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Case Reports in Dentistry

Volume 2015, Article ID 138474, 9 pages
http://dx.doi.org/10.1155/2015/138474

Case Report
Biological Restoration of a Fractured Anterior Tooth with the
Use of Dentine Pin (Biopins)

Lilian Capanema Nogueira,1 Karine Tas Aguiar Tavano,1,2,3 Nayara Kelly Lyrio Ferraz,1
Jos Cristiano Ramos Glria,3 and Adriana Maria Botelho3,4
1
The Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
2
The Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG, Brazil
3
The Federal University of the Jequitinhonha and Mucuri Valleys (UFVJM), Diamantina, MG, Brazil
4
The Bauru Dental College, Federal University of Sao Paulo, Sao Paulo, SP, Brazil

Correspondence should be addressed to Karine Tas Aguiar Tavano; ktavano@gmail.com

Received 13 October 2015; Revised 22 November 2015; Accepted 23 November 2015

Academic Editor: Andrea Scribante

Copyright 2015 Lilian Capanema Nogueira et al. This is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is
properly cited.

This case study describes the esthetic and functional reconstruction of a fractured maxillary central incisor. Due to the requirement
for additional retention, treatment was performed using the homogenous technique of biological restoration associated with
cementation of posts made from human dentin (biopins). This type of treatment is a new alternative to conventional techniques
and favors the dental esthetic and function, as well as biocompatibility, and is an inexpensive procedure.

1. Introduction
Dental trauma occurs quite frequently and principally affects
children and adolescents [1, 2]. The maxillary central incisors
are the most susceptible teeth to fractures because of their
vulnerable position in the dental arch [3, 4]. Traumatic
injuries cause a significant impact on the quality of life of
children in terms of physical and psychological discomfort
and have the potential to negatively affect social relationships
[5, 6].
Depending on the type and extent of the trauma, the
reestablishment of the esthetic and function of a fractured
tooth can be performed using a number of restorative meth-
ods: composite resin restorations and ceramic restorations,
with or without additional retentions (intracanal or dental
posts) [7, 8]. Whenever possible, the most commonly recom-
mended technique is autogenous or homogenous fragment
bonding [9, 10]. Fragment bonding is a procedure that can
be labeled as biological restoration, consisting of the use
of fragments of the fractured tooth (autogenous bonding) or
fragments obtained from an extracted tooth (homogenous
bonding) [11, 12]. This technique allows reestablishment of
the dental element with its original characteristics and the
maintenance of occlusion in natural teeth and is inexpensive
and has a positive psychological effect, since the social
and emotional well-being of the patient and their family is
restored [1315].
Restorative dental materials have reached high levels of
development and stability although there is no material in
existence that completely meets the requirements to restore
the loss of tooth structure in terms of plastics, esthetics, and
functionality [16, 17]. Whenever possible, fragment bonding
is the most adequate restoration technique for fractured
anterior teeth. The result is esthetically satisfactory in terms
of translucence, opalescence, fluorescence, and the texture of
the natural surface [18, 19].
When the remainder of the tooth is not sufficient to retain
the fragment or the restorative material, it is necessary to use
additional resources for retention in both vital and devitalized
teeth [20]. It is possible to use prefabricated cemented,
rubbed, or screwed interdental posts for devitalized teeth [21].
Cement posts are the most commonly used as they do not
cause tension in the dentin [21]. Interdental posts of human
dentin or biopins are one possible option for permanent
2 Case Reports in Dentistry

(a) (b)

Figure 1: (a) Initial clinical aspect. (b) Initial radiographic aspect.

