Long-term Survival of Fragment Bonding in the Treatment of Fractured Crowns: a Multicenter Clinical Study

In three Scandinavian dental facilities, a series of 334 permanent incisors with fractures of the crown or crown and root was treated by reattachment of the fragment with a resin composite. Two centers (Oslo and Stockholm) employed acid etching of enamel alone for fragment bonding (n = 146), while the third center (Copenhagen) used a combination of enamel etching and dentinal bonding (n = 188). Although the final retention rate of fragment bonding was similar in the two groups, it took the dentinal bonding group almost three times as long to drop to 50% fragment retention. This difference could be attributed to greater bonding strength in the dentinal bonding group, greater risk of second injury in the younger acid-etching group, or difficulty in maintaining a dry operative field in the younger age group. The good fragment retention, acceptable esthetics, and pulpal vitality observed in the present series indicate that reattachment of the coronal fragment is a realistic alternative to placement of conventional resin-composite restorations.