Simone Grandini

Simone was born on 22nd February 1970 in Florence, Italy and graduated in 1994 from the Dental School of Florence University. In 1995 he obtained a postgraduate certificate in Periodontology at the University of Genoa, Italy and in 1996 he obtained a postgraduate certificate in Restorative dentistry at the University of Florence, Italy. He was clinical instructor of Restorative Dentistry at the University of Florence (1997-1999) In 1999 he started working as visiting professor at the University of Siena, Italy. In 2002 he obtained a Master of Science in Dental Materials and Clinical applications, and in 2004 he completed his PhD studies at Siena University with the thesis “Basic and clinical aspects of selection and application of fiber posts”. Since 2005 he has been Head of Department and has the chair of Endodontics and Restorative Dentistry, at Siena University. He also teaches Restorative Dentistry and Dental Hygiene at the School of Dental Hygienists, and Preventive Dentistry at the postgraduate School of Orthodontics. Since 2010 he has been the Dean of the School of Dental Hygienists. Over the last 18 years he has given more than 250 lectures on Endodontics and Restorative dentistry in Europe, America, and Asia. He has published in many national and international journals, and is a reviewer for many peer reviewed journals.
Simone was born on 22nd February 1970 in Florence, Italy and graduated in 1994 from the Dental School of Florence University. In 1995 he obtained a postgraduate certificate in Periodontology at the University of Genoa, Italy and in 1996 he obtained a postgraduate certificate in Restorative dentistry at the University of Florence, Italy. He was clinical instructor of Restorative Dentistry at the University of Florence (1997-1999) In 1999 he started working as visiting professor at the University of Siena, Italy. In 2002 he obtained a Master of Science in Dental Materials and Clinical applications, and in 2004 he completed his PhD studies at Siena University with the thesis “Basic and clinical aspects of selection and application of fiber posts”. Since 2005 he has been Head of Department and has the chair of Endodontics and Restorative Dentistry, at Siena University. He also teaches Restorative Dentistry and Dental Hygiene at the School of Dental Hygienists, and Preventive Dentistry at the postgraduate School of Orthodontics. Since 2010 he has been the Dean of the School of Dental Hygienists. Over the last 18 years he has given more than 250 lectures on Endodontics and Restorative dentistry in Europe, America, and Asia. He has published in many national and international journals, and is a reviewer for many peer reviewed journals.

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ARTICLES PUBLISHED BY THIS AUTHOR

It is widely known that fractures of anterior teeth are common among children, particularly those aged be- tween 8 and 11. Many techniques and materials are available to restore uncomplicated fractured crowns. Porcelain veneers or jacket crowns require substantial sacrifice of dental structure. Resin composite materials guarantee a more conservative approach, and reattachment of the fragment is nowadays a reality. It is a faster procedure, with a better and longer lasting esthetic results, and an incisal margin wear that matches that of adjacent teeth. The purpose of this article is to make a critical appraisal, based on scientific and clinical evidence, of the optimal technique to reattach a fragment. Different materials (mainly dentin bonding agents, flowable composites, regular composites and dual curing resin cement), and different techniques (bevel before vs after reattachment, silicone guides vs no silicone guides) have been used for the purpose. In this article an ex-vivo study will be shown and discussed in details to understand which is the best procedure to be used in cases where a fragment is available for reattachment. Different methods and preparations have been proposed: bonding without preparation of the tooth/fragment, a V-shaped enamel notch both on the fragment and on the tooth; internal groove within the fragment and the remaining tooth; labial and circumferential bevel. These preparation techniques have sometimes been combined with a superficial overcontouring with composite over the fracture line, which may be circumferential or lingual. The reported results vary considerably, from fracture strength as high as that of sound teeth to only approximately 50% .
Fragment reattachment can be a valid alternative to a direct restoration whenever coronal fractures occur in anterior teeth. If the fragment is available, and if it fits well enough, it should be reattached to the remaining tooth structure. After the reattachment procedure the margin should be opened with a round bur to create a double bevel on the tooth and on the fragment. This procedure (described in our previous article) is also known as post-reattachment bevel, and it will ensure esthetic results together with an increased resistance to dislocation of the fragment. Tommaso, 8 years old, had a traumatic accident 2 years ago causing the fracture of tooth #2.1, which was restored in another dental office. Last August he had an additional trauma resulting in the fracture (the fragment was available) of tooth #1.1. The fragment reattachment and the margin hiding procedure had already been performed, and it was time to improve the aesthetic quality of the restoration of tooth #2.1.
When coronal fracture occurs in anterior teeth, fragment reattachment can be a valid alternative to a direct restoration. If the fragment is available, it should be kept in a liquid environment to prevent dehydration, thus allowing a more aesthetic result after the reattachment procedure. If the fragment fits well enough, it should be reattached as it is; only after the reattachment procedure the margin should be opened with a round bur to create a double bevel on the tooth and on the fragment. This procedure is also known as post-reattachment bevel, and it will ensure esthetic results together with an increased resistance to dislocation of the fragment. In a paper we published in 2011 (Evaluation of the fracture resistance of reattached incisal fragments using different materials and techniques. Chazine et al, Dent Traum 2011), the influence of the material and the technique used to reattach the fragment was evaluated using a shear bond strength test. Pure Adhesive, flowable composite, regular composite and dual curing resin cement were used to reattach 80 fragments. Another variable was the use or not of a post reattachment procedure as demonstrated in this article. The choice of material seemed to have no influence on the test, whereas a bevel performed on the buccal surface could significantly improve the Shear bond strength of the reattached fragment, independently of the material used for the reattachment procedure. Tommaso, 8 years old, had a traumatic accident 2 years ago causing the fracture of tooth #2.1, which was restored in another dental office. Last august he had an additional trauma resulting in the fracture of tooth #1.1. This time the fragment was available. In the first part of this clinical case, the fragment reattachment and the margin hiding procedure is performed. In a future article the direct restoration of #2.1 will also be described.

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