Shear bond strengths of tooth fragments reattached or restored. Effect of fractured or sectioned fragments on the fracture strength of different reattachment techniques. A clinical study of the "open sandwich" technique in pediatric dental practice. Clinical evaluation of a polyacid-modified resin composite (compomer) in Class II restorations of primary teeth: a two-year follow-up study. Fracture resistance of tooth fragment reattachment: effects of different preparation techniques and adhesive materials. Evaluation of the fracture resistance of reattached incisal fragments using different materials and techniques. Four-year clinical evaluation of two self-etching dentin adhesives of different pH values used to restore non-retentive cervical lesions. A clinical evaluation of two glass ionomer cements in primary molars using atraumatic restorative treatment technique in India: 1 year follow up. Soft tissue flaps. Improved periodontal conditions following therapy. COMPARISON OF TWO MINIMALLY INVASIVE METHODS ON THE LONGEVITY OF GLASS IONOMER CEMENT RESTORATIONS: SHORT-TERM RESULTS OF A PILOT STUDY Preservation of alveolar bone in extraction sockets using bioabsorbable membranes. Extraction socket healing in humans after ridge preservation techniques: comparison between flapless and flapped procedures in a randomized clinical trial. Periodontal surgery in plaque-infected dentitions. Clinical evaluation of tooth-colored materials in cervical lesions. Clinical performance of novel resin composites in posterior teeth: 18-month results. Effects of oral hygiene, residual caries and cervical Marginal-gaps on the survival of proximal atraumatic restorative treatment approach restorations
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 PURPOSE This study evaluated the clinical efficacy of the " open s and wich " restoration for pediatric dental practice . METHODS Three pediatric dentists used a st and ardized preparation and restorative technique to place the restorations . The prepared tooth was etched with a phosphoric acid semigel and rinsed . A resin modified glass ionomer ( Fuji II LCor Photac-Fil ) was placed short of the margins and then light cured . The resin modified glass ionomer was covered with an occlusal layer of a microhybrid flowable composite ( Aeliteflo or Flow-it ) . The same preparation for the experimental restorations was used for the control conventional amalgam ( Tytin ) restorations . The restorations were evaluated at 6-month intervals and ranked with a modified United States Public Heath Survey ( USPHS ) scale as follows : Alfa : No discernible marginal opening or stain ; Beta : Slight opening of margin discernible with dental explorer , but without stain ; Charlie : Open margin and stain ; Delta : Recurrent caries or restoration failure . Restoration failures were categorized according to etiology , pulpal necrosis , bruxism , marginal leakage , isthmus fracture , or adhesive failure . RESULTS All recalled experimental restorations , except 8 , were rated as either Alpha or Beta . Six failed due to isthmus fracture and 2 due to pulpal necrosis . Fifteen restorations had delaminating of the flowable composite from the resin modified glass ionomer . The use of the " open s and wich " technique compared favorably with a similar study using adhesive amalgam restorations . CONCLUSIONS The " open s and wich " technique can be successfully used in a pediatric dental practice PURPOSE The aim of the study was to assess the clinical performance of a compomer restorative material ( Dyract , DeTrey/Dentsply ) for the restoration of Class II cavities , extended into dentin in primary teeth . METHODS The sample of the study consisted of 25 patients with 68 restored cavities . The restorations were evaluated with the modified Ryge criteria at baseline and after 6 , 12 and 24 months . Examination was clinical , radiographic , and observation of cast replicas under scanning electron microscope ( SEM ) . RESULTS After 24 months , 100 % of the restorations were retained , 3 % presented bulk fractures , and 6 % developed secondary caries at cervical margins . After 24 months , there was a significant reduction in marginal integrity while there was only slight change in anatomic form . Proximal contact was defective in 6 % of the restorations and 8 % showed marginal discoloration . SEM evaluation revealed a generalized occlusal and scattered marginal wear with no marginal gaps . CONCLUSION The compomer presented acceptable clinical performance in Class II restorations of primary teeth