The fractures of the anterior teeth are a common form of dental trauma that mainly affects children and adolescents. One of the therapeutic options for managing coronal tooth fractures when the tooth fragment is available and there is no or minimal violation of the biological width is the Autogenous reattachment of the dental fragment.. Reattachment of fractured fragment can provide good and long lasting esthetics. This is a report of a 12 -year follow-up of a coronal fracture case successfully treated using tooth fragment reattachment.
Keywords: Composite resins, coronal fracture, fragment reattachment
Clinical procedures for the immediate reattachment jc / dental implant coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Clinical procedures for the immediate reattachment jc / dental implant coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Zirconium Dental Implants And Crown for Congenitally Missing Maxillary Latera...Abu-Hussein Muhamad
Zirconia implants were familiarized into dental implantology. Zirconia appears
to be an appropriate implant material due to its low plaque affinity, tooth like color, biocompatibility and mechanical properties. The following a case presentations will show how the acid-etched zirconia Implant can be used to functionally and aesthetically replace congenitally missing left lateral incisor tooth germ in the maxilla, and achieve optimal soft tissues and health.
Mouth preparation for rpd /certified fixed orthodontic courses by Indian dent...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Strip Crowns Technique for Restoration of Primary Anterior Teeth: Case ReportAbu-Hussein Muhamad
Dental caries is the single most common chronic childhood disease affecting worldwide. In early childhood caries, there is early pulp involvement and gross destruction of maxillary anterior teeth as well as posterior teeth. Treatment of such caries represents a challenge to pediatric dentists especially, when teeth are badly destroyed. By the time the dentist sees the child, most of the coronal structure is lost. This case report describes challenging task of a Case of early childhood caries patients with mutilated maxillary incisors restored with a strip form composite restorations.
Prosthodontic-Orthodontic Treatment Plan with Two-Unit Cantilevered Resin-Bon...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Zirconium Dental Implants And Crown for Congenitally Missing Maxillary Latera...Abu-Hussein Muhamad
Zirconia implants were familiarized into dental implantology. Zirconia appears
to be an appropriate implant material due to its low plaque affinity, tooth like color, biocompatibility and mechanical properties. The following a case presentations will show how the acid-etched zirconia Implant can be used to functionally and aesthetically replace congenitally missing left lateral incisor tooth germ in the maxilla, and achieve optimal soft tissues and health.
Mouth preparation for rpd /certified fixed orthodontic courses by Indian dent...Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
0091-9248678078
Strip Crowns Technique for Restoration of Primary Anterior Teeth: Case ReportAbu-Hussein Muhamad
Dental caries is the single most common chronic childhood disease affecting worldwide. In early childhood caries, there is early pulp involvement and gross destruction of maxillary anterior teeth as well as posterior teeth. Treatment of such caries represents a challenge to pediatric dentists especially, when teeth are badly destroyed. By the time the dentist sees the child, most of the coronal structure is lost. This case report describes challenging task of a Case of early childhood caries patients with mutilated maxillary incisors restored with a strip form composite restorations.
Prosthodontic-Orthodontic Treatment Plan with Two-Unit Cantilevered Resin-Bon...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Prosthodontic-Orthodontic Treatment Plan with Two-Unit Cantilevered Resin-Bon...Abu-Hussein Muhamad
Abstract: Congenitally missing lateral incisors create an esthetic problem with specific orthodontic and prosthetic considerations. Selecting the appropriate treatment option depends on many factors, such us the malocclusion, the anterior relationship, specific space requirements, bone volume, root proximity, the condition of the adjacent teeth, and esthetic prediction mainly when the canine must be reshaped.Resin bonded bridges were considered to be doomed owing to their very high decementation rate, have come alive once again because of newer resin based cements. This article will discuss the variety of treatment managements in case of space opening and treated with two 2-unit cantilevered resin-bonded fixed partial dentures supported by the cuspids. This conservative treatment plan was cost-effective without having any significant biological cost. Keywords: Agenesis, Resin- bonded fixed partial denture, interim prosthesis.
DENTAL AVULSION- IMMEDIATE REPLANTATION: 8- YEAR FOLLOW UP CASEAbu-Hussein Muhamad
Avulsion of permanent front teeth is a rare accident , mostly affecting children between seven and nine year s of age.
Replanted and splinted, these teeth often develop inflammat ion, severe resorption or ankylosis affect ing alveolar bone
development and have to be extracted sooner or later . This repor t proposes a discussion on the var ious pecul iar ities of a
tooth avulsion case with immediate replantation, such as a long retent ion per iod, root canal fil ling with MTA, or thodontic
treatment.
Multidisciplinary Approach in the Rehabilitation of Congenitally Maxillary C...Abu-Hussein Muhamad
Objective: This case report describes the multidisciplinary
approach to treat a congenitally missed maxillary canine, how to
improve patient’s smile using orthodontic fixed appliance, endosseous
dental implant, and porcelain veneer to achieve the treatment results of
function and esthetic.
Materials and procedures: Unilateral agenesis of the permanent
maxillary canines in healthy individuals is extremely rare. This
paper presents the case of a female patient diagnosed with congenital
unilateral agenesis of the permanent maxillary canines as well as
occlusal abnormalities in the form of left-side crossbite. To restore the
proper aesthetics and function, interdisciplinary therapeutic treatment
was implemented. In the case presented in this paper, the aim of
oral rehabilitation was to restore a functional balance by obtaining
proper skeletal relationships, creating optimal occlusal conditions and
obtaining arch continuity.
