Comparative evaluation of fracture resistance of re-attached teeth using self-adhesive bioactive flowable composite after preconditioning the fractured coronal fragments with different remineralizing agents

Abstract

One of the common forms of dental injury is anterior crown fractures, which mainly affect teenagers and young adults. Fractures of the coronal portion of the permanent incisors characterize 18-22% of total traumatic injuries to dental hard tissues, of which 96% of them comprise the maxillary incisors. An uncomplicated fracture of the crown is one of the most common types of dental traumatic injury. Dental trauma has an emotional impact on the patient's overall health and can seriously harm to the dentition. The treatment, as well as prognosis of the fracture of the coronal portion, is a major challenge for a dentist because it has to accomplish various parameters like the need to obtain an aesthetical result that approaches itself to its natural form and measurement, opaqueness and translucency of the original tooth structure in obtaining an effective restoration. It is suggested that reattachment of the fractured fragment is the best procedure for restoring an uncomplicated crown fracture, if a fragment is present. Fragment reattachment offers superior aesthetics and function compared to composite restorations, preserving the tooth's natural characteristics, like the tooth's true shape, colour, intensity, and surface texture. Success depends on the fracture line's direction and location; simple enamel or enamel-dentin fractures are ideal. However, reattached fragments remain vulnerable to subsequent trauma. The reattached fragments are susceptible to further fracture when the restored teeth undergo further trauma. The resistance of the fractured teeth that have been reattached is the subject of the majority of concerns. Preconditioning the fractured fragments with remineralizing agents may aid in hydration. Thus, a study will be conducted to evaluate the resistance of the fracture of a tooth that is reattached and pre-treated with remineralizing agents such as sodium fluoride and casein phosphopeptide-amorphous calcium phosphate and further reattached using one of the self-adhesive bioactive composite.

Keywords: Bioactive; Casein phosphopeptide–amorphous calcium phosphate; Fracture resistance.; Reattachment technique; Sodium fluoride; Traumatic dental injury; Uncomplicated crown fracture.