This case report describes and analyses a tooth fragment reattachment technique used to resolve crown fractures of the anterior teeth. This treatment allows a conservative approach to traumatic coronal lesions offering a better possibility of maintaining aesthetics and function. The authors have illustrated here a clinical case of a fractured incisor. This case is characterized by several traumas on the same tooth that required different therapeutic solutions. We used an easy and ultra-conservative technique without any tooth preparation in the first and third traumatic injuries. In the second trauma, a direct restoration of the fractured tooth was performed. The adhesive reattachment is a simple system to achieve good aesthetic and functional results.Our clinical experiences demonstrated that, when tooth and fragment margins are intact, the reattachment technique without any tooth preparation is a simple and predictable procedure. Quality of adhesion is shown by the retention of the reattached fragment in the second trauma that caused only partial enamel fractures.
The aim of this study is to evaluate the color changes and the stability at a 1-year follow-up of white spot lesions (WSLs) treated with an infiltrating technique by using etching and TEGDMA resin. The color of 22 white spot lesions and the sound adjacent enamel (SAE) were assessed with a spectrophotometer at T0 (baseline), T1 (after treatment), and T2 (1 year after). The color change ΔE (WSLs-SAE) at T0 vs. T1 were compared to evaluate the camouflage effect efficiency, and at T1 vs. T2 to assess the stability of outcomes. To evaluate the effect on the treatment outcome of gender, the presence or not of previous orthodontic treatment, WSLs onset more/less than 10 years, the age of the patient, and the ΔE WSL (T0 vs. T1) was analyzed. The difference between ΔE (WSLs-SAE) at T0 and T1 resulted in statistical significance (p < 0.01). No statistical difference was found between ΔE (WSLs-SAE) at T1 vs. T2. The variables considered showed no statistical differences in treatment outcomes. The results of our investigation show that the technique used is immediately effective and the camouflage effect keeps up and steady one year after treatment. Such results do not appear to be influenced by analyzed clinical variables.
In this study, the effectiveness of an experimental clinical technique for the reproduction of attachments during an orthodontic treatment with clear aligners was evaluated using a new index (CorAl) for quality assessment that exploits the differential entropy of point clouds. The procedure involves the use of a pre-drilled template and a second pre-loaded template with a high-viscosity composite and is compared with the standard technique. Attachment planning was conducted on four prototypes of dental arches with extracted teeth which were divided into two groups according to the proposed operating procedures. Digital scans were utilized to capture dental impressions for both the purposes of virtual planning and to reproduce the clinical outcomes post-procedure. The point clouds obtained after the reproduction of the attachments were aligned with those from the virtual planning, and the deviation analysis was conducted using the quality index of the CorAl method. Though no significant discrepancies were found among the groups regarding morphological flaws, detachments, or maximum defect values, the differential entropy analysis revealed that the experimental technique offers good alignment in attachment placement. The outcome supports that the innovative procedure of the clinical reproduction of attachments proved to be reliable and operationally simple, with additional benefits derived from using the CorAl index. The advantages of CorAl include the use of a single comparison index, no problem of comparison commutativity, noise immunity, low influence from the presence of holes, and point cloud densities. This allows for the drawing of quality maps that show areas with the highest deviation.
In invisible orthodontics, the role of composite attachments in facilitating complex tooth movements is crucial. This study, which evaluates the efficacy of a novel clinical attachment procedure, holds significant implications for the field. The technique used two templates (one pre-drilled and the other pre-loaded with high-viscosity composites) and was compared with the standard procedure. Fifty attachments were planned for four dental arch prototypes. Dental impressions were taken using digital scans for virtual planning and after tested techniques. The stereolithographic files (STL) obtained were aligned with those of the virtual planning, and a colorimetric map was used to evaluate the composite resin’s maximum excess and defect deviation. The enamel–resin interfaces were observed by scanning electron microscopy (SEM). The Fisher test for the distribution of detachments and morphological defects and the Mann–Whitney test for the maximum values of excess and defect were used. No significant results were found between groups for morphological defects and detachments, and the maximum values of defect and excess were reported. SEM images for the experimental technique showed integrated adhesion. This innovative procedure, which has proven reliable and operationally straightforward, holds promise, instilling confidence in its practicality and potential to advance the field of orthodontics.
The aesthetics of clear aligners is a critical factor that can influence patient satisfaction and psychological and social well-being. However, their transparency can be compromised by exposure to staining agents. This study aimed to evaluate the color stability of PET-G aligners following prolonged exposure to common daily substances, including food, tobacco products, and cleaning agents. Flat samples of PET-G (n = 220) were immersed in various solutions, including coffee, tea, Coca-Cola, red wine, a colloidal silver-based disinfectant, nicotine, artificial saliva, cigarette smoke, and mixtures of saliva with smooth, coffee, and nicotine. Immersion times of 10 (n = 110) and 15 days (n = 110) were randomly assigned. Colorimetric assessments were conducted by measuring L*a*b* parameters before and after immersion, and total color change (ΔE) was calculated. Non-parametric statistical tests revealed significant color changes in PET-G samples after both immersion durations, with pairwise comparisons indicating notable differences in ΔE values among groups exposed to different substances, particularly coffee, tea, and Coca-Cola. The findings highlight the psychological and social impact of aligner staining on patient confidence and compliance. Understanding these effects highlights the need for enhanced patient education to improve aligner aesthetics and satisfaction.