(a) (b)

(c) (d)

Figure 2: (a), (b) Initial clinical aspect, close-up. (c) and (d) Malocclusion in laterality.

anterior vital teeth that require additional retention [22].
Biopins provide a greater level of retention and stability in
vital teeth and also have the following advantages: biocom-
patibility; resilience; coefficient of thermal expansion similar
to dental element; being esthetically favorable; production of
fewer cracks in the dentin; and being inexpensive [23].
An ex vivo study demonstrated a significant increase in
fracture resistance among teeth restored with experimental
dentin posts in comparison to teeth restored with fiber-
reinforced composite posts. This suggests the possible rein-
forcing potential of the dentin post. However, there are no
existing studies that test the effectiveness of dentine pins [24].
The aim of the present case study was to describe
a new homogenous fragment bonding technique for vital
teeth, associated with the cementation of interdental posts
produced with human dentin (biopins).
2. Case Study
A nine-year-old girl attended the dental clinic of the Univer-
sidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM),
Diamantina, MG (Brazil), exhibiting a fracture in the middle
third of the crown of tooth 21 (Figures 1(a), 2(a), and 2(b)).
The guardian reported that the child had undergone previ-
ous unsuccessful treatments. The restorations had loosened
during protrusive movements in the two years since the
treatment. Clinical and radiographic examinations revealed
fractured enamel and dentin without pulp involvement.
Since the child did not have the original fragment, a
homogenous biological restoration procedure was proposed,
associated with the use of dentine pins (biopins) in order to
increase the retention of the fragment to the remainder of
the tooth. The technique was explained in terms of esthetics,
functional, and hygienic characteristics, and the guardian
signed an informed statement of consent.
The technique was executed during two separate sessions.
After anamnesis and clinical and radiographic examination,
an assessment of the color and the incisal guides (Figures
2(c) and 2(d)), upper and lower arch molding was performed,
as well as casting of the mold with a special type of plaster
(Durone Tipo IV, Dentsply, Brazil) to enable the cutting of the
tooth fragment and the production of the dentine pins in the
laboratory.
An extracted tooth of the same size, shape, and color
as tooth 21 (Figure 3) was used to cut the dental fragment
and in the subsequent homogenous bonding. The tooth to be
Case Reports in Dentistry
(a)
(c)
(e)
Figure 3: (a) Selected extracted central incisor. (b), (c) Mesiodistal measurement of the extracted tooth. (d), (e) Mesiodistal measurement of
the remaining tooth in the laboratory.
used in the homogenous restoration was sterilized in moist
heat at 121 C for 15 minutes [16]. The cutting of the dental
fragment and the biopins was performed under extreme
refrigeration with diamond burs (Figure 4). Figure 5(a)
displays the production process of the biopins, which was
performed by cutting a coronal slice, following the transverse
direction of the tooth, in order that the dentinal tubules were
perpendicular along the axis of the pin. These were then
separated until a cylindrical shape of approximately 1 mm
diameter and 4 mm length was obtained (Figure 5(b)).
After the cutting and adaptation of the restorative frag-
ment to the model (Figure 4), a drilling simulation was
performed to place the biopins in the plaster die (Figure 6(a))
and in the fragment (Figure 6(d)), using a spherical bur (1 mm
diameter and a depth of 2 mm) with a low rotation. This was
to simulate what would be performed at a later stage with the
remainder of the tooth.
3
(b)
(d)
In the second clinical session, perforation of the remain-
der of the tooth was conducted, through absolute isolation,
for the cementation of the biopins with a spherical bur
of 1 mm diameter (Figure 7(a)). Subsequently, conditioning
treatment with phosphoric acid (37%) was performed for 30
seconds in enamel and for 15 seconds in dentin from the
fragment, from the remainder of the tooth, and from the
biopins (Figure 7). This was followed by application of the
adhesive system (Adper Single Bond 2, 3M ESPE, Brazil)
and photopolymerization for 20 seconds (Figure 7). After
conditioning, the biopins were cemented to the dentin with
FLOW resin of color A2 (Vigodent, 3M ESPE, Rio de Janeiro,
Brazil) and photopolymerized for 40 seconds (Figures 8(a)
and 8(b)). Subsequently, the dental fragment was embedded
in the dentine pins, cemented with FLOW resin A2 (Figures
8(c) and 8(d)), and photopolymerized for 40 seconds on all
sides (Figure 8(f)).
4 Case Reports in Dentistry

(a) (b)

(c) (d)

Figure 4: (a) Cut of the dental element to obtain the restorative fragment. (b) Cut of dental fragment. (c) Adaptation of the fragment to the
plaster model, vestibular view. (d) Adaptation of the fragment to the plaster model, palatal view.

