Biologic esthetic restorations

Development and characterization of biological bovine dentin posts

This study aimed at evaluating the use of biological dentin post (BDP), achieved by milling bovine root, through the analyses of mechanical and optical properties. BDPs were compared to a glass fiber post (GFP) in the following tests (n = 10): a) elastic modulus (E) and flexural resistance (σ) by three point bending test; b) fracture resistance (FR) by compressive load at 45° and failure pattern; c) light transmitting (LT) ability and their influence on the resin cement's degree of conversion (DC%); d) bond strength (BS) by push-out test and failure pattern. Bovine teeth were decoronated and root length was standardized at 14 mm. The canals were prepared and irrigated with 2.5% NaOCl. GFP's surface was conditioned by 1 min immersion in 24% H₂O₂ solution before silanization. After root embedment, the root canal walls and the BDP's surface were hybridized (H₃PO₄ 37% + self-cured adhesive) for FR and DC% analyses. Posts were fixed into the root canals using a conventional dual resin cement. For BS test, both posts were luted using the conventional and the self-adhesive cementation. A universal testing machine (EMIC DL2000; 1 mm/min) was employed for the mechanical tests (E, σ, FR and BS). For the LT analysis, opaque polyethylene discs were transfixed by the posts, leaving 10 mm of the posts' apical section for measurements. Posts' cervical portion was irradiated (800 mW/cm²) and a spectrometer recorded the number of photons transmitted to previously chosen lateral post regions and at the apical tip. The resin cement DC% was evaluated in several sites of the cement film. After normal distribution were checked (Shapiro-Wilk test), data were submitted to ANOVA (5%) and Scheffe post-hoc test (5%). Results showed that: a) E: BDP > GFP; b) σ: BDP < GFP; c) RF: BDP < GFP; d) LT could not be observed for BDP. For GFPs, the greatest number of photons was observed at the post apical tip. An exponential decay was observed from the cervical to the apical post region; e) resin cement DC% was statistically similar at all points of measurements for both posts; and, f) BS: BDP = GFP, regardless the adhesive protocol used. It was concluded that: a) teeth restored with BDP exhibited lower fracture resistance than those restored with GFP; b) resin cement DC% was not influenced by the light transmitting ability of the post; c) the retention provided by the BDP was similar to the one provided by GFP, independently of the luting protocol.

Allogenous tooth fragment reattachment

Coronal fractures of the anterior teeth are a common form of dental trauma and its sequelae may impair the establishment and accomplishment of an adequate treatment plan. Among the various treatment options, reattachment of a crown fragment obtained from a previously extracted tooth is a conservative treatment that should be considered for crown fractures of anterior teeth. This article reports reattachment of an allogenous tooth fragment in a fractured maxillary lateral incisor in a 38-year-old patient. It is suggested that allogenous reattachment in a fractured anterior tooth serves to be a better alternative and should be further researched. Aesthetic and functional rehabilitation of a fractured complicated anterior crown using allogenous tooth fragment is a better alternative to other more conventional treatment options.

Reattachment using a fragment from an extracted tooth to treat complicated coronal fracture

Reattachment of fragment is the preferred alternative to restore the fractured teeth, offering several advantages. Partial pulpotomy has demonstrated satisfactory results as a conservative treatment for pulp exposures because of trauma. This study reports a case in which the treatment of a complicated coronal fracture was accomplished by partial pulpotomy and reattachment of a dental fragment obtained from an extracted tooth using composite resin. The results show the feasibility of the conservative pulp therapy and the restorative approach.

Mechanical strength of tooth fragment reattachment

The aim of this study was static and fatigue test investigation of the strength of a tooth fragment reattached with adhesives to the tooth body. Central bovine incisor teeth were used, and standardized fragments were obtained by cutting the incisal edge of the selected teeth. All the fragments were reattached using a multistep dentine adhesive system, and the specimens were randomly divided into two groups (A and B). Group B specimens underwent a further dental treatment: a circumferential double chamfer prepared around the external cut interface was filled with light cured composite restorative resin. Static and fatigue bending tests were performed and linear elastic equations were used to analyze and compare the strength of the treated teeth. The results indicated that the static and fatigue bending properties were improved by using reinforcement with composite restorative resin.