after 24 months in service 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 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 PURPOSE To evaluate the clinical performance of two self-etching adhesives of different pH values when used to restore non-retentive cervical lesions . METHODS 84 paired non-retentive class 5 restorations were originally placed in 21 subjects in need of 2 , 4 or 6 restorations in incisors , canines and premolars . The retention of the placed restorations relied on the two adhesives only , which were iBOND NG plus B ( iB ) , now marketed as iBOND Self Etch , and Clearfil SE ( CB ) . Lesions were restored with a micro-hybrid composite ( Venus ) . Following a baseline evaluation , the subjects were recalled and evaluated after 3 months , 1 year , 2 years and 4 years . RESULTS At the 4-year evaluation , 17 subjects remained who had originally received 66 restorations ( 33 of each adhesive ) . Eight of these 66 restorations had dropped out during the 4 years ( 4 iB and 4 CB ) for different reasons . Two of the drop-outs ( one iB and one CB ) had fractured in the same patient , leaving a large piece of the composite still bonded to the dentin . Two other drop outs ( both material iB ) were not available for evaluation because they had been crowned ( one after endodontic treatment and one after cusp fracture ) , while the remaining drop-out iB restoration had debonded . Regarding material CB , except for the fractured and partly retained drop-out restoration , the remaining three drop-outs had debonded . Pair-wise comparison of the evaluated parameters using Fishers Exact Test revealed no statistically significant ( P < 0.05 ) differences between the two material AIM To compare the clinical performance of two glass ionomer cements , Amalgomer CR and Fuji IX in small and medium cavities prepared using Atraumatic restorative treatment approach in India . STUDY DESIGN One hundred school children in the age group of 4 - 9 years who had bilateral matched pair of carious lesions in primary posterior teeth were included . A split mouth design was used in which two material s were r and omly placed in contralateral sides . The performance of the restorations was assessed after 1 year using Frenken 's criteria ( 1996 ) . Survival analysis of restoration was done using chi-square test . RESULTS The survival rate of Amalgomer CR and Fuji IX class I restorations were 97.4 % and 94.9 % , respectively . In class II cavities 95.1 % and 88.5 % of Amalgomer CR and Fuji IX restorations were successful . Amalgomer CR and Fuji IX showed a success of 94.2 % and 92.3 % in small sized class II cavities . Amalgomer CR showed a 100 % success for medium sized class I and II restorations . Whereas Fuji IX showed a 100 % and 66.7 % success in medium sized class I and II cavities . CONCLUSION The clinical performances of both material s were satisfactory at the end of 1 year and ART is suitable procedure to be done in a dental clinic for children Significant challenges are faced by the oral and and a variety of donor sites available to the surgical maxillofacial reconstructive surgeon . As health care professionals , we are in a constant search for excellence in patient care , education , and research . The objective of this issue of the Oral and Maxillofacial Surgery Clinics of North America is to address the needs of a continually evolving specialty , combined with the stated goal of expected excellence . Rehabilitation of the facial structures is a complex task . Optimal treatment requires the achievement of multiple reconstructive goals : oral competence , effective mastication , functional deglutition , preservation of speech , and an acceptable cosmetic appearance . When we assess the cosmetic needs of a patient , we should address symmetry , color , texture , strength , sensibility , and motor innervation of the tissues to be replaced . Appropriate choice of the harvest site is key in the decision process . We can reach these stated objectives through a systematic prospect i ve analysis by using outcome measures . The goal of academic surgery is to translate research into education and delivery of care . Successful clinical outcomes can be applied to maximize patient management . The success of translational research in the area of reconstruction has result ed in a plethora of The aim of the present clinical trial was to evaluate the effect of different modes of periodontal therapy on patients with moderately advanced periodontal disease and to express the findings in terms of probing