IDRR APRIL -MAY -JUNE 2020 - Flipbook - Page 80
ESTHETIC DENTISTRY
A V-shaped double bevel is placed on the fracture
line on the labial and palatal aspect using a round bur
(Figure 14). This will significantly improve the bond
strength as well as helps in hiding the fracture line.
After making the V shaped bevel the enamel is
etched with 37% orthophosphoric acid (Figure 15).
Bonding agent was applied and light cured. The
bevel is filled with heated packable A3 composite
from 3M ESPE and adapted with composite brushes
(Figure 16 & 17). After initial curing, the composite surface is covered with water soluble glycerine gel (Liquid Strip from Ivoclar) and cured through the gel to
ensure removal of the oxygen inhibition layer (Figure
18).
Finishing is done initially with Sof-Lex polishing discs (3M
ESPE) followed by pre-polishing with Sof-Lex spirals,
beige followed by pink (3M ESPE). Final polishing was
done with diamond polishing paste (DiaShine) and
chamois wheel and cotton buff (DiaShine)(Figure 19,
20, 21) .
The fragment reattachment procedure is by far the
best, easiest and the most minimally invasive that can
be done whenever a fractured segment is available.
Complete rehydration will happen only after 7 days.
Recall should be done after this period. Any minor aesthetic correction can be done. With this simple clinical
procedure anatomy and function can be easily restored with very high success rates if the clinical steps
are followed correctly.
FURTHER READING
AUTHOR
1.
Chazine M, Sedda M, Ounsi HF, Paragliola R,
Ferrari M, Grandini S
Evaluation of fracture resistance of reattached incisal
fragments using different materials and techniques.
Dent Traumatol 2011 Feb;27(1):15-8
2.
Granddini R, Pagni L, Pagavino G, De Fraia E
Using the coronal fragment for the repair of anterior
tooth fracture.
Quintessence Int Dent Dig 1985;10:839 :45 and 925:33
3.
Rappelli G, Massaccesi C, Putignano
Clinical procedures for the immediate reattachment
of a tooth fragment.
Dent Traumatol 2002;18;281;4.
4.
Pusman E, Ceherili ZC, Altay N, Unver B, Saracbasi O, Ozgun G
Fracture resistance of tooth fragment reattachment:
effects of different preparation techniques and adhesive materials
Dent Traumatol .2010;26;9;15
5. Davis MJ, Roth J, Levi M
Marginal integrity of adhesive fracture restorations;
chamfer versus bevel.
Quintessence int 1983:14;1135;46
6. Demarco FF, Fay RM, Pinzon LM, Powers JM
Fracture resistance of reattached coronal fragments:
influence of different adhesive materials and bevel
preparations.
Dent Traumatol 2004;20:157:63
7.
Yilmaz Y,Zehir C,Eyuboglu O,Belduz N.
Evaluation of success in the reattachment of coronal
fractures.
Dent Traumatol 2008;24;151;8
8. Worthington RB, Murchinson DF, Vandewalle KS.
Incisal edge reattachment: the effect of preparation,
utilization and design.
Quintessence int 1999;30;637;43
9. Farik B, Munksgaard EC, Andreasen JO
Impact strength of teeth restored by fragment - bonding.
Endod Dent Traumatol 2000:16:15;13
prove the shear bond strength of the reattached fragment (Figure 13).
Dr. Rajeeve S Pillai, Aesthetic and Biomimetic Dentist, Dr. Anu Krishna Priya, Aesthetic Dentist and Dental
Photographer, Susmitham Dental Care, Venmony, Chengannur, Alappuzha
July-August-September 2019
www.idrr.in
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