(a) (b)

Figure 5: (a) Dental slice cut to obtain the dentinal pins, with outline showing the area from which they were obtained. (b) Dentinal biopins.

After the cementation of the dental fragment (Figure 9),
occlusal adjustment was carried out. Seven days after the
conclusion of the homogenous bonding of the fragment,
the bevel was constructed at the apparent bond line, with
spherical diamond bur number 1014. This was done using
light-cured composite resin A1 (Z250, ESPE, USA) in order
to produce a satisfactory esthetic result. The newly restored
dental surface was then finished and polished (Figure 10).
The child and their guardian were instructed regarding
hygiene, diet, and the need for regular monitoring to preserve
the esthetics and functional conditions. Figure 10(c) displays
the aspects of the restoration after one year of clinical follow-
up (Figure 11).
3. Discussion
The clinical decision regarding the restorative procedure
selected for fractured teeth directly affects the treatment
prognosis and requires a careful assessment of different
factors, such as the extent and pattern of the fracture,
the endodontic involvement, and the possibility of using
the fragment in the bonding process [25]. In the present
Case Reports in Dentistry
(a)
(c)
(e)
Figure 6: (a) Simulated holes in the model for placement of the biopins. (b) Biopins in place, incisal view. (c) Biopins in place, vestibular view.
(d) Holes made in the fragment for adaptation of the biopins. (e) Laboratory sample of the fragment to the biopins. (f) Fragment suitably
adapted to the plaster model.
case study, homogenous bonding was selected since it was
impossible to perform autogenous bonding as the patient no
longer had the dental fragment. The association of biopins
with homogenous bonding was conducted in an attempt
to improve retention of the fragment to the remainder
of the tooth. The shape, location, and number of biopins
fundamentally depend on the extent of the cavity preparation,
the vestibulolingual volume, and the position of the tooth in
the arch [8]. The alternative to biopins would be metallic posts
threaded in dentin. However, there are disadvantages in using
these metallic posts, such as the greater risk of perforating
the pulp chamber, inflammatory responses of the pulp, and
cracks in the dentin [26].
5
(b)
(d)
(f)
In previous studies, the dentin post closely resembled
root dentin in all physical properties, such as the modulus
of elasticity, viscoelastic behavior [24], compressive strength
[25], and thermal expansion [26]. Furthermore, dentin has
been found to be tougher than most of the other current
restorative materials [27]. A dentin post forms a microme-
chanical homogenous unit with the root dentin, resulting
in uniform stress distribution [28, 29]. The similarity in
elasticity of a dentin post to root dentin may allow post
flexion to mimic tooth flexion so that the post acts as a shock
absorber, transmitting only a fraction of the stresses placed
on the tooth to the dentinal walls [30]. It is possible that these
properties are also applicable to biopins. However, laboratory
6 Case Reports in Dentistry

(a) (b) (c)

(d) (e) (f)

Figure 7: (a) Sample of the biopins in the holes made in the remaining tooth. (b) Acid conditioning of remaining tooth. (c) Acid conditioning
of dental fragment. (d) Acid conditioning of the biopins. (e) Application of the primer/adhesive on the remaining teeth. (f) Application of
the primer/adhesive in the biopins and dental fragment.