Conclusion: Interdisciplinary treatment combined of orthodontics,
implant surgery, and prosthodontics was useful to treat a nonsyndromic
oligodontia patient. Especially, with the new strategy, implantanchored
orthodontics, which can facilitate the treatmentand make it
more simply with greater predictability.
THE ART AND SCIENCE OF TREATMENT PLANNING ON ORTHODONTIC EXTRUSIONAbu-Hussein Muhamad
Traumatized anterior teeth with subgingival fractures of crown are a challenge to treat. This paper reports the man¬agement of subgingival fractures of crown of the maxillary central incisor in an 29 year old female. The technique described here involves the use of fixed appliance, post and core with a loop fabricated on it for retention of fixed appliance.
Keywords: Fracture, Tooth, Root Extrusion, Crown Fracture.
Intentional replantation of maxillary second molar; case report and 15-year f...Abu-Hussein Muhamad
Abstract: Intentional reimplantation is a procedure in which tooth extraction is performed followed by reinsertion of the extracted tooth into its own socket after performing the desired procedure. In this article, intentional reimplantation is described and discussed as a treatment approach for aperiapical lesion that is in maxillary second molar. After 15 years, the patient was asymptomatic, the tooth was still functional and a recall intraoral periapical radiograph showed an intact periodontal ligament space and lamina dura with no evidence of gross root resorption or ankylosis.
Keywords: Intentional replantation, calcified canals, mineral trioxide aggregate
Pre-Prosthetic Orthodontic Implant for Management of Congenitally Unerupted L...Abu-Hussein Muhamad
The maxillary lateral incisor is one of the most common congenitally missing teeth of the permanent
dentition. With the advent of implants in the field of restorative dentistry, a stable and predictable fixed
prosthetic replacement has become a reality, especially for young adult patients who suffer from congenital
absence of teeth. The dual goals of establishment of functional stability as well as enhancement of esthetic
outcomes are made achievable by the placement of implants. A multidisciplinary team approach involving the
triad of orthodontist, periodontist and restorative dentist will ensure the successful completion of the integrated
treatment approach in these patients. The present case report achieved successful implant based oral
rehabilitation in a patient diagnosed with congenital absence of bilateral maxillary lateral incisors utilizing a
preprosthetic orthodontic implant site preparation for the purpose of space gain.
Keywords: Preprosthetic, interdisciplinary treatment, implant placement
Pre prosthetic orthodontic implant for management of congenitally unerupted l...Abu-Hussein Muhamad
The maxillary lateral incisor is one of the most common congenitally missing teeth of the permanent dentition. With the advent of implants in the field of restorative dentistry, a stable and predictable fixed prosthetic replacement has become a reality, especially for young adult patients who suffer from congenital absence of teeth. The dual goals of establishment of functional stability as well as enhancement of esthetic outcomes are made achievable by the placement of implants. A multidisciplinary team approach involving the triad of orthodontist, periodontist and restorative dentist will ensure the successful completion of the integrated treatment approach in these patients. The present case report achieved successful implant based oral rehabilitation in a patient diagnosed with congenital absence of bilateral maxillary lateral incisors utilizing a preprosthetic orthodontic implant site preparation for the purpose of space gain.
Single-Step Apexification with Mineral Trioxide Aggregate (MTA) –Case ReportsAbu-Hussein Muhamad
The completion of root development and closure of the apex occurs up to 3 years after the eruption of
the tooth. The treatment of pulpal injury during this period provides a significant challenge for the clinician.
The most commonly advocated medicament is calcium hydroxide, although recently considerable interest has
been expressed in the use of mineral trioxide aggregate (MTA). We report a case with MTA were used
successfully for one step apexification in teeth with open apex
Clinical Replacement Therapy and the Immediate Post-extraction Dental ImplantAbu-Hussein Muhamad
Immediate dental implants have greatly reduced the treatment time and the number of surgical intervene tions. Recently it has been noted that this treatment modality can be used in aesthetically demanding cases especially the anterior maxilla. The aim of this article is to describe a clinical case in which a fractured maxillary canine was replaced by an osseointegrated implant using a simplified technique in a patient who was a smoker and presented poor oral hygiene. The technique adopted permits a reduction of the number of implant components and consequently a lower cost of treatment, while at the same time maintaining acceptable aesthetic and functional outcomes.
Similar to Autogenous tooth fragment reattachment ; a 12 years follow-up (20)
Congenital absence of maxillary lateral incisors is a frequent clinical challenge which must be solved by a multidisciplinary approach in order to obtain an
esthetic and functional restorative treatment. . Fixed prosthodontic and removable prostheses, resin bonded retainers, orthodontic movement of maxillary
canine to the lateral incisor site and single tooth implants represent the available treatment modalities to replace congenitally missing teeth. This case report
demonstrates the team approach in prosthetic and surgical considerations and techniques for managing the lack of lateral incisors. The aims of this case
report of replacement of bilaterally congenitally missing maxillary lateral incisors with dental implants.
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations.
