{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:54:30Z","timestamp":1791550470454,"version":"4.3.4"},"reference-count":26,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Esthet Restor Dent"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n This systematic review aimed to compare the clinical performance and survival rates of two restorative techniques, fragment reattachment and direct composite resin restoration, in the management of complicated crown fractures in permanent anterior teeth.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n \n A comprehensive search was conducted across seven electronic databases and the gray literature, following\n PRISMA<\/jats:styled-content>\n guidelines. The methodological quality of the studies included was assessed using the\n QUIPS<\/jats:styled-content>\n tool. A meta\u2010analysis and certainty of evidence assessment (\n GRADE<\/jats:styled-content>\n approach) were conducted.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 8140 records identified, six studies met the inclusion criteria, encompassing both prospective and retrospective designs. The meta\u2010analysis suggested a significantly lower failure risk for composite restorations than for fragment reattachment (RR\u2009=\u20090.43; 95% CI: 0.24\u20130.79); no statistically significant heterogeneity was detected among the included studies (\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20090%,\n p<\/jats:italic>\n \u2009=\u20090.35), but only two studies were included. Fragment reattachment showed survival rates between 57.7% and 66.6%, whereas direct restorations achieved survival rates of up to 82.1%. Pulpal complications were more frequent in teeth with pulp exposure in cases treated with fragment reattachment. The certainty of the evidence was rated low for the primary outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Within the limitations of the present study, both restorative strategies demonstrated clinical viability; however, direct composite resin restorations showed higher survival rates and lower complication risks than fragment reattachment.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jerd.70270","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:31:18Z","timestamp":1791549078000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Success Rate of Composite Resin Restoration Versus Fragment Reattachment in Complicated Crown Fractures of Permanent Anterior Teeth: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3844-470X","authenticated-orcid":false,"given":"Emerson de Sousa","family":"Pinheiro","sequence":"first","affiliation":[{"name":"University of Bras\u00edlia Bras\u00edlia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5180-3546","authenticated-orcid":false,"given":"Rafaella Maria Vasconcelos","family":"da N\u00f3brega","sequence":"additional","affiliation":[{"name":"University of Bras\u00edlia Bras\u00edlia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5499-3966","authenticated-orcid":false,"given":"Regina Cardoso","family":"de Moura","sequence":"additional","affiliation":[{"name":"University of Bras\u00edlia Bras\u00edlia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3709-1212","authenticated-orcid":false,"given":"Fernanda Cristina Pimentel","family":"Garcia","sequence":"additional","affiliation":[{"name":"University of Bras\u00edlia Bras\u00edlia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4712-9779","authenticated-orcid":false,"given":"Cristine Miron","family":"Stefani","sequence":"additional","affiliation":[{"name":"University of Bras\u00edlia Bras\u00edlia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0280-4259","authenticated-orcid":false,"given":"Liliana Vicente Melo de Lucas","family":"Rezende","sequence":"additional","affiliation":[{"name":"University of Bras\u00edlia Bras\u00edlia Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,9]]},"reference":[{"issue":"4","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1111\/edt.12574","article-title":"International Association of Dental Traumatology Guidelines for the Management of Traumatic Dental Injuries: General Introduction","volume":"36","author":"Levin L.","year":"2020","journal-title":"Dental Traumatology"},{"issue":"1","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/adj.12395","article-title":"Epidemiology and Outcomes of Traumatic Dental Injuries: A Review of the Literature","volume":"61","author":"Lam R.","year":"2016","journal-title":"Australian Dental Journal"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1007\/s00784-020-03344-y","article-title":"Treatment Outcomes After Uncomplicated and Complicated Crown Fractures in Permanent Teeth","volume":"25","author":"Bissinger R.","year":"2021","journal-title":"Clinical Oral Investigations"},{"issue":"2","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/edt.12389","article-title":"World Traumatic Dental Injury Prevalence and Incidence, a Meta\u2010Analysis: One Billion Living People Have Had Traumatic Dental Injuries","volume":"34","author":"Petti S.","year":"2018","journal-title":"Dental Traumatology"},{"key":"e_1_2_10_6_1","doi-asserted-by":"crossref","DOI":"10.1155\/2021\/5587431","article-title":"Prevalence and Etiological Factors of Dental Trauma Among 12\u2010 and 15\u2010Year\u2010Old Schoolchildren of Lebanon: A National Study","volume":"2021","author":"Abdel Malak C.","year":"2021","journal-title":"Scientific World Journal"},{"issue":"4","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1111\/edt.12578","article-title":"International Association of Dental Traumatology Guidelines for the Management of Traumatic Dental Injuries: 1. Fractures and Luxations","volume":"36","author":"Bourguignon C.","year":"2020","journal-title":"Dental Traumatology"},{"issue":"2","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0172235","article-title":"Impact of Traumatic Dental Injuries on Oral Health\u2010Related Quality of Life of Preschool Children: A Systematic Review and Meta\u2010Analysis","volume":"12","author":"Borges T. S.","year":"2017","journal-title":"PLoS One"},{"issue":"3","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1111\/edt.12392","article-title":"Tooth Fragment Reattachment Techniques: A Systematic Review","volume":"34","author":"Garcia F. C. P.","year":"2018","journal-title":"Dental Traumatology"},{"issue":"1","key":"e_1_2_10_10_1","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/edt.12602","article-title":"Fragment Reattachment After Complicated Crown\u2010Root Fractures of Anterior Teeth: A Systematic Review","volume":"37","author":"Khandelwal P.","year":"2021","journal-title":"Dental Traumatology"},{"issue":"3","key":"e_1_2_10_11_1","first-page":"59","article-title":"Survival of Reattached Tooth Fragment: A Systematic Review","volume":"8","author":"Ajayi D. 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