(a) (b)

(c) (d)

Figure 8: Continued.
Case Reports in Dentistry 7

(e) (f)

Figure 8: Cemented biopins in the remaining tooth. (a) Vestibular view. (b) Incisal view. (c) Clinical sample of the dental fragment. (d)
Fragment adapted to the remaining tooth. (e) Vestibular aspect after bonding the vestibular fragment. (f) Palatal aspect after bonding the
fragment.

(a) (b)

(c) (d)

Figure 9: (a) Clinical aspect of the restoration after removal of the absolute isolation. (b) Clinical aspect in protrusion. (c) and (d) Clinical
aspects in laterality.

studies should be performed to test the fracture resistance of
fragments and of composite resin restorations associated with
biopins.
In the present case study, it was confirmed that the
child had already undergone a number of composite resin
restorative procedures. These were unsuccessful due to the
fact that the patient did not yet have complete permanent
dentition. The guides and occlusion were not mutually
protected, which led to pressure during jaw movements that
could have compromised the stability of prior restorations.
After one year of monitoring, the fragment and tooth had
correctly adapted their functionality with excellent results in
terms of smoothness, esthetic, and maintenance of the incisor
guide, as well as physiological and natural characteristics of
the dental structure.
In the present case study, the pulp chamber was obliter-
ated with reactionary dentin, which improved the possibility
of success of the retention technique using biopins. The use
of this technique in young patients is significant, since the
volume of pulp is an important contraindication [25].
In spite of the previously mentioned advantages of using
biopins, it is important to refer to a number of their
limitations: there is the difficulty of acquisition of extracted
teeth; they are difficult to create due to the reduced size; and
there is a possibility of perforating the pulp chamber during
completion of the technical preparation of the pin hole.
8 Case Reports in Dentistry
(a)
(c)
Figure 10: (a) Initial clinical aspect. (b) Clinical aspect shortly after bonding. (c) Final radiographic aspect.
Figure 11: Clinical aspect after 12 months.
With regard to the ethical aspect, it is necessary to clarify
to the patient and/or the parents/guardians that the post is
made from duly donated and properly sterilized extracted
teeth, thus preventing biosecurity risks. However, a tooth
fragment obtained from another patient may be rejected,
which is a disadvantage of this technique. The teeth used
in biological restoration procedures can be obtained from
human teeth banks or from nonprofit institutions, which
store and provide teeth for didactic, clinical, and scientific use
[31]. The low number of human teeth banks and the limited
dissemination of the technique make this an uncommon
routine in dental practice [15].
(b)
The technique of biological restoration associated with
the use of pins created from human dentin (biopins) is
another alternative among the different treatment options
for vital teeth. This technique is inexpensive and exhibits
excellent biocompatibility, as well as maintaining the char-
acteristics of tooth structure such as smoothness, surface
brightness, texture, hardness, size, shape, color, resistance,
and, consequently, functionality and esthetic.
However, this is a little known technique, and there are
very few studies reporting its use in the literature. Therefore,
further studies are necessary which demonstrate the mechan-
ical properties of biological restorations and biopins, as well
