From the Guidelines
Yes, a chipped fragment of a front tooth can be reattached if the fragment is available and the fracture is contained within the enamel and dentin surfaces without exposure of the pulpal tissues. According to a study published in Pediatrics in 2014 1, if the tooth fragment is available, it can be rebonded to the tooth. For the best chance of successful reattachment, it is essential to recover and properly preserve the tooth fragment, and see a dentist immediately—ideally within a few days of the injury. When the fragment is reattached, the procedure typically involves cleaning both the fragment and the remaining tooth, applying dental bonding material, positioning the fragment precisely, and using a curing light to harden the bond. Some key factors to consider for successful reattachment include:
- The size of the fragment
- How clean and intact the fragment is
- How the fragment was stored
- How quickly treatment is sought If the fragment is unavailable or too damaged, alternative treatments include dental bonding using composite resin, veneers, or crowns depending on the extent of the damage, as the goal is to restore the tooth's appearance and function while minimizing morbidity, mortality, and impact on quality of life.
From the Research
Reattachment of Chipped Front Tooth Fragment
- Reattachment of a chipped fragment of a front tooth is possible and can provide esthetically pleasing results, as long as the fragment is available 2, 3, 4, 5.
- This procedure can restore the tooth's original anatomic form, color, and surface texture, and is considered a conservative approach 3, 4.
- The use of adhesive materials for tooth fragment reattachment is a common technique, and modifications such as placement of veneer and radicular post can also be used 2.
- Patient cooperation and understanding of the limitations of the treatment are crucial for a good prognosis 3.
Factors Affecting Reattachment
- The storage medium used to preserve the tooth fragment prior to reattachment can affect the bond strength between the restoration and the tooth 6.
- Hydration of the fragment is an important aspect of the treatment, and storing the fragment in a medium such as egg white or a hypertonic solution can result in a higher bond strength 6.
- The periodontal, endodontic, coronal, and occlusal aspects of the tooth must be evaluated to determine the best approach for reattachment 2.
Advantages of Reattachment
- Reattachment of a chipped fragment can restore tooth function and esthetics, and provide a positive psychological response for the patient 3, 5.
- This procedure is considered a conservative approach, as it preserves sound tooth structure and maintains the original anatomy and translucency of the tooth 4.
- The rate of incisal wear after reattachment can match that of the original tooth structure 4.