Cracked tooth syndrome. Part 2: restorative options for the management of cracked tooth syndrome

Banerji, Subir; Mehta, Shamir B.; Millar, Brian

doi:10.1038/sj.bdj.2010.496

Cited by 50 publications

(36 citation statements)

References 34 publications

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“…A previous National Dental practicebased research network (PBRN) study found that the most common reason for treatment planning a crown was a tooth with a crack or fracture. 11 Many treatments have been suggested for cracked teeth, ranging from short-term treatment directed at pain relief and aiding in diagnosis such as occlusal adjustment, sedative restoration, placement of an orthodontic band or interim crown, [6][7][8][9] or a direct composite onlay splint 3 to definitive restorations including direct resin composite, 6 indirect resin composites, 4 and crowns. 5 The clear preference found in this study was a crown.…”

Section: Discussionmentioning

confidence: 99%

“…Various procedures have been suggested either to aid in the diagnosis or treatment of a cracked tooth, including occlusal adjustment, sedative interim restorations, placement of orthodontic bands, interim crowns, direct or indirect composite resin restorations, complex and bonded amalgam restorations, and partial and complete indirect crowns. [3][4][5][6][7][8][9][10][11][12] In a practice-based study in which 1777 dentists were presented with various clinical scenarios, the presence of a crack or fracture was the factor most likely to result in the dentist recommending a crown. 11 Another study presented 95 dentists (generalists, prosthodontists, and endodontists) with 4 different clinical cracked tooth scenarios and asked what treatment they would recommend.…”

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confidence: 99%

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Recommended treatment of cracked teeth: Results from the National Dental Practice-Based Research Network

Hilton

Funkhouser

Ferracane

et al. 2020

The Journal of Prosthetic Dentistry

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Statement of problem. Despite the high prevalence of posterior cracked teeth, questions remain regarding the best course of action for managing these teeth. Purpose. The purpose of this clinical study was to identify and quantify the characteristics of visible cracks in posterior teeth and their association with treatment recommendations among patients in the National Dental Practice-Based Research Network. Material and methods. Network dentists enrolled patients with a single, vital posterior tooth with at least 1 observable external crack. Data were collected at the patient, tooth, and crack levels, including the presence and type of pain and treatment recommendations for subject teeth. Frequencies according to treatment recommendation were obtained, and odds ratios (ORs) comparing recommendations for the tooth to be restored versus monitored were calculated. Stepwise regressions were performed using generalized models to adjust for clustering; characteristics with P<.05 were retained. Results. A total of 209 dentists enrolled 2858 patients with a posterior tooth with at least 1 crack. Mean ±standard deviation patient age was 54 ±12 years; 1813 (63%) were female, 2394 (85%) were non-Hispanic white, 2213 (77%) had some dental insurance, and 2432 (86%) had some college education. Overall, 1297 (46%) teeth caused 1 or more of the following types of pain: 1055 sensitivity to cold, 459 biting, and 367 spontaneous. A total of 1040 teeth were recommended for 1 or more treatments: restoration (n=1018; 98%), endodontics (n=29; 3%), endodontic treatment and restoration (n=20; 2%), extraction (n=2; 0.2%), and noninvasive treatment, for example, occlusal device, desensitizing (n=11; 1%). The presence of caries (OR=67.3), biting pain (OR=7.3), and evidence of a crack on radiographs (OR=5.0) were associated with over 5-fold odds of recommending restoration. Spontaneous pain was associated with nearly 3-fold odds; pain to cold, having dental insurance, a crack that was detectable with an explorer or blocked transilluminated light, or connected with a restoration were each weakly associated with increased odds of recommending a restoration (OR<2.0). Conclusions. Approximately one-third of cracked teeth were recommended for restoration. The presence of caries, biting pain, and evidence of a crack on a radiograph were strong predictors of recommending a restoration, although the evidence of a crack on a radiograph only accounted for a 3% absolute difference (4% recommended treatment versus 1% recommended monitoring).

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Recommended treatment of cracked teeth: Results from the National Dental Practice-Based Research Network

Hilton

Funkhouser

Ferracane

et al. 2020

The Journal of Prosthetic Dentistry

View full text Add to dashboard Cite

show abstract

“…If a dentist decides to permanently restore a cracked tooth with a direct restoration,[ 24 58 59 60 61 ] the dentist may want to adjust[ 62 63 64 ] the bio-mechanical circumstances of the tooth to increase the tooth's resistance to further cracking. If the dentist decides to crown[ 65 66 ] the tooth, the dentist may also want to adjust the tooth to stabilize the tooth bio-mechanically in the days or weeks prior to the crown preparation appointment. Such stabilization may be accomplished by reducing, on the cracked tooth, the steep inclines[ 67 ] of any nonfunctional or guiding cusps that are in deep overbite with opposing teeth (ideally without exposing dentin), or smoothing the pointy plunger cusps of opposing teeth that are occluding into the cracked tooth, to reduce tensile forces on the tooth.…”

Section: Direct Versus Cuspal Coverage Restoration Of Cracked Teethmentioning

confidence: 99%

Cracked tooth diagnosis and treatment: An alternative paradigm

Mamoun¹,

Napoletano²

2015

Eur J Dent

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This article reviews the diagnosis and treatment of cracked teeth, and explores common clinical examples of cracked teeth, such as cusp fractures, fractures into tooth furcations, and root fractures. This article provides alternative definitions of terms such as cracked teeth, complete and incomplete fractures and crack lines, and explores the scientific rationale for dental terminology commonly used to describe cracked teeth, such as cracked tooth syndrome, structural versus nonstructural cracks, and vertical, horizontal, and oblique fractures. The article explains the advantages of high magnification loupes (×6–8 or greater), or the surgical operating microscope, combined with co-axial or head-mounted illumination, when observing teeth for microscopic crack lines or enamel craze lines. The article explores what biomechanical factors help to facilitate the development of cracks in teeth, and under what circumstances a full coverage crown may be indicated for preventing further propagation of a fracture plane. Articles on cracked tooth phenomena were located via a PubMed search using a variety of keywords, and via selective hand-searching of citations contained within located articles.

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“…[27] The gold overlays were reported to have 89% survival rate over 5 years. [28] However, patients might object to the metal color, especially if the tooth lies in the esthetic zone of the patient.…”

Section: Clinical Results One Week 3 Months 6 Months Movement Of the mentioning

confidence: 99%

Restoration of Endodontically Treated Teeth With Different Crowns: A Comparative Study

Raman

Kumar

Jain

2019

IJMBS

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The optimal way to restore teeth after endodontic treatment continues to remain a controversial topic of heated debate to this day. Endodontically treated teeth (ETT) present with significantly different mechanical properties compared to vital teeth. The modifications in the biomechanical properties and structural integrity of the teeth are most-likely attributed to the volumetric loss of the hard tissues, extent of carious lesion, fracture propagation, final cavity preparation in addition to the access cavity prior to endodontic therapy. Hence based on above findings the present study was planned for comparative evaluation of Restoration of Endodontically Treated Teeth with Different Crowns. The study was planned in Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar. The 60 cases of the Endodontically treated teeth (ETT) were enrolled in the present study. The patients were divided in the 4 groups as per different material and restorations given. The survival of ETT is contingent on the residual sound tooth structure that remains after the endodontic access