as assessing and monitoring long-term clinical cases.
Conflict of Interests
The authors declare that there is no conflict of interests
regarding the publication of this paper.
Acknowledgment
The authors would like to thank Professor Dr. Maria Letcia
Ramos Jorge for assistance in drafting the present study.
References
[1] G. Rappelli, C. Massaccesi, and A. Putignano, Clinical pro-
cedures for the immediate reattachment of a tooth fragment,
Dental Traumatology, vol. 18, no. 5, pp. 281284, 2002.
Case Reports in Dentistry
[2] B. Rubel and E. E. Hill, Replacement of maxillary permanent
central incisors lost due to trauma in the mixed-dentition, The
Journal of the Michigan Dental Association, vol. 97, no. 4, pp. 50
78, 2015.
[3] E. A. V. Maia, L. N. Baratieri, M. A. C. De Andrada, S. Monteiro
Jr., and E. M. De Araujo Jr., Tooth fragment reattachment: fun-
damentals of the technique and two case reports, Quintessence
International, vol. 34, no. 2, pp. 99107, 2003.
[4] R. Rajesh, K. Baroudi, K. B. Reddy, B. H. Praveen, V. S. Kumar,
and S. Amit, Modified anchor shaped post core design for
primary anterior teeth, Case Reports in Dentistry, vol. 2014,
Article ID 306910, 4 pages, 2014.
[5] M. L. Ramos-Jorge, L. S. Marques, S. M. Pavia, J. M. Serra-
Negra, and I. A. Pordeus, Predictive factors for child behaviour
in the dental environment, European Archives of Paediatric
Dentistry, vol. 7, no. 4, pp. 253257, 2006.
[6] M. I. De Souza Cortes, W. Marcenes, and A. Sheiham, Impact
of traumatic injuries to the permanent teeth on the oral health-
related quality of life in 1214-year-old children, Community
Dentistry and Oral Epidemiology, vol. 30, no. 3, pp. 193198,
2002.
[7] F. M. Andreasen, E. Flugge, J. Daugaard-Jensen, and E. C.
Munksgaard, Treatment of crown fractured incisors with lam-
inate veneer restorations. An experimental study, Endodontics
& Dental Traumatology, vol. 8, no. 1, pp. 3035, 1992.
[8] S. Segerstrom, J. Astback, and K. Ekstrand, A retrospective long
term study of teeth restored with prefabricated carbon fiber
reinforced epoxy resin posts, Swedish Dental Journal, vol. 30,
no. 1, pp. 18, 2006.
[9] A. Pagliarini, R. Rubini, M. Rea, and M. Campese, Crown
fractures: effectiveness of current enamel-dentin adhesives in
reattachment of fractured fragments, Quintessence Interna-
tional, vol. 31, no. 2, pp. 133136, 2000.
[10] F. F. Demarco, F. R. R. De Moura, S. B. C. Tarquinio, and F.
G. Lima, Reattachment using a fragment from an extracted
tooth to treat complicated coronal fracture: case report, Dental
Traumatology, vol. 24, no. 2, pp. 257261, 2008.
[11] L. N. Baratieri, S. Monteiro Junior, M. A. C. Andrada, L. C. C.
Vieira, A. C. Cardoso, and A. V. Ritter, Estetica: Restauracoes
Adesivas Diretas em Dentes Anteriores Fraturados, Livraria
Editora Santos, Sao Paulo, Brazil, 1995.
[12] M. Manju, S. L. Shanthraj, K. C. Savitha, and N. Sethi, Esthetic
and biologic mode of reattaching incisor fracture fragment
utilizing glass fiber post, Journal of Natural Science, Biology and
Medicine, vol. 6, no. 2, pp. 446448, 2015.
[13] K. T. A. Tavano, A. M. Botelho, T. P. Motta, and T. M.
O. Paes, Biological restoration: total crown anterior, Dental
Traumatology, vol. 25, no. 5, pp. 535540, 2009.
[14] P. Correa-Faria, C. E. P. De Alcantara, M. V. Caldas-Diniz, A. M.
Botelho, and K. T. A. Tavano, Biological restoration: root canal
and coronal reconstruction, Journal of Esthetic and Restorative
Dentistry, vol. 22, no. 3, pp. 168177, 2010.
[15] C. E. P. de Alcantara, P. Correa-Faria, W. A. Vasconcellos,
and M. L. Ramos-Jorge, Combined technique with dentin