pocket depth and attachment level alterations at periodontal sites with different initial probing depths . The material consisted of 16 patients , 35 - 65 years of age . Following a Baseline examination including assessment s of oral hygiene status , gingival conditions , probing pocket depths and probing attachment levels , the patients were subjected to periodontal treatment . A " split-mouth " design approach of therapy was used and the jaw quadrants were r and omly selected for the following different treatment procedures : ( 1 ) scaling and root planning , ( 2 ) scaling and root planing in conjunction with a gingivectomy procedure , ( 3 ) scaling and root planing in conjunction with an apically repositioned flap procedure without bone recontouring , ( 4 ) scaling and root planing in conjunction with an apically repositioned flap procedure including bone recontouring , ( 5 ) scaling and root planing in conjunction with a modified Widman flap procedure without bone recontouring and ( 6 ) scaling and root planing in conjunction with a modified Widman flap procedure including bone recontouring . The patients were following active treatment enrolled in a supervised maintenance care program including " professional tooth cleaning " once every 2 weeks during a 6-month period of healing , after which a final examination was performed . The investigation demonstrated that active therapy including meticulous subgingival debridement result ed in a low frequency of gingival sites which bled on probing , a high frequency of sites with shallow pockets ( less than 4 mm ) and the disappearance of pockets with a probing depth of greater than 6 mm . Between the Baseline examination and the 6-month re-examination , the probing attachment level for initially shallow pockets remained basically unaltered , but with a tendency of a minor apical shift . This occurred in all 6 treatment groups . For sites with initial probing depths of 4 - 6 mm and greater than 6 mm , there was in all groups some gain of probing attachment . This gain was most pronounced in the initially deeper ( greater than 6 mm ) pockets . With the use of regression analysis , the " critical probing depth " ( CPD ) value ( i.e. the initial probing depth value below which loss of attachment occurred as a result of treatment and above which gain of probing attachment level result ed ) was calculated for each of the 6 methods of treatment used . A comparison of the CPD-values between the 6 treatment groups did not reveal any major differences The purpose of this study was to evaluate the clinical performance of glass ionomer cement ( GIC ) restorations comparing two minimally invasive methods in permanent teeth after 12 months . Fifty pregnant women ( second trimester of pregnancy ) , mean age 22 ± 5.30 years , were treated by two previously trained operators . The treatment approaches tested were : chemomechanical method ( CarisolvTM ; MediTeam ) and atraumatic restorative treatment ( ART ) . A split-mouth study design was used in which the two treatments were r and omly placed in 50 matched pairs of permanent teeth . The chemomechanical method ( CM ) was the test group and the ART was the control group . The treatments were performed in Public Health Centers . The tested restorative material was a high-strength GIC ( Ketac Molar ; 3M/ESPE ) . The restorations were placed according to the ART guidelines . Two calibrated independent examiners evaluated the restorations in accordance with ART criteria . The interexaminer kappa was 0.97 . Data were analyzed using 95 % confidence interval on the binomial distribution and Fisher 's exact test at 5 % significance level . In a 12-month follow-up , 86 % of the restorations were evaluated . In the test group ( CM ) , 100 % ( CI=93.3 - 100 % ) of the restorations were considered successful . In the control group ( ART ) 97.6 % ( CI=87.4 - 99.9 % ) of the restorations were considered successful and 2.4 % unsuccessful ( marginal defect > 0.5 mm ) . There was no statistically significant difference between the 12-mounth success rate for both groups ( Fisher 's exact test : P=0.49 ) and between the two operators ( Fisher 's exact test : P=1.00 ) . Both minimally invasive methods , chemomechanical method and ART , showed a similar clinical performance after 12 months of follow up The purpose of this study was to evaluate the clinical effectiveness of a bioabsorbable membrane made of glycolide and lactide polymers in preserving alveolar ridges following tooth extraction using a surgical technique based on