 Introduction Dental injuries are very common, and up to 30% of children injure their primary teeth. These injuries become common again in the mid- elementary school years (ages 8 to 10) as children join sports teams and become more independently active outdoors (eg, bicycles, playgrounds, trampolines).

The most common injury site is the maxillary (upper) central incisors, which account for more than 50% of all dental injuries. Oral injuries typically result from falls (most common), bike and car accidents, sports-related injuries

 There are various treatment options in sports related injuries like direct composite veneers, porcelain laminate veneers,removable partial dentures, dental bridges, dental crowns, reimplantation of avulsed tooth

 Discoloured teeth due to pulp damage, intrusion, extrusion and even total luxation of the teeth and broken or fractured teeth

There are 5 basic types of tooth fracture: 1. Infraction: incomplete fracture (crack) of the enamel without loss of tooth structure. 2. Uncomplicated Crown fracture: an enamel fracture or an enamel-dentin fracture that does not involve the pulp. 3. Complicated Crown fracture: an enamel-dentin fracture with pulp exposure. 4. Crown/root fracture: an enamel, dentin, and cementum fracture with or without pulp exposure. 5. Root Fracture: a dentin and cementum fracture involving the pulp

 Reattachment of fractured tooth fragments can provide  good and long-lasting esthetics (because the tooth’s original anatomic form, color, and surface  texture are maintained). It also restores function, provides a positive psychological response, and  is a relatively simple procedure. Patient cooperation and understanding of the limitations of the  treatment is of most importance for good prognosis.

 A particular challenge is the restoration of fractured segments to match form and color so as to be indistinguishable from the real thing. Direct composite restorations are the most.  popular anterior esthetic restorative materials as they provide excellent esthetics, mechanical properties and also conserve healthy tooth structure

 Treatment :composite build up of the fractured segment by using composite resins.  During the recall appointment, an assessment of the stability and longevity of the restoration perform. Color stability, surface staining, or fracture of the composite build-up material were evaluated and found to be acceptable. The patient had no complaints about the restoration

 Reattachment of fractured tooth fragments offers a viable restorative option for the clinician  because it restores tooth function and esthetics with the use of a very conservative and cost-effective

 Several factors influence the management of coronal tooth fractures,  including extent of fracture (biological width violation, endodontic  involvement, alveolar bone fracture), pattern of fracture and restorability of fractured tooth (associated root fracture),  presence/absence of secondary trauma injuries (soft tissue status),  fractured tooth fragment and its condition for use (fit between  fragment and the remaining tooth structure), occlusion, esthetics,finances, and prognosis

 Prior to giving composite restorations, it is mandatory to have good preoperative photographs and accurate shade selection for best results. Shade guides should be used under proper natural light and shade selection should go well with patient ‟ s complexion and age.

 Sports injuries to the mouth and oral environment can be disfiguring and costly, both financially and in terms of athletes' time away from school, work or training. Sports-related injuries to the mouth can become expensive, depending upon the nature and extent of the trauma. Fortunately, many sports-related injuries to the mouth can be easily prevented with properly designed mouth guard protection

There are 3 types of mouth guards: 1. Stock. 2. Mouth-formed, or “boil-and-bite.” 3. Custom fit. 28

These pre-formed, over-the-counter, ready-to-wear mouth guards are generally the least comfortable and, therefore, the least likely to be worn. Because of poor fit, they also offer the least protection and require constant biting down to stay in place. 29

Made of thermoplastic material that conforms to the shape of the teeth after being placed in hot water, these mouth guards are commercially available and the most common type used by athletes. They vary in fit, comfort, and protection.

This type of mouth guard must be made by a dentist for the individual. It is the most expensive, but also offers the most protection and comfort. Custom mouth guards are preferred by dentists and usually preferred by athletes because of their increased comfort, wear-ability, and retention, as well as ease of speaking when worn. This type of mouth guard is particularly important for adolescents with orthodontic appliances. 31