceramic crowns . MATERIAL AND METHODS Subjects included in this study had one maxillary or m and ibular premolar for which endodontic treatment and crown build up was indicated and met specific inclusion /exclusion criteria . Only premolars with Class II carious lesions and preserved cusp structure were included . Subjects were r and omly assigned to 1 of the following 2 experimental groups : ( 1 ) teeth endodontically treated and restored with adhesive techniques and composite or ( 2 ) teeth endodontically treated , restored with adhesive techniques and composite , and then restored with full-coverage metal-ceramic crowns .  Sixty teeth were included in the first group and 57 in the second . All restorations were performed by one operator . Causes of failure were categorized as root fracture , post fracture , post decementation , clinical and /or radiographic evidence of marginal gap between tooth and restoration , and clinical and /or radiographic evidence of secondary caries contiguous with restoration margins . Subjects were examined for the listed clinical and radiographic causes of failure by 2 calibrated examiners at intervals of 1 , 2 , and 3 years . Exact 95 % confidence intervals for the difference between the 2 experimental groups were calculated . RESULTS At the 1-year recall , no failures were reported . The only failure modes observed at 2 and 3 years were decementations of posts and clinical and /or radiographic evidence of marginal gap between tooth and restoration . There was no difference in the failure frequencies of the 2 groups ( 95 % confidence interval , -17.5 to 12.6 ) . There was no difference between the number of failures caused by post decementations and the presence of marginal gaps observed in the 2 groups ( 95 % confidence intervals , -9.7 to 16.2 and -17.8 to 9.27 ) . CONCLUSION Within the limitations of this study , the results upheld the research hypothesis that the clinical success rates of endodontically treated premolars restored with fiber posts and direct composite restorations after 3 years of service were equivalent to a similar treatment of full coverage with metal-ceramic crowns PURPOSE To report the 4-year clinical performance of  posterior resin-based composite restorations placed using the total-etch technique . MATERIAL S AND METHODS Over a period of 1 year , 726 restorations ( 248 molars , 478 premolars ; 260 Class I , 466 Class II ; 540 replacements , 186 primary decay ) were placed on conservative preparations , using the incremental placement technique in a clinical environment . Baseline data were collected , and the restorations were evaluated after 4 years . Z100 and Scotchbond Multi- Purpose ( SBMP ) ( 3 M Dental Products , St. Paul , Minnesota ) were used as the restorative system . The criteria evaluated were color match , marginal adaptation , anatomic form , cavosurface marginal discoloration , axial contour , interproximal contact , secondary caries , postoperative sensitivity , and tooth vitality . RESULTS At baseline , 24 % of the teeth restored presented postoperative sensitivity ; 86 % of the sensitive teeth were from the replacement group . At 4 years , all teeth were vital to cold test . Eighteen restorations ( 2.5 % ) presented clinical ly detectable marginal fracture . The shade was acceptable in all restorations . Cavosurface marginal discoloration was observed in 47 restorations ( 6.5 % bravo scores ) . Axial contour , interproximal contact , and marginal adaptation received 100 % alfa scores . No secondary caries was diagnosed in any of the teeth examined . None of the examined restorations required replacement . CLINICAL SIGNIFICANCE Under controlled clinical conditions , posterior resin-based composite restorations placed with the total-etch technique and restorative Z100/SBMP have the potential to present a high success rate at 4 years . None of the examined restorations required replacement , and there was no clinical ly detectable wear in any of the restorations . Simultaneous etching of enamel and dentin followed by the application of a resin adhesive can be considered an adequate modality of pulp protection in nonexposed tooth preparations OBJECTIVE Evaluate a light-enhanced in-office tooth whitening system in order to assess tooth color and safety . METHODS Thirty-three adults were r and omly assigned to one of three treatment groups . Professional treatment involved application of a 25 % H(2)O(2 ) gel ( Discus Dental ZOOM ! ) with light enhancement , H(2)O(2 ) gel alone , or the light alone with no peroxide . The 12 anterior