the principles of guided bone regeneration . Sixteen patients requiring extraction s of 2 anterior teeth or bicuspids participated in the study ( split-mouth design ) . Following elevation of buccal and lingual full-thickness flaps and extraction of teeth , experimental sites were covered with bioabsorbable membranes ; control sites did not receive any membrane . Titanium pins served as fixed reference points for measurements . Flaps were advanced in order to achieve primary closure of the surgical wound . No membrane became exposed in the course of healing . Reentry surgeries were performed at 6 months . Results showed that experimental sites presented with significantly less loss of alveolar bone height , more internal socket bone fill , and less horizontal resorption of the alveolar bone ridge . This study suggests that treatment of extraction sockets with membranes made of glycolide and lactide polymers is valuable in preserving alveolar bone in extraction sockets and preventing alveolar ridge defects BACKGROUND The preservation of hard and soft tissue volume , partially lost after tooth removal , can potentially reduce the need for the more dem and ing augmentation procedures used in implant-supported rehabilitation . The objective of this research study is to investigate the effect of filling with xenogeneic material the postextractive sockets of two surgical procedures ( flapless versus flapped ) . METHODS In this prospect i ve r and omized clinical survey , two types of socket preservation were performed on two groups of patients : the control , treated via full-thickness mucoperiosteal flap , and the test , via a flapless procedure .  Anatomic measurements and related outcome variables at the third month were analyzed using multiway analysis of variance . Multiple comparison tests , using Tukey honestly significant difference test , and appropriate pairwise comparison tests for independent sample s were carried out . RESULTS Sixty-four patients were treated , 32 for each of the two socket preservation procedures . Statistically significant differences were registered for the output variables -- changes in width of keratinized gingiva , changes in bucco-lingual width , and vertical bone changes at four sites -- between the two socket preservation techniques , with P values of < 0.001 , < 0.001 , and 0.0105 , respectively . CONCLUSIONS A full-thickness mucoperiosteal flap gave significantly more negative results than that of the less-dem and ing flapless procedure , with an increased width resorption of the post extraction site . Moreover , the increased value of the keratinized gingival width attested to the positive outcome of a flapless procedure in terms of soft tissue preservation and improvement . On the other h and , the flapped technique seemed to show less vertical bone resorption on the buccal aspect than the flapless technique A clinical trial was performed to study the result of periodontal treatment following different modes of periodontal surgery in patients not recalled for maintenance care . The material consisted of 25 patients distributed into 5 groups . Following an initial examination , all patients underwent presurgical treatment including case presentation and instruction in oral hygiene measures . This instruction was given once . The various patient groups were then subjected to one of the following surgical procedures : 1 ) the apically repositioned flap operation including elimination of bony defects 2 ) the apically repositioned flap operation including curettage of bony defects but without removal of bone 3 ) the " Widman flap " technique including elimination of bony defects 4 ) the " Widman flap " technique including curettage of bony defects but without removal of bone 5 ) gingivectomy including curettage of bony defects but without removal of bone . Six , 12 and 24 months after completion of the treatment , the patients were recalled for assessment of their oral hygiene st and ard and periodontal conditions . The results showed that case presentation and oral hygiene instruction given once , only temporarily improved the patient 's oral hygiene habits . Renewed accumulation of plaque in the operated areas result ed in recurrence of periodontal disease including a significant further loss of attachment . All five different techniques for surgical pocket elimination were equally ineffective in preventing recurrence of destructive periodontitis PURPOSE To determine the 18-month clinical performance of four tooth-colored restoratives in non-carious cervical