Impacted Maxillary Central Incisors: Surgical Exposure and Orthodontic Treat...Abu-Hussein Muhamad
The maxillary permanent central incisor develops early in life and forms part of an aesthetic smile. Disruption of the formation or eruption of the permanent
central incisor has multiple etiological factors. Treatment options depend to some extent on the cause of failure of eruption of the central incisor. Generally,
the earlier treatment is provided, the higher the likelihood of success and the less the complexity. Our results suggest that close monitoring and interdisciplinary
cooperation during the treatment phases led to a successful esthetic result, with good periodontal health and functional occlusion.
Excess of space in the dental arch is diagnosed as a
generalised spacing or a local divergence, often
observed in the maxillary anterior region, as a median
diastema, traumatic loss of central incisors, or
congenital absence of lateral incisors. Furthermore,
spacing is observed in aging individuals, due to
pathological migration of teeth caused by
periodontitis. Finally, adult individuals with partial
edentulous jaws demand pre-prosthetic orthodontic
treatment from functional aspects. Thus, indication for
orthodontic treatment in subjects with spacing of teeth
exists for aesthetic reasons, but also for facilitating
prosthetic restorations with optimal occlusalstability.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting
cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically
induced failures, since low primary implant stability, low bone density, short implants and overload have been
identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a
successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field.
Aesthetic Management of Fractured Anteriors: A Case ReportAbu-Hussein Muhamad
Introduction: Coronal fracture of anterior teeth is an important topic for esthetic dentistry. Such fractures may jeopardize esthetics, function, tissue biology
and occlusal physiology, thus endangering tooth vitality and integrity. Coronal fractures resulting from dental trauma most frequently occur to the maxillary
anterior teeth of adolescents and less frequently to mandibular teeth. Adult teeth may also suffer traumatic fracture, although less frequently than for
adolescents.
Case Report: In our case, an economical and time-saving novel technique has been described for direct composite restoration in a young patient with
uncomplicated fractured maxillary anterior tooth.
Conclusion: As restoring a fractured tooth is a complex procedure, this technique can prove as a simple, effective and appropriate technique that will fulfill all
the requirements of dental personnel. This technique can also prove to be easy for inexperienced beginner clinicians without requiring special skills in
providing the patients with direct composite restorations
Orthodontic tooth movement is basically a biologic response towards a mechanical force. Osteoclast and osteoblast cells mediate bone resorption and apposition, which eventually produces tooth movement. Researches showed that the rate of orthodontic tooth movement can be altered by certain drugs locally or systemically. The Objective of this article is to discuss the current data concerning the effect of drugs on orthodontic tooth movement.
The multifactorial factors influenc cleft Lip-literature review Abu-Hussein Muhamad
Congenital cleft-Lip and cleft palate have been the subject of many genetic
studies, but until recently there has been no consensus as to their modes of
inheritance. In fact, claims have been made for just about every genetic
mechanism one can think of. Recently, however, evidence has been
accumulating that favors a multifactorial basis for these malformations. The
purpose of the present paper is to present the etiology of cleft lip and cleft palate
both the genetic and the environmental factors. It is suggested that the genetic
basis for diverse kinds of common or uncommon congenital malformations may
very well be homogeneous, whilst, at the same, the environmental basis is
heterogeneous.
Dental implants represent one of the most successful treatment modalities in dentistry.
However, failures do occur in the range from 5 to 8% for routine procedures and up to 20% in major grafting cases after at least 5 years of function . The majority of implant losses may be explained as biomechanically induced failures, since low primary implant stability, low bone density, short implants and overload have been identified as risk factors . Hence, achievement and maintenance of implant stability are pre-conditions for a successful clinical outcome with dental implants.
The review focuses on different methods used to assess implant stability and recent advances in this field
Over time, progressively shorter implants have been placed such that short implants are now available that are less than 6 mm in length. The viability and high success rates seen with short implants can be explained by osseointegration, the macro geometric design of the implant, as well as physics and the distribution of forces. This paper was aimed to review the stability and survival rate of short implants under functional loads. Numerical and clinical studies were reviewed. Keywords: Short dental implants, sinus augmentation, factors affecting bone regeneration in dental implantology
Porcelain laminate veneers are among the most esthetic means of creating a more pleasing and beautiful smile. Porcelain veneers within reason allow for the alteration of tooth position, shape, size and color. They require a minimal amount of tooth preparation, approximately 0.5 mm to 0.7mm of surface enamel reduction. This study describes the use of ceramic veneers without tooth wear, reinforcing the concept that minimally invasive porcelain laminate veneers could become versatile and conservative allies in the fi eld of esthetic dentistry. Keywords: Ceramics, dentin-bonding agents, esthetics
Immediate Restoration of Single Implants Replacing Lateral Incisor Compromis...Abu-Hussein Muhamad
Today, the diagnosis of internal root resorption is significantly improved by the three-dimensional imaging. Furthermore, the CBCT’s superior diagnosis accuracy resulted in an improved management of the resorptive defects and a better outcome of Implant therapy of teeth with internal resorption.Implant has become a wide option to maintain periodontal architecture. Diagnosis and treatment planning is the key factors in achieving the successful outcomes after placing and restoring implants placed immediately after tooth extraction. The purpose of this clinical update is to report on the success and survival of Immediate restoration of single implants replacing right lateral incisor compromised by internal resorption.
