PMC3502796_01
Reattachment of fractured tooth segments using a prefabricated fiber post. (a) Clinical appearance of the patient, (b) preoperative radiograph, (c) sectional obturation of the root canals, (d) fiber post luted in the root canal with 2 mm of the retentive part of the post outside the chamber, (e) postoperative radiograph, and (f) clinical view after segments reattachment.
CRIM.DENTISTRY2012-756526.001.jpg
PMC3502796_01_CRIM.DENTISTRY2012-756526.001.jpg
fig1
Initial examination revealed the horizontal fracture on teeth no. 11 and 21, and associated pulp exposure (Figure 1(a)). Radiographic examination showed the horizontal fracture line at cervical third of both the crowns, and no root fracture (Figure 1(b)). Single visit root canal treatments were carried out on both the teeth, and only the apical thirds were obturated by gutta percha with sectional obturation technique (Figure 1(c)). Thin layer of dual cure composite resin cement (3M_ RelyX_ Adhesive Resin Cement, 3M ESPE) was applied, and the post was cemented into the canal such that 2 mm of its coronal portion was outside the chamber (Figure 1(d)). Silicon-based polishing discs (Soft-Lex, 3M ESPE) were used in decreasing coarseness to polish marginal areas (Figures 1(e) and 1(f)).
PMC3502796_02
Reattachment of fractured tooth segments and reinforcing the attachment by pre-fabricated fiber post. (a) Clinical appearance of the patient, (b) preoperative radiograph, (c) reattachment of fractured tooth segment, and splinting with stainless steel wire and light cure composite resin, (d) radiograph showing fiber post reinforcing the attachment, (e) clinical view after removal of the splint, and (f) clinical view showing orthodontic treatment in progress.
CRIM.DENTISTRY2012-756526.002.jpg
PMC3502796_02_CRIM.DENTISTRY2012-756526.002.jpg
fig2
A complicated crown fracture was observed in relation to left maxillary central incisor, tooth no. 21 (Figure 2(a)). Radiographic examination revealed horizontal fracture line at cervical third of the crown in relation to tooth no. 21, and no root fracture (Figure 2(b)). Since adjacent teeth had mobility, they were splinted with 19-gauge stainless steel wire and light cure composite resin (Figure 2(c)). The canal walls were etched, rinsed, dried, and treated with bonding agent and fiber-reinforced post was cemented into the canal as described in case report 1 (Figure 2(d)). The patient was advised to report after a week for the removal of the splint (Figure 2(e)). One-year followup showed stabilization of the fragment, and orthodontic treatment in progress (Figure 2(f)).
PMC3502796_03
Reattachment of fractured tooth segment. (a) Clinical appearance of the patient, (b) preoperative radiograph, (c) fractured crown segment bought by the patient, (d) working length radiograph, (e) postoperative radiograph, and (f) clinical view after segment reattachment.
CRIM.DENTISTRY2012-756526.003.jpg
PMC3502796_03_CRIM.DENTISTRY2012-756526.003.jpg
fig3
Clinical examination revealed a fracture of the middle third of the crown, exposing the pulp with tooth no. 11 (Figure 3(a)). Radiographic examination revealed horizontal fracture at middle third of the crown, an intact periodontal ligament space, and complete root formation with no root fracture (Figure 3(b)). The patient had brought the displaced tooth segment in water (Figure 3(c)). Following local anaesthesia root canal treatment was performed (Figure 3(d)). Adhesive Resin Cement, 3M ESPE) (Figure 3(e)). All margins were light cured for 40 s and then polished using diamond stones and a composite polishing kit (Shofu Co., Kyoto, Japan) (Figure 3(f)). At 12-month-followup, the tooth was symptom-free and the crown was aesthetically satisfactory.