Introduction: Currently, a substance called casein phosphopeptide-amorphous calcium phosphate has been used as a substitute for fluoride mouthwash. This study aimed to compare the remineralization rate of fluoridated GC Tooth mousse with concomitant use of fluoride mouthwash and GC Tooth mousse on demineralized enamel lesions.Materials & Methods: In this laboratory study, 50 samples were selected from 30 intact human premolars, halved into buccal and lingual segments, and randomly divided into five groups. Enamel health was recorded using a DIAGNOdent device and Vickers micro hardness test.Afterwards, the remineralized agents were applied to the surface of samples for two weeks as follows: 1) Control, 2) Fluoridated GC Tooth mousse, 3) GC Tooth mousse, 4) Sodium fluoride mouthwash and 5) Sodium fluoride mouthwash+GC Tooth mousse. Repeatedly, enamel remineralization values were recorded via DIAGNOdent device, and data were analyzed using one-way and two-way repeated measures ANOVA tests.Results: Our findings indicated that no significant difference was observed between remineralization rate of fluoridated GC Tooth mousse and concomitant use of fluoride mouthwash and GC Tooth mousse, evaluated by DIAGNOdent device (P=0.959) and Vickers micro hardness test (P=0.884).Conclusion: According to the results, application of fluoridated GC Tooth mousse with concomitant use of fluoride mouthwash and GC Tooth mousse had a similar impact on remineralization of demineralized enamel lesions.

The management of traumatic dental injuries as well as crown-root Fractures is always challenging in everyday general dental practice. A number of treatment modalities are available for crown-root Fractures, depending on the position, extent and severity of the fracture. The aim of this case report was to describe a clinical case of rehabilitation of a complicated crown-root fracture of the maxillary left central incisor, successfully treated by a multidisciplinary approach including orthodontic extrusion. The final result was esthetically pleasant and periodontally sound in the follow ups.

Background and Aim: Regarding to the importance of anterior permanent teeth in mastication, speaking and esthetic, also high prevalence of crown fracture due to traumatic injuries of the permanent teeth, this study was designed to evaluate the etiology and prevalence of crown fracture of anterior permanent teeth in 2nd _5th grade children of primary schools in Rasht, in year 2007.Materials and Methods: For this descriptive, cross-sectional study 1042 ,2nd 5Thgrade students were selected from 10 randomly chosen primary schools in Rasht. Examination was carried out by flash light. Information in regard to age, gender, type of crown fracture, Tooth number, amount of over jet, overbite, lip seal, etiology of trauma and performed treatments following trauma were recorded. The data were analyzed with SPSS software and Chi-Square test.Results: Prevalence of crown fracture in anterior teeth was 15.2%. The male to female ratio was 1.7/1. Maxillary central incisors were the most affected (53.5%) and the most common type of crown injury was enamel fracture (80.3%). Most of injuries had occurred at home (49%) and during summer (40.8%). Falls and foreign bodies striking were the most frequent cause of dental traumatic injuries.Conclusion: There was a tendency for children with an increased over jet and deep bite to have more dental injuries.

Teeth with root fracture may need orthodontic treatment. This case report presents the management of unerupted canines in a patient with previously-healed/untreated horizontal root fracture in the maxillary left central incisor. The malocclusion was treated maintaining pulp vitality considering the principles to improve the eruption path of maxillary canines and move short-rooted teeth. The root-fractured Tooth remained symptomless after orthodontic treatment without significant adverse effects, and stayed stable following 2-year follow-up.

Acute traumatic injuries to the maxillary incisors may lead to a crown-root fracture. If the fracture is left untreated, the fracture line will propagate and extend apically, resulting in microbial contamination of the attachment apparatus and subsequent bone loss. In cases with extensive periodontal involvement, extraction has been suggested. However, bonding and sealing the fracture line with a biocompatible material seems to be an effective alternative treatment option. In this case report, management of a central incisor with an incomplete crown-root fracture that showed signs and symptoms of vertical root fracture is discussed. As the extension of the fracture line was not clear, intentional replantation and sealing the fracture line with a glass ionomer was performed. The Tooth showed no signs and symptoms at sixmonth follow up, and the radiographic examination exhibited substantial bone repair.