teeth were treated three times for 20 minutes each . Efficacy was measured objective ly as L*a*b * color change using digital images , tooth shade was measured , and safety was evaluated immediately after treatment and at posttreatment days 7 and 30 . RESULTS After adjusting for baseline and age , immediate ( end-of-treatment ) means ( SE ) for Deltab * ( yellowness ) were -3.1 ( 0.25 ) for the gel + light , -2.0 ( 0.25 ) for the gel-only group , and -2.4 ( 0.25 ) for the light-only group . Significant ( p < 0.05 ) color rebound was evident at posttreatment day 7 . By day 30 , adjusted means (SE)for Deltab * were -1.7 ( 0.20 ) for the gel + light group , -1.1 ( 0.20 ) for the gel-only group , and -0.5 ( 0.20 ) for the light-only group . Both peroxide groups differed significantly ( p < 0.05 ) from light alone on Deltab * and DeltaL*. In the gel + light group , 91 % of subjects experienced tooth sensitivity , the majority of which was moderate or severe . Adverse events were low in the light-only group . CONCLUSION Use of light enhancement for in-office whitening leads to immediate color change , after which there was significant color and shade rebound within 7 days as well as moderate-to-severe tooth sensitivity during and after treatment . CLINICAL SIGNIFICANCE Increased tooth sensitivity during treatment and appreciable short-term color rebound after treatment may impact the utility of in-office tooth whitening with peroxide and light as a st and -alone esthetic procedure . ( J Esthet Restor Dent 21:336 - 347 , 2009 ) Objectives This retrospective study analyzed restoration survival of  composite fillings in children with at high caries risk in relation to age , sex , operator , tooth type , filling extension , and material used . Material s and methods Among 667 children treated in 2004–2012 in a university setting without sedation or general anesthesia , 2388 composite fillings were included . Relevant data from regular recall intervals were retrieved from patients ’ records . Either total-etch or a self-etch adhesive combined with flowable and /or (nano)hybrid composite was used . The Kaplan-Meier estimator and Cox proportional hazard analysis with backward elimination model were applied for survival analysis . Results For the observation period of 8 years ( mean 1.7 years ) , the cumulative failure rate was 17.2 % with annual failure rates of 10.0 % . In 8.8 % of the cases , fillings failed due to secondary caries . In 8.3 % technical failure due to total filling loss , loosening , marginal gaps , or tooth fracture occurred . Tooth type , filling extension , age , operator , dental dam , and type of adhesive were significant for survival ( p < 0.05 ) . Conclusions Filling survival was comparably lower to composite restorations observed in prospect i ve clinical studies on permanent teeth and other tooth-colored restoratives used in primary teeth . Due to the very high caries risk and young age of the population , frequent loss due to secondary caries was observed . With respect to the high caries risk , composite restorations can be used to treat carious primary teeth , though a strict caries prevention regimen should be followed to minimize restoration failure . Clinical relevance Filling loss of composites in the primary dentition is associated with secondary caries on the long term BACKGROUND A prospect i ve study was started in 1995 to evaluate the success of carbon fibre reinforced epoxy resin ( CFRR ) posts used to restore endodontically treated teeth . All the teeth in the study had lost more than 50 % of their coronal structure . METHODS Fifty-nine carbon fibre Composiposts cemented with Metabond and built up with Core Paste cores were placed into the teeth of 47 patients . Each tooth received a full-coverage restoration ( porcelain fused to metal crown ) and was followed for 6.7 - 45.4 months ( average = 28.0 months , st and ard deviation = 10.7 ) . RESULTS Results for 52 teeth in 42 patients were analyzed . There were no fractures . The overall failure rate was 7.7 % and the cumulative survival rate was 89.6 % at the end of the follow-up period . The only statistically significant finding ( p = 0.04 ) was that posts in lower premolars were at higher risk of failure . CONCLUSION CFRR posts are among the most predictable systems available today . CFRR posts in the upper anterior teeth are associated with a higher success rate and longer life than those placed in premolars , especially lower premolars . This study contributes to the growing body of evidence that supports the use of CFRR posts