Immediate Implant Placement And Restoration With Natural Tooth In The Maxilla...Abu-Hussein Muhamad
Anterior tooth loss and restoration in the esthetic zone is a common challenge in dentistry today. The prominent visibility of the area can be especially distressing to the patient and requires a timely and esthetically pleasing solution. Immediate single-tooth implantation followed by immediate provisionalization is becoming an increasingly desirable treatment that offers numerous benefits over conventional delayed loading. Provisionalization for immediately-placed implants using the patient’s existing tooth can enhance the final aesthetic outcome if certain steps are
followed. If the natural tooth is intact and can be used as a provisional, the emergence profile can be very similar to the preoperative condition. This article outlines a technique to use the patient’s natural tooth after extraction to provisionalize an implant.
Clinical Management of Bilateral Impacted Maxillary CaninesAbu-Hussein Muhamad
Introduction: Impaction of maxillary canines is a frequently encountered clinical problem in orthodontic therapy. When a preventive
approach fails, treatment involves surgical exposure of the impacted tooth, followed by orthodontic traction to guide and align it into the
dental arch. The aim of the present report was to demonstrate by case reports of an adult patient with bilateral impacted maxillary canines
treated with surgical exposure and orthodontic treatment.
Material and Methods: A 15year-old female with various degrees of bilateral palatal impaction of maxillary canines were managed
by the described technique.
Results and Discussion: Autonomous eruption of the impacted canines after surgical uncovering was witnessed in all patients
without the need for application of a vertical orthodontic force for their extrusion.
Conclusion: The described method of surgical uncovering and autonomous eruption created conditions for biological eruption of the
palatally impacted canines into the oral cavity and facilitated considerably the subsequent orthodontic treatment for their proper alignment
in the dental arch.
Keywords: Impacted canines; Surgical; Tooth exposure; Orthodontic treatment
“One-Piece” Immediate-Load Post-Extraction Implant In Maxillary Central IncisorAbu-Hussein Muhamad
Abstract: This case report describes extraction of a fractured left maxillary central incisor tooth, followed by immediate placement of an one-piece implant in the prepared socket and temporization by a bonded restoration.
Materials And Methods: The tooth was extracted with minimal hard and soft tissue trauma and without flap reflection. The socket was prepared to the required depth and a Implant was inserted.
Results: The atraumatic operating technique and the immediate insertion of the one-piece Implant resulted in the preservation of the hard and soft tissues at the extraction site.
Conclusion: The “One-piece” dental implant and provisional restoration provided the patient with immediate esthetics, function, comfort and most importantly preservation of tissues. The one-piece implant design resulted in a high cumulative implant survival rate and beneficial marginal bone levels.
Single Visit Replacement of Central Maxillary Using Fiber-Reinforced Composi...Abu-Hussein Muhamad
Fiber reinforced composites are high strength filling materials composed of conventional composites and glass fibres. They exhibit extensive applications in different fields of dentistry. This clinical report present a case where FRC technology was successfully used to restore central maxillary incisor edentulous area in terms of esthetic-cosmetic values and functionality.
Surgery of Labially Impacted Canine & Orthodontic Management – A Case ReportAbu-Hussein Muhamad
Maxillary canines are one of the most common teeth that are impacted among patients seeking orthodontic treatment. Depending on the position of these impacted teeth, various surgical techniques have been employed for their exposure. His primary goal of surgical phase is to provide the means for correct position of orthodontic anchorage. Additionally, the technique used must ensure favorable tissue anatomy that will permit long-term maintenance of periodontal health. In the present case, a labially impacted maxillary left canine was surgically exposed using an apically positioned flap. Orthodontic extrusion was carried out further.
Taurodontism is a rare dental anomaly in which the involved tooth has an enlarged and elongated body and pulp chamber
with apical displacement of the pulpal floor. Endodontic treatment of a taurodont tooth is challenge to a clinician and
requires special handling because of the proximity and apical displacement of the roots. The present article describes the
diagnosis and management of hypertaurodontism by endodontic treatment in a left mandibular second molar.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Autogenous tooth fragment reattachment ; a 12 years follow-up
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 15, Issue 4 Ver. XIII (Apr. 2016), PP 85-90
www.iosrjournals.org
DOI: 10.9790/0853-1504138590 www.iosrjournals.org 85 | Page
Autogenous Tooth Fragment Reattachment ; A 12 -Years
Follow-Up
Abu-Hussein Muhamad *, Abdulgani Azzaldeen,
Ziyad Kamal Mohammad,Watted Nezar
Arab -American University,School Of Dentistry,Jenin, ,Palestine
Abstract: The fractures of the anterior teeth are a common form of dental trauma that mainly affects children
and adolescents. One of the therapeutic options for managing coronal tooth fractures when the tooth fragment
is available and there is no or minimal violation of the biological width is the Autogenous reattachment of the
dental fragment.. Reattachment of fractured fragment can provide good and long lasting esthetics. This is a
report of a 12 -year follow-up of a coronal fracture case successfully treated using tooth fragment
reattachment.
Keywords: Composite resins, coronal fracture, fragment reattachment
I. Introduction
Traumatic injuries of teeth involve varying degrees of damage to the supporting soft tissues or the teeth
itself. A very common injury to the permanent dentition affecting children and adolescents during their growing
years is the anterior crown fracture.
