Multidisciplinary Management of Complicated Crown-Root Fracture of an Anterior Tooth Undergoing Apexification

The purpose of this case report was to present the multidisciplinary management of a subgingival crown-root fracture of a patient undergoing apexification treatment. A 12-year-old male patient was referred to the pediatric dentistry clinic with an extensive tooth fracture of the right permanent maxillary lateral incisor. Clinical and radiographic examinations revealed the presence of a complicated crown-root fracture, which had elongated to the buccal subgingival area. The dental history disclosed that the apexification procedure had been started to be performed after his first trauma experience and he had neglected his appointment. The coronal fragment was gently extracted; endodontic treatment was performed; flap surgery was performed to make the fracture line visible. The coronal fragment was reattached to the root fragment with a dual-cure luting composite. A fiber post was stabilized and the access cavity of the tooth was restored with composite resin. At the end of the 24th month, the tooth was asymptomatic, functionally, esthetically acceptable and had no periapical pathology. It is important for the patients undergoing apexification treatment to keep their appointments because of the fracture risk. Restoration of the fractured tooth by preparing retention grooves and a bonding fiber-reinforced post are effective and necessary approaches for successful management.

Influence of Cement Shade and Water Storage on the Final Color of Leucite-reinforced Ceramics

Clinical Relevance Luting cement under 0.8 mm thick leucite-reinforced ceramic changed the final color of the ceramic and could be seen by the human eye. Therefore, clinicians may prefer to use try-in pastes or polymerized luting composite shade guides to compensate for the change in color of definitive restorations, such as laminate veneers. The final color differences between ceramics luted with cements in A1 and A3 shades were not clinically perceivable at each measurement. Within the limitations of this study, changing the color of an IPS Empress laminate veneer restoration via the shade of the cement seems not to be a preferred method.

Effect of surface treatments of laboratory-fabricated composites on the microtensile bond strength to a luting resin cement

The purpose of this study was to evaluate the influence of different surface treatments on composite resin on the microtensile bond strength to a luting resin cement. Two laboratory composites for indirect restorations, Solidex and Targis, and a conventional composite, Filtek Z250, were tested. Forty-eight composite resin blocks (5.0 x 5.0 x 5.0mm) were incrementally manufactured, which were randomly divided into six groups, according to the surface treatments: 1- control, 600-grit SiC paper (C); 2- silane priming (SI); 3- sandblasting with 50 mm Al2O3 for 10s (SA); 4- etching with 10% hydrofluoric acid for 60 s (HF); 5- HF + SI; 6 - SA + SI. Composite blocks submitted to similar surface treatments were bonded together with the resin adhesive Single Bond and Rely X luting composite. A 500-g load was applied for 5 minutes and the samples were light-cured for 40s. The bonded blocks were serially sectioned into 3 slabs with 0.9mm of thickness perpendicularly to the bonded interface (n = 12). Slabs were trimmed to a dumbbell shape and tested in tension at 0.5mm/min. For all composites tested, the application of a silane primer after sandblasting provided the highest bond strength means.