Comparing fracture resistance on bovine incisors restored by tooth fragment reattachment versus direct composite restoration techniques

Shiran Aharonian, Andrea Dora Schachter, Mahmoud Masri, Tanya Sella Tunis, Sigalit Blumer, Tamar Brosh, Tal Ratson*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Background/Aim: Anterior teeth are prone to traumatic dental injuries (TDIs). Although a number of techniques ranging from original tooth fragment reattachment (TFR) to direct composite restoration (DCR) can be used to restore uncomplicated crown fractures, there is no consensus on which method is best. The purpose of this study was to investigate the fracture resistance of bovine incisors restored by two different techniques (TFR and DCR) in three different fracture models. Materials and Methods: Sixty extracted bovine lower incisors were randomly divided into three groups (n = 20). Angle, oblique, or transverse sections of all the teeth in a group were prepared by using a disk. The cut surfaces were scanned, and the cross-sectional areas (CSA) of the enamel and dentin were measured. Half the teeth in each group were restored by DCR (n = 10) and the other half by TFR (n = 10). The forces required to fracture the restored teeth were then measured using a Universal testing machine, and the fracture modes were analyzed (cohesive, adhesive, or mixed). Results: No statistically significant differences between the TFR and DCR restorations were detected for total and enamel CSAs in any of the restoration shapes (p >.067). The fracture forces required to break DCR angle and transverse restorations were significantly greater than for the corresponding shapes restored with TFR (p <.033). However, the difference in the forces needed to fracture oblique section restorations by DCR or TFR was not statistically significant (p =.239), despite a similar trend (143.4 ± 51 N and 120.9 ± 25 N, respectively). Conclusion: This study revealed that a greater force is required to fracture teeth restored by the DCR than by the TFR technique, especially for a transverse section. This demonstrates that restoring a fractured tooth provides a superior outcome compared to reattaching the fractured fragment.

Original languageEnglish
Pages (from-to)298-305
Number of pages8
JournalDental Traumatology
Issue number3
StateAccepted/In press - 2023


FundersFunder number
Ernst & Tova Turnhein


    • crown fracture
    • direct composite restoration
    • fracture force
    • tooth fragment reattachment


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