in the restoration of endodontically treated teeth Objectives This study aim ed to compare the diagnostic accuracy of two different cone-beam computed tomography ( CBCT ) units with several intraoral radiography techniques for detecting horizontal root fractures . Methods The study material comprised 82 extracted human maxillary incisors without root fractures that had not undergone any root canal treatment . Root fractures were created in the horizontal plane in 31 teeth by a mechanical force using a hammer with the tooth placed on a soft foundation as described in a previous study . The teeth were divided into two groups : a control group with no fractures and a test group with fractures . These were r and omized to the empty maxillary anterior sockets of a dry human maxilla . Each tooth was imaged at various vertical angles using each of the following modalities : a 3D Accuitomo 170 CBCT , a NewTom 3 G CBCT , a VistaScan PSP , a CCD sensor , and conventional film .  Specificity and sensitivity for assessing horizontal root fracture by each radiographic technique were calculated . Chi-square statistics were used to evaluate differences between modalities . Kappa statistics assessed the agreement between observers . Results were considered significant at P < 0.05 . Results The kappa values for inter-observer agreement between observers ranged between 0.88 and 0.98 for the 3D Accuitomo 170 , 0.82 and 0.91 for the NewTom 3 G , and 0.61 and 0.72 for the different types of intraoral images . The diagnostic accuracy for detecting fracture lines in 3D Accuitomo 170 ( 0.93 ) was significantly higher than NewTom 3 G ( 0.87 ) , VistaScan ( 0.71 ) , CCD ( 0.70 ) , and CF ( 0.68 ) . Conclusions 3D Accuitomo 170 has the highest sensitivity and diagnostic accuracy for detecting horizontal root fracture among the 5 radiographic modalities examined . CBCT should be considered as the most reliable imaging modality of choice for the diagnosis of horizontal root fracture . Clinical relevance CBCT imaging offers the clear advantage over conventional imaging that traumatized teeth can be visualized in all three dimensions — especially the oro-facial OBJECTIVE This study determined the efficacy of LED-laser treatment and the control of sensitivity caused by in-office bleaching . BACKGROUND DATA Auxiliary power sources ( halogen light , arc plasma , LED , LED-laser , and laser ) are used in in-office teeth bleaching techniques to accelerate the redox reaction of the whitening gel to increase ease of use , to improve comfort and safety , and to decrease the procedure time . METHODS Sixteen volunteers participated in this r and omized , blinded and split-mouth clinical study . The volunteers were divided into two groups : GL , activation with LED ; and GLL , activation with LED-laser ( 300 mW/cm2 ) . The upper and lower arches were bleached in accordance with each treatment . Tooth sensitivity was recorded by a verbal pain scale and the color analysis was evaluated by the VITA scale , up to 6 months after bleaching . Tooth sensitivity and color change were compared between groups at each time period using the Wilcoxon and NcNemar tests . The sensitivity and color within the same group at different periods were analyzed using the Friedman test or Cochran 's Q test . RESULTS The intensity of sensitivity was similar for both groups at different periods , with no statistical difference between them ( p>0.05 ) . There were no significant differences in the color change comparing the two techniques ( p>0.05 ) ; however , it was significant within each group at the different evaluation periods between the groups ( p<0.05 ) . CONCLUSIONS LED-laser treatment was not able to prevent or reduce the sensitivity of teeth and did not improve the efficacy of bleaching Objective : Bacterial leakage and root fractures are the most important reasons of root canal treatment failure . Due to the lack of adhesion of gutta percha to the canal walls , Resilon has been introduced as a root-filling material able to bond to the root walls . Metal posts may predispose the tooth walls to oblique and vertical fracture which usually leads to tooth loss ; whereas , fiber posts may reinforce the remaining tooth structure . The purpose of this study was to compare the effect of Resilon and gutta-percha on the fracture resistance of root canal following restoring with quartz fiber posts . Material s and Methods : Forty-four maxillary incisor root canals were chemo-mechanically prepared , then r and omly divided into three groups : 1-Control group ( n=20 ) , 2-Experimental group ( n=20 ) and a negative control group ( n=4 ) . Root filled teeth were restored with quartz fiber posts and composite resin cores .  