post reinforcement and original fragment reattachment for the
esthetic recovery of a fractured anterior tooth: a case report,
Dental Traumatology, vol. 26, no. 5, pp. 355358, 2010.
[16] J. C. P. Imparato, Banks of Human Teeth, Editora Maio, Curitiba,
Brazil, 2003 (Portuguese).
9
[17] B. Celikten, C. F. Uzuntas, R. Safaralizadeh, G. Demirel, and S.
Sevimay, Multidisciplinary approach for the treatment of hor-
izontal root-fractured maxillary anterior teeth, Case Reports in
Dentistry, vol. 2014, Article ID 472759, 7 pages, 2014.
[18] R. J. Hedge, Tooth fragment reattachmentan aesthetic alter-
native: report of case, Journal of the Indian Society of Pedodon-
tics and Preventive Dentistry, vol. 21, pp. 117119, 2003.
[19] G. Lehl and R. Luthra, Reattachment of fractured fragments
of maxillary central incisorsreport of a case, Journal of the
Indian Society of Pedodontics and Preventive Dentistry, vol. 22,
no. 2, pp. 5455, 2004.
[20] T. Attin, E. Hellwig, R. D. Hilgers, and U. Zimmermann, Frac-
ture toughness of pin-retained class 4 restorations, Operative
Dentistry, vol. 19, no. 3, pp. 110115, 1994.
[21] J. A. Muhlbauer, W. J. Dunn, H. W. Roberts, and D. F. Mur-
chison, The effect of resin composite pins on the retention of
class IV restorations, Operative Dentistry, vol. 27, no. 3, pp. 284
288, 2002.
[22] J. Aksornmuang, R. M. Foxton, M. Nakajima, and J. Tagami,
Microtensile bond strength of a dual-cure resin core material
to glass and quartz fibre posts, Journal of Dentistry, vol. 32, no.
6, pp. 443450, 2004.
[23] L. F. Valandro, M. Ozcan, R. M. de Melo et al., Effect of silica
coating on flexural strength of fiber posts, International Journal
of Prosthodontics, vol. 19, no. 1, pp. 7476, 2006.
[24] A. Kathuria, M. Kavitha, and S. Khetarpal, Ex vivo fracture
resistance of endodontically treated maxillary central incisors
restored with fiber-reinforced composite posts and experimen-
tal dentin posts, Journal of Conservative Dentistry, vol. 14, no.
4, pp. 401405, 2011.
[25] S. Olsburgh, T. Jacoby, and I. Krejci, Crown fractures in the
permanent dentition: pulpal and restorative considerations,
Dental Traumatology, vol. 18, no. 3, pp. 103115, 2002.
[26] D. A. Felton, E. L. Webb, B. E. Kanoy, and C. F. Cox, Pulpal
response to threaded pin and retentive slot techniques: a pilot
investigation, The Journal of Prosthetic Dentistry, vol. 66, no. 5,
pp. 597602, 1991.
[27] J. J. Lee, A. Mettey-Marbell, A. Cook Jr., L. A. F. Pimenta, R.
Leonard, and A. V. Ritter, Using extracted teeth for research.
The effect of storage medium and sterilization on dentin bond
strengths, The Journal of the American Dental Association, vol.
138, no. 12, pp. 15991603, 2007.
[28] K. Attam, S. Talwar, S. Yadav, and S. Miglani, Comparative
analysis of the effect of autoclaving and 10% formalin storage
on extracted teeth: a microleakage evaluation, Journal of
Conservative Dentistry, vol. 12, no. 1, pp. 2630, 2009.
[29] F. M. Andreasen, J. G. Noren, J. O. Andreasen, S. Engelhardtsen,
and U. Lindh-Stromberg, Long-term survival of fragment
bonding in the treatment of fractured crowns: a multicenter
clinical study, Quintessence International, vol. 26, no. 10, pp.
669681, 1995.
[30] A. J. Ayers, How enamel preparations aid in retention of etched
resin restorations as compared to pin retain resins, The Arizona
Dental Journal, vol. 22, no. 3, pp. 3941, 1976.
[31] A. C. D. S. Nassif, F. Tieri, P. A. da Ana, S. B. Botta, and J. C. P.
Imparato, Structuralization of a human teeth bank, Pesquisa
Odontologica Brasileira, vol. 17, pp. 7074, 2003.
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