[Treatment of crown fractured incisors: reattachment instead of restoration?]

Abstract

Crown fractures are the most common form of traumatic dental injuries in the permanent dentition. Reattachment of the coronal fragment to the remaining tooth structure may offer a conservative, esthetic and cost-effective restorative option which has been shown to be an accepted alternative to conventional restoration (resin composite build-up, veneer or crown) of the fractured teeth. Fragment retention is significantly influenced by reattachment techniques and materials. Regarding reattachment techniques, placement of an internal groove seems advisable when the remnant and the fragment fit well, while an overcontouration should be used when the partial loss of hard tissue must be compensated. Materials used for reattachment seem to be less important than technique for a successful treatment, but adhesives and composite resin materials should correspond to each other. However, up to now, self-etching adhesives have shown less fracture strength of the reattachment than multi-bottle adhesives. Since many case reports and several clinical studies reported clinical success, further studies are recommended to analyse the impact of reattachment techniques and materials on the long-term survival of fragment bonding.