lesions . MATERIAL S AND METHODS Buccal abrasion lesions in 83 teeth were restored with each of the following material s : Fuji Cap II , Fuji II LC , APH/Universal Bond 3 , Lite Fil II A/Imperva Bond . Baseline and an 18-month recall was carried out using the Ryge ( USPHS ) method for retention , color match , marginal adaptation , cavosurface marginal discoloration , anatomic form and secondary caries . RESULTS The USPHS results ( % alfa ) for the four products were , respectively : color match ( 9 % , 48 % , 57 % , 55 % ) , marginal discoloration ( 71 % , 76 % , 52 % , 50 % ) , marginal adaptation ( 24 % , 24 % , 33 % , 15 % ) , anatomic form ( 67 % , 86 % , 95 % , 45 % ) and retention ( 100 % , 95 % , 100 % , 65 % ) . Results indicated that ( 1 ) Fuji Cap II exhibited a poor color match at baseline ( 2 ) Color matching of Fuji II LC was comparable to the resin composites and ( 3 ) seven Lite Fil II/Imperva Bond restorations ( 35 % ) were dislodged after 1 1/2 years PURPOSE The aim of this study was to evaluate the clinical success potential of two nanocomposites placed in posterior teeth using an antibacterial adhesive system over 18 months . METHODS A total of 49 Class I and 47 Class II restorations were placed in the permanent teeth of thirty adult patients . The carious lesions were restored with Gr and io ( Voco ) or Filtek Supreme ( 3 M ESPE ) using a two-step self-etching antibacterial adhesive system Clearfil Protect Bond ( Kuraray ) . The restorations were finished with fine-grit diamond burs , Enhance polishing system , and Sof-Lex finishing brushes . The restorations were evaluated at baseline , 6 , 12 , and 18 months after placement using modified Ryge criteria for color stability , marginal discoloration , marginal adaptation , caries formation , anatomic form , postoperative sensitivity , surface roughness , and retention . RESULTS The changes in the parameters were assessed using the Cochran Q test and the McNemar test at a significance level of p < 0.05 . All restorations were classified as clinical ly satisfactory after 18 months . Statistical analysis demonstrated differences only in superficial roughness , with Gr and io exhibiting more surface roughness than Filtek Supreme ( p < 0.05 ) . CONCLUSION Posterior restorations built up with the novel nanocomposites using an antibacterial self-etching system showed satisfactory results at the 18-month recall appointment relative to all criteria except the surface texture in the case of Gr and io . Further evaluations are necessary for a more in-depth analysis Background : Although Atraumatic restorative treatment ( ART ) approach has been in existence for a while , the reasons for the poor performance of multisurface ART restorations are not very clear . Aim : The aim of this study is to investigate the effects of oral hygiene , residual caries and cervical marginal-gaps on survival of proximal ART restorations . Setting s : Two rural divisions in Kenya were selected for the study . Design : A r and omized clinical trial . Material and Methods : The 804 children in the study had their baseline- and 2-year dental plaque levels documented . Each child received one proximal restoration in a primary molar using ART approach , together with trained and pre-tested operators/assistants , three glass ionomer cements (GIC)-br and s and two tooth-isolation methods . The restorations were clinical ly evaluated soon after placement and after 2 years . Post-restorative bite-wing radiographs taken soon after restoration were also evaluated . Statistical analysis : Statistical Package for Social Sciences ( SPSS ) version 14 computer programme was used and results tested using Pearson 's correlation , Cox Proportional Hazards regression analysis and Multiple Logistic regression models tests . Results : At baseline and after 2 years , the mean cumulative survival and plaque index changed from 94.4 % to 30.8 % and 2.34 ( St and ard Deviation , or SD of 0.46 ) to 1.92 ( SD 2.1 ) respectively , with higher plaque indices associated with higher restoration failures . Of the 507 radiographs evaluated , 48 ( 9.5 % ) , 63 ( 12.4 % ) and 9 ( 1.8 % ) restorations had residual caries ( RC ) , cervical marginal-gaps ( CMG ) and both RC/CMG respectively . Survival of the restorations with RC/CMG was significantly lower ( p = 0.003 ) compared to those with RC or without RC . Conclusion : Low survival of proximal restorations in the study was associated with the presence of cervical marginal-gaps
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 .