Four teeth with a conservative prepared access cavities and without any further post preparation were used as a negative control group . After simulating the clinical situation , specimens were loaded in the Universal Testing Machine for compressive strength test . All data were statistically analyzed by the T-test . Results : The mean compressive strengths for group 1 was 535.8 ± 155.23 N and 645.93 ± 182.98N for group 2 , which were statistically significant ( p-value= 0.047 ) . Conclusion : Root canals filled with Resilon were significantly more resistant than that of gutta-percha , following restoration with quartz fiber posts BACKGROUND Various agents are used these days for increasing the esthetics . One such procedure is bleaching that offers various advantages , as it is minimal invasive and cheap option to color the teeth and remove stain . The altered enamel after the bleaching process shows surface demineralization and porosities . The present study aim ed to evaluate the effect of different bleaching agents on the microhardness of enamel . MATERIAL S AND METHODS A total of 100 freshly human extracted maxillary premolar teeth were selected for the study . Teeth with sound tooth structure were included for the study . All the specimens were r and omly divided into four groups with 25 specimens in each group depending upon the type of bleaching agent used : Group A , artificial saliva ( Control group ) ; Group B , 35 % hydrogen peroxide ( HP ) ; Group C , 25 % HP ; Group D , 10 % carbamide peroxide ( CP ) .  Knoop Hardness Number ( KHN ) was calculated at 24 , 48-hour , and 7-week interval . RESULTS Results showed no statistical significant differences between the microhardness of enamel of different groups ( p < 0.005 ) . A slight fall in the value of KHN was seen in all the groups , except for the control group , although the results were statistically nonsignificant ( p > 0.005 ) . CONCLUSION Although nonsignificantly , all the bleaching solutions produced some amount of alterations in the microstructure of enamel . More studies with higher study groups and more advanced estimation technologies are required to minimize microstructure alterations and promote for better outcome of bleaching procedures OBJECTIVES This retrospective study investigated the clinical effectiveness over up to 8 years of parallel-sided and of tapered glass-fiber posts , in combination with either hybrid composite or dual-cure composite resin core material , in endodontically treated , maxillary anterior teeth covered with full-ceramic crowns . METHODS The study population comprised 192 patients and 526 endodontically treated teeth , with various degrees of hard-tissue loss , restored by the post- and -core technique .  Four groups were defined based on post shape and core build-up material s , and within each group post- and -core restorations were assigned r and omly with respect to root morphology . Inclusion criteria were symptom-free endodontic therapy , root-canal treatment with a minimum apical seal of 4 mm , application of rubber dam , need for post- and -core complex because of coronal tooth loss , and tooth with at least one residual coronal wall . Survival rate of the post- and -core restorations was determined using Kaplan-Meier statistical analysis . RESULTS The restorations were examined clinical ly and radiologically ; mean observation period was 5.3 years . The overall survival rate of glass-fiber post- and -core restorations was 98.5 % . The survival rate for parallel-sided posts was 98.6 % and for tapered posts was 96.8 % . Survival rates for core build-up material s were 100 % for dual-cure composite and 96.8 % for hybrid light-cure composite . CONCLUSIONS For both glass-fiber post design s and for both core build-up material s , clinical performance was satisfactory . Survival was higher for teeth retaining four and three coronal walls
Fragment reattachment using a technique with no preparation and an adhesive system associated with an intermediate composite with good mechanical properties can restore part of the resistance of the fractured tooth
BACKGROUND / AIMS Fragment reattachment is a procedure that offers advantages , such as preservation of tooth structure and maintenance of color , shape , and translucency of the original tooth .
The aim of this study was to analyze the reattachment techniques used to restore anterior teeth fractured by trauma .