Uncomplicated crown fractures are a frequent form of dental injuries encountered in a dental clinic
requiring immediate management. Uncomplicated crown fractures are a frequent form of dental injuries
encountered in a dental clinic requiring immediate management.[1,2]
Reattachment of fractured tooth provides the best esthetic results as natural tooth shape,contour,surface
texture,occlusal alignment and color are maintained (5-10). Additionaly,this approach provide positive
psychological and social response from the patient.[3]
Numerousl factors influence the management of coronal tooth fractures, including extent of fracture ,
pattern of fracture and restorability of fractured tooth (associated root fracture), secondary trauma injuries ,
presence/absence of fractured tooth fragment and its condition for use (fit between fragment and the remaining
tooth structure), occlusion, esthetics, finances, and prognosis.[4–6].Patient cooperation and understanding of the
limitations of the treatment is of utmost importance for better treatment outcome. When there is a substantial
associated periodontal injury or invasion of the biological width, the restorative management of the coronal
fracture should follow the proper management of those associated issues. Coronal fractures must be approached
in a systematic way to gain a successful restoration.
One of the options for managing coronal tooth fractures, especially when there is no or minimal
violation of the biological width, is the reattachment of the dental fragment when it is available.[7]. Tooth
fragment reattachment offers a conservative, esthetic, and cost effective restorative option that has been shown
to be an acceptable alternative to the restoration of the fractured tooth with resin-based composite or full-
coverage crown.[6,8–10]. Reattachment of a fragment to the fractured tooth can provide good and long-lasting
esthetics (because the tooth’s original anatomic form, colour, and surface texture are maintained),[9] can restore
function, can result in a positive psychological response, and is a reasonably simple procedure. [11]. In addition,
tooth fragment reattachment allows restoration of the tooth with minimal sacrifice of the remaining tooth
structure. Furthermore, this technique is less time-consuming and provides a more predictable longterm wear
than when direct composite is used.[12]. Clinical trials and long-term follow-up have reported that reattachment
using modern dentin bonding agents or dual cure adhesive luting systems may achieve functional and esthetic
success.[6,13]
Tennery was the first to report the reattachment of a fractured fragment using acid-etch technique[14].
Subsequently,Starkey [15] and Simonsen [16,17] have reported success with similar cases. The introduction
of composite in combination with the use of acid-etch technique to bond composite to enamel, made restoration
possible for the fractured incisor, with minimal preparation[16] . However, composite resin has the
disadvantages of poor abrasion resistance in comparison to enamel [17],water absorption, and staining.
Reattachment techniques for tooth fragments present several advantages over restorations obtained with
composite resin systems: better and long-lasting esthetics, improved function,immediate results, a positive
psychosocial response, and faster and less complicated procedures[5,6,10] .
Tooth fragment reattachment offers a conservative esthetic and cost-effective restoration option that
has been shown to be an acceptable alternative to the restoration of the fractured tooth with resin-based
2. Autogenous Tooth Fragment Reattachmen ; A 12 -Years Follow-Up
DOI: 10.9790/0853-1504138590 www.iosrjournals.org 86 | Page
composite as full coverage crown. Reattachment of a fragment to the fractured tooth can provide good and
long-lasting esthetics (as the original tooth anatomic form, colour, and surface texture are maintained), can
restore function, can result in a positive psychological response and is a reasonably simple procedure. [5,6]
This article reports on coronal tooth fracture cases that were successfully treated using Autogenous tooth
fragment reattachment of a 12 -year follow-up.
II. Case Report
A 9-year-old female patient reported to my pediatric dental clinic , after sustaining an uncomplicated crown
fracture to her maxillary left central incisor while playing about 6 hours ago.
The fractured tooth fragment was recovered by the patient at the site of the injury and she had kept it in an
empty box. Clinical examination revealed that the teeth had fracture of the incisal angle involving the enamel
and dentin . The fractured part of the tooth was intact, with some crack and craze lines . No abnormal mobility
of the injured tooth was recorded and the surrounding tissues were healthy.A periapical radiograph showed that
the root formation was complete and there were no other injuries. The tooth fragment was checked for the fit
with the tooth and immediately maintained in normal saline. (Fig.1a,b)
Fig.1a; Fracture fragment
The treatment options were presented to the patient and her parents, which included a) no treatment; b)
crown build up with composite; c) reattachment of the fractured fragments. After some deliberation about the
advantages, disadvantages and prognosis, the patient opted to have tooth fragment reattached.
Fig.1b; Pre-operative view, labial
The tooth fragment was analyzed and tried intraorally to check for proper positioning and fit with the
fractured coronal structure. The operating field was isolated with rubber dam; the fractured fragment and the
tooth surface was treated with 37% phosphoric acid (Scotchbond etchant, 3M ESPE, St. Paul, USA) for 15
seconds and after, rinsed with water for 15 seconds.
3. Autogenous Tooth Fragment Reattachmen ; A 12 -Years Follow-Up
DOI: 10.9790/0853-1504138590 www.iosrjournals.org 87 | Page
Fig.2a; post-operative view, labial
The excess water was removed with absorbent paper, Primer (Adper Scotchbond multi-purpose primer,
3M ESPE, St. Paul, USA)was applied to the etched enamel and dentin and air-dried gently for 5 seconds. The
adhesive (Adper Scotchbond multi-purpose adhesive, 3M ESPE, St. Paul, USA) was applied to the primed
enamel and dentin, which penetrates in the tubules of the dentin in order to create a hybrid layer. The adhesive
was light cured for 10 secondswith a QTH light-cure unit (Optilux 500, KEER, Orange, CA, EUA).
Fig.2b; post-operative view, occlusal
A small amount of resin composite universal dentin shade (Filtek Z250, 3M ESPE, St. Paul, USA) was
placed on the tooth before the compound with the tooth fragment was indexed. The excess resin composite was
removed with a plastic instrument prior topolymerization. The resin composite was polymerized for 20 seconds
with a QTH light-cure unit (Optilux 500, KEER, Orange, CA, EUA), finished with serial finishing burs (KG
SORSEN, Sao Paulo, Brazil) and polished with sandpaper disks (Diamond Pro, FGM, Joinville, Brazil) for the
final fragment reattachment procedure (Figure 5). Each layer of resin composite was polymerized for 20
seconds with a QTH light-cure unit (Optilux 500, KEER, Orange, CA, EUA). The external surfaces were
finished with serial finishing burs FG 2134, FG 2134 F, FG 2134FF (KG SORSEN, Sao Paulo, Brazil) and
polished with sandpaper disks (Diamond Pro, FGM, Joinville, Brazil). (Fig.2a,b)
Fig.3; 12-years after fractured tooth fragment reattachment
4. Autogenous Tooth Fragment Reattachmen ; A 12 -Years Follow-Up
DOI: 10.9790/0853-1504138590 www.iosrjournals.org 88 | Page
Proximal contacts were verified for both restorations using floss (Colgate Total floss, Colgate, New
York, USA) and occlusal contacts were marked with double-sided articulating film (AccuFilm II, Parkell,
Edgewood, USA). All excursive movements were verified and postoperative instructions provided. The patient
was placed on 6 and 12 months recall monitoring the direct pulp cap and too evaluating the stability of the
reattached tooth fragment. The follow-up period showed positive tooth vitality on cold testing using ethyl
Chloride Spray (Endo Ice, Coltene Whaledent, USA). Follow-up radiographs were normal without any evidence
of periapical pathology. Clinical and radiographic examinations were carried out regularly over a period of 12
years. During this period, the reattached fragment was intact without any distortion. Occasionally, it required
polishing to remove some mild stains. Nine years follow-up showed a predictable outcome of the reattached
fragment.( Fig.3)
III. Discussion
Fragment reattachment and root canal dental trauma is a situation that requires acute decision making
by the dental provider for optimal treatment outcomes. Traumatic injuries to an immature permanent tooth may
result in cessation of dentin deposition and root maturation and can also affect the tooth’s prognosis.[19]
Crown fractures comprise 26-76% in the permanent dentition. i f an intact tooth fragment is present after
trauma, the reattachment procedure presents a conservative, simple and esthetic treatment option. The procedure
is reasonably economical, while restoring function and esthetics with a very conservative approach.[4,5 ]
Incisal fractures of anterior teeth have been successfully treated by reattachment. Complicated fractures
involving pulp have been treated by reattachment with post and core . There are certain other factors to be
considered during reattachment procedures. If endodontic therapy is required, the pulp chamber can be used as
an internal reinforcement, avoiding excessive tooth preparation, but the disadvantage is that the esthetics is
compromised as the pulpless teeth lose a part of their translucency and brightness. If the fracture extends close
to the pulp, a direct pulp-capping agent is essential, and this would prevent placement of an internal groove in
the fragment. If the fragments are very small, simple reattachment is done without any additional
preparation.[19.20,21]
When a fractured tooth occurs due to an accident, the patient should follow some important steps:
1. Locate and bring the broken piece/s to the emergency room or dental office.
2. Transport the fragment in an appropriate solution: Hank’s Balanced Solution (HBSS), milk, egg white,
hypertonic dextrose solution or saliva, water [4,5]. If these solutions are not available, store the fragment in the
patient’s saliva [17]. Pulpal protection is paramount in these acute traumatic situations. An indirect pulp
capping procedure is indicated if the fracture approaches the pulp, but no exposure occurs. A root canal
treatment or a direct pulp cap is indicated if the pulp tissue is exposed. Direct pulp capping with calcium
hydroxide or MTA has been shown to be controversial [22]. On the other hand, some authors believe that direct
pulp capping has clinical merit and should be considered as a non-aggressive alternative to root canal treatment
[22,23].
The remarkable advancement of adhesive systems and resin composites has made reattachment of tooth
fragments a procedure that is no longer a provisional restoration but rather a restorative treatment, offering a
favourable prognosis. Fabrication of a mouth guard and patient education about treatment limitations may
enhance clinical success, as reattachment failures may occur with new trauma or parafunctional habits[4,57].
Despite these factors, case reports and multicentre studies have described functional and aesthetic successes for
over `12 years now.
Fabrication of a mouth guard and patient education about treatment limitations may enhance clinical
success as reattachment failures may occur with new trauma orparafunctional habits.[5,6]
Clinic applications and long term follow-up has revealed that modern dentin bonding agents and adhesive
bonding systems used in the reattachment technique increase the functional and aesthetic success.[4,5,24]
Reis et al. reported on the fracture resistance of reattachment technique, and noted that without any
preparation, the application fracture resistance was only 37.1%, while in the buccal chamfer application
resistance was 60.6%, in bonding with an over contour it was 97.2%, and in the placement of an internal groove
it was 90.5%.[9,25]Demarco et al. evaluated the different adhesive systems and the effects of the bevel
preparation in regards to resistance against fracture. They reported that bevel applications in all groups increased
the resistance against the fracture, whileadhesive bonding applications yielded poor results.[26] Eden et al.
reported that the reattachment technique that more comply the fracture segments were better in complied with
together, positively affected the stability of the natural tooth surface, as well as successful biocompatibility with
periodontal tissue.[27]Kararia et al. and Saha SG et al. reported more successful short and long-term results in
coronal fragment repairs with the reattachment technique.[28,29]Cavalleri and Zerman have reported longterm
follow up studies of the reattachment technique, and confirmed that the reattachment technique yielded
5. Autogenous Tooth Fragment Reattachmen ; A 12 -Years Follow-Up
DOI: 10.9790/0853-1504138590 www.iosrjournals.org 89 | Page
more successful results than composite resin restorations.[30] Preeti Kore et al reported a successful one year
follow up of esthetic reattachment of a coronal fragment in a complicated crown fragment of permanent right
central incisor.[31]
Wadhwani et al reported a successful one year follow up of esthetic reattachment of a coronal
fragment in a complicated crown fracture of permanent right central incisor.[32]
Macedo GV et al reported two coronal tooth fracture cases that were successfully treated using tooth fragment
reattachment. Reattachment of fractured tooth fragment
offers a viable restorative option for the clinician because it restores tooth function and esthetics with the use of
very conservative and cost effective approach.[33]
Badami and associates have shown neither the bevel nor the material used could obtain the original
fracture resistance of the tooth. Specimens prepared with chamfer and bonded had a fracture resistance of 40 to
60%, with internal dentin groove and over contour it reached around 90%. A simple reattachment procedure as
in the first case is indicated, since bevel with flowable composite improves fracture strength recovery. The
resistance of the fracture segment can be directly proportional to the surface area of adhesion. Most of the 5th
generation bonding agents increased the fracture resistance of reattached coronal fragments when used with
conjunction with unfilled resin. Extensively fractured fragments have to be restored with conjunction with a
resin. The highest fracture resistance was obtained by chemically cured composite followed by light cured and
resin cement and least by only dentin bonding agent.[34]
In our case, retention technique used have found to be esthetically & functionally in good condition at
the first year recall visit, suggesting fragment reattachment can be a choice of treatment in management of
anterior traumatic teeth, if the original tooth fragment is retained following fracture.
With the materials available today, in conjunction with an appropriate technique, esthetic results can be
achieved with predictable outcomes. Thus, the reattachmentof a tooth fragment is a viable technique that
restores function and esthetics with a very conservative approach, and it should be considered when treating
patientswith coronal fractures of the anterior teeth, especially younger patients.
IV. Conclusion
Recent development in restorative materials, placement techniques, preparation designs, adhesive protocols,
allow clinicians to effortlessly complete this procedure in a single appointment. Thus, reattachment of the intact
fractured segment can be considered as an ultraconservative biologic method for aesthetic rehabilitation and it is
an excellent choice of treatment.
Disclosure
The authors do not have any financial interest in the companies whose products are included in this
article.
References
[1]. Olsburgh S, Jacoby T, Krejci I. Crown fractures in the permanent dentition: pulpal and restorative considerations. Dent Traumatol
2002;18(3):103-115.
[2]. Andreasen FM, Noren JG, Andreasen JO, et al. Long‑term survival of fragment bonding in the treatment of fractured crowns.
Quintessence Int 1995;26:669-681.
[3]. .Baratieri LN, Ritter AV, Junior SM, Filho JCM. Tooth fragment reattachment: an alternative for restoration of fractured anterior
teeth. Pract Periodont Aesthet Dent 1998;10:115-127.
[4]. Abu-Hussein M ., Watted N ., Abdulgani A,;Eshetics,biological and restorative consideration in coronal segment reattachment for
fractured teeth. Int J Dent Health Sci 2015; 2(4): 998-1004
[5]. Abu-Hussein M ., Watted N ., Abdulgani A, , Abu-Shilabayeh H .. Anterior Dental Esthetics in Primary Teeth.International Journal
of Public Health Research. Vol. 3, No. 1, 2015, pp. 25-36.
[6]. Andreason JO, Andreason FM.Fractured tooth fragment reattachment. Textbook & color atlas of traumatic injuries to the teeth.3rd
edition.Copenhagen: Munksgaard publishers; 1993:p.151-177
[7]. Baratieri LN, Ritter AV, Junior SM, Filho JCM. Tooth fragment reattachment: an alternative for restoration of fractured anterior
teeth. Pract Periodont Aesthet Dent 1998;10: 115–27.
[8]. El-Askary FS, Ghalab OH, Eldemerdash FH et al. Reattachment of a severely traumatized maxillary central incisor, one-year
clinical evaluation: a case report. J Adhes Dent 2006;8(5):343–9.
[9]. Reis A, Loguercio AD, Kraul A, Matson E. Reattachment of fractured teeth: a review of literature regarding techniques and
materials. Oper Dent 2004;29(2):226–33.
[10]. Rappelli G, Massaccesi C, Putignano A. Clinical procedures for the immediate reattachment of a tooth fragment. Dent Traumatol
2002;18(5):281–4.
[11]. Maia EA, Baratieri LN, de Andrada MA, et al. Tooth fragment reattachment: fundamentals of the technique and two case reports.
Quintessence Int 2003;34(2):99–107.
[12]. Baratieri LN, Monteiro S Jr., Andrada MAC. Tooth fracture reattachment: case reports. Quintessence Int 1990;21(4):261–70.
[13]. Oz IA, Haytac MC, Toroglu MS. Multidisciplinary approach to the rehabilitation of a crown-root fracture with original fragment for
immediate esthetics: a case report with 4-year follow-up. Dent Traumatol 2006;22(1):48–52.
[14]. Tennery NT. The fractured tooth reunited using the acid etch bonding technique. Texas Dent J 1988;96:16.
[15]. Starkey P.E.: Reattachment of a fractured fragment to a tooth. J Ind Dent Assoc 1979; 58: 37 - 38.
6. Autogenous Tooth Fragment Reattachmen ; A 12 -Years Follow-Up
DOI: 10.9790/0853-1504138590 www.iosrjournals.org 90 | Page
[16]. .Simonsen R., Thompson V.P., Barrark G.: Etched cast restorations: clinical and laboratory technique. Chicago, Quintessence
Publishing Co. 1985: 150 - 151.
[17]. Chosack A, Eildeman E.Rehabilitation of fractured incisor usingthe patient’s natural crown. Case report. J Dent Child 1964;31: 19-
21.
[18]. Osborne J.W., Lamsen R.L.: Reattachment of fractured Incisal tooth segment. Gen Dent 1985; 3: 516 – 517
[19]. .Fidel SR, Fidel-Junior RA, Sassone LM, Murad CF, Fidel Clinicalmanagement of a complicated crown-root fracture: a case
report. Braz Dent J 2011,22: 258-262
[20]. Vijayaprabha K, Marwah N, Dutta S A biological approach to crownfracture: Fracture reattachment: A report of two cases.
Contemp Clin Dent2012,3: 194-198
[21]. .Abdulkhayum A, Munjal S, Babaji P, Chaurasia VR, Munjal S, et al. In-vitro Evaluation of Fracture Strength Recovery of
Reattached Anterior Fractured Tooth Fragment Using Different Re-Attachment Techniques. J Clin Diagn Res 2014,8: 208-211.
[22]. Mente J, Hufnagel S, Leo M, Michel A, Gehrig H, et al. Treatment outcomeof mineral trioxide aggregate or calcium hydroxide
direct pulp capping: long-term results. J Endod2014 40: 1746-1751.
[23]. Willershausen B, Willershausen I, Ross A, Velikonja S, Kasaj A, et al Retrospective study on direct pulp capping with calcium
hydroxide. Quintessence Int211, 42: 165-171.
[24]. Palma-Dibb RG, Taba Autogenous tooth fragment reattachment--association of periodontal surgery and endodontic and restorative
procedures:a case report. Quintessence Int2004, 35: 179-184.
[25]. ,Reis A, Loguercio AD. Tooth fragment reattachment: current treatment concepts. Pract Periodontics Aesthet Dent 2004;16:739-40.
[26]. Demarco FF, Fay RM, Pinzon LM, Powers JM; Fracture resistance of re-attached coronal fragments-influence of different adhesive
materials and bevel preparation. Dent Traumatol., 2004; 20(3):157-163.
[27]. .Eden E, Çiçek YS, Sönmez S; Reattachment of subgingivally fractured central incisor with an open apex. Dent Traumatol., 2007;
23:184– 189.
[28]. Kararia N, Chaudhary A, Kararia V; Tooth fragment reattachment: An esthetic, biological restoration. World J Dent., 2012; 3(1):
91-94
[29]. Saha SG, Saha MK. Management of a fractured tooth by fragment reattachment a case report. International Journal of Dental
Clinics 2010;2(2):43-7.
[30]. .Cavalleri G, Zerman N; Traumatic crown fractures in permanent incisors with immature roots: a follow-up study. Endod Dent
Traumatol., 1995;11: 294–296.
[31]. Preeti Kore , Hugar SM,Kumar S.Reattachment of an autogenous tooth fragment in complicated crown fracture. World J of Dent
2011; 2(2) 135-138.
[32]. Wadhwani CPK .A single visit, multidisciplinary approach to the management of traumatic tooth crown fracture.Br Dent J
2000;188: 593-598 |
[33]. Macedo GV, Diaz PI,Fernandes CA, Rilter AV.Reattachment of anterior teeth
[34]. fragments. A conservative approach. J Esthet Restor Dent 2008;20: 5-20
[35]. Badami A., Dunnes, Scheer B.: As in vitro investigation into shear bond strengths of two dentine bonding agents used in the
reattachment of incisal edge fragments. Endo Dent Traumat 1995; 11: 129 - 135.
*Corresponding Author Address:
Abu-Hussein Muhamad
DDS,MScD,MSc,MDentSci(PaedDent) ,FICD
Limited to Pediatric Dentistry
123 Argus Street
10441 Athens
Greece
abuhusseinmuhamad@gmail.com