Autogenous Bonding The Journal of Clinical Pediatric Dentistry Volume 37, Number 1/2012 5 INTRODUCTION F racture of enamel or enamel and dentin is one of the most common types of dental trauma and mainly affects the maxillary incisors. 1-4 The etiology is associated with gender, overjet, lip coverage, age, falls, collisions and violence 4,8 causing physical and psychological discomfort, which can affect the patient’s quality of life. 9-12 Esthetic and functional problems can be minimized by restoring the fractured tooth. Several authors have suggested the use of autogenous tooth fragment bonding as an method for restoring fracture anterior. 13-15 Autogenous tooth fragment bonding offers advantages over restorations with composite resins and porcelain, including superior esthetics, greater durability, reestablishment of the natural function and short execution time. 15-17 Furthermore, this method achieves positive social and emotional responses for the patient due to the preservation of his/her natural dental structure. 15,17 The purpose of the present article is to describe a case of crow fracture of a permanent maxillary central incisor and esthetic and functional results two years of follow-up. Case report A 13-year-old boy was referred to the Dentistry Clinic at Federal University of Vales do Jequitinhonha e Mucuri reporting a fracture of the permanent right maxillary central incisor. The patient brought in the fragment, which had remained dehydrated for the last 6 hours. After a clinical and radiographic exam, an oblique crown fracture was observed, involving the enamel and dentin, with pulp exposure and with no invasion of the biological space (Figure 1-A, B and C). The proposed treatment plan included fragment reattachment associated with intrarradicular reinforcement. During the emergency treatment, and after local infiltrative anesthesia the tooth structure and fragment were cleaned with a calcium hydroxide solution. The contaminated pulp was removed and the tooth was restored temporarily with a glass ionomer restoration (Vidrion R, SSWhite, Juiz de For a, MG, Brazil). A splint was fashioned with a temporary restoration using denture tooth and autopolymerizable acrylic resin (Duralay, Dental MFG, IL, USA).Tooth was anchored to it as a temporary restoration (Figure 1 - D). The fragment was stored in physiological solution, where it was kept for 14 days until use. Due to the extensive fracture and contamination of the coronal pulp, endodontic treatment was necessary (Figure 2 - A). In order to enhance the retention of the fragment, a Esthetic Smile Rehabilitation through Autogenous Bonding of Dental Fragment: A Case Report Gonçalves-Sena L * / Guimarães Rosa Dutra AC ** / Corrêa-Faria P *** / Botelho AM **** / Ramos-Jorge ML ***** / Aguiar Tavano KT ****** Autogenous tooth fragment bonding offers advantages over restorations with composite resins and porce- lain, including better esthetics, greater durability, reestablishment of the natural function of the dental ele- ment and short execution time. A case is presented of a 14-year-old male patient who suffered an oblique crown fracture of the permanent right maxillary central incisor (11) due to a traumatic fall. The clinical examination revealed pulp exposure with no invasion of the biological space. Due to the extension of the fracture, endodontic treatment and the placement of an intra-root esthetic pin was needed. The tooth was restored using the autogenous fragment bonding method. Excellent esthetic and functional results were observed after two years of follow up. Keywords: tooth fracture, esthetics, permanent dentition J Clin Pediatr Dent 37(1): 5–8, 2012 * Larryson Gonçalves-Sena, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Brazil ** Ana Carolina Guimarães Rosa Dutra, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Brazil *** Patrícia Corrêa-Faria, MsC Pediatric Dentistry, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Brazil **** Adriana Maria Botelho,PhD, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Brazil ***** Maria Leticia Ramos-Jorge, PhD, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Brazil ****** Karine Tais Aguiar Tavano PhD, Federal University of Vales do Jequitinhonha e Mucuri, Diamantina, Brazil Send all correspondence to: Patrícia Corrêa-Faria, Rua da Glória, 187 Diamantina, Brasil CEP: 39100-000 Phone: +55 38 3532-6099 Fax: +55 38 3532 6099 E-mail: patricia.faria08@yahoo.com.br Downloaded from http://meridian.allenpress.com/jcpd/article-pdf/37/1/5/1746029/jcpd_37_1_9v7u29m18mgh4v06.pdf by Bharati Vidyapeeth Dental College & Hospital user on 23 July 2022