Background and Aim: This study compared the fracture resistance and esthetic appearance of reattached incisor Tooth fragments with different preparation techniques in simulated crown Fractures (CFs). Materials and Methods: In this in vitro study, 50 permanent maxillary incisors were randomly divided into five groups (n=10). After induction of uncomplicated CFs, the fractured teeth were restored using five methods: (I) simple reattachment (SR), (II) circumferential chamfer (CC), (III) buccal scalloped bevel and lingual bevel (BSB&LB), (IV) buccal and lingual overcontour (BO&LO), and (V) buccal scalloped bevel and lingual overcontour (BSB&LO). After thermocycling, the fracture resistance of the teeth was measured, and their esthetic appearance was assessed using Easyshade spectrophotometer and the United States Public Health Service (USPHS) visual scale. One-way ANOVA, Tukey’s post-hoc test, and paired t-test were used to analyze the data (alpha=0.05).  Results: The secondary fracture resistance was significantly lower than the primary fracture resistance in the control (P=0.000), CC (P=0.01), BSB&LB (P=0.004), BO&LO (P<0.001), and BSB&LO (P<0.001) groups. The CC group showed a significantly higher secondary fracture resistance than the BO&LO group (P=0.02). Although a more favorable esthetic appearance was observed in the BSB&LB group, no significant difference was found in color difference (∆E) among the groups. Moreover, no statistically significant difference was detected among the study groups regarding the USPHS scale (P>0.05). Conclusion: Restoration with the CC method may improve the fracture resistance of reattached fragments in simulated CFs in maxillary incisors. However, no considerable difference was found regarding the esthetic appearance among the tested techniques.

One of the most challenging issues in the field of dentistry is to decide whether to preserve or extract a compromised Tooth with subgingival caries/crown Fractures. Several patient-related factors (i.e. biological, behavioral, or financial factors), Tooth-related factors (i.e. periodontal, endodontic, or restorative factors), and the role of the Tooth in the overall treatment plan should be considered to make the most accurate decision. This article has focused on the decision-making process related to the management of compromised teeth with subgingival caries/crown Fractures. Based on the current scientific evidence and clinical experience of the authors, an algorithm has been suggested to simplify this process of decision. In the first step, compromised teeth were classified as single-root or multi-root groups. “Crown-to-root ratio” (C/R ratio), and “apical extension of caries to the crestal bone” were considered the main clinical parameters in the decision-making process for single-root and multi-root teeth, respectively. We do not recommend restoring the compromised teeth if the C/R ratio is more than 1 (for single-root teeth) or if the extension of caries has reached the alveolar bone crest (for multi-root teeth). For maintainable single-root teeth, there are three treatment options to provide space for the re-establishment of supracrestal soft tissue attachment (previously named as biologic width) between the future restorative margin and underlying crestal bone. These approaches include: surgical crown lengthening (SCL), orthodontic forced eruption (OFE), and deep marginal elevation (DME). For multi-root teeth, SCL and DME are usually the procedures of choice. Multi-root teeth are not amenable to OFE due to the heavy orthodontic forces needed for extrusion. We also discussed the indications and limitations related to each treatment option. Further studies should be conducted to evaluate the external validity of this decision tree.

This case report documents the clinical approach adopted for two maxillary incisors with intrusion and horizontal root fracture in the middle third after trauma. The proposed procedures involved maintaining pulp vitality and periodontal stability of the fractured teeth with 8 years of follow-up.

The crown-root fracture is a common Tooth injury which compromises the biological width and need proper endodontic and prosthodontic treatment to achieve acceptable clinical outcome. This case report describes clinical management of crown-root fracture in maxillary central incisors which was successfully treated by forceps eruption with 180˚ rotation to restore the biological width. The patient was followed-up for 18 months. Clinical and radiographic evaluation showed acceptable results, the replanted teeth have normal function and no obvious inflammatory root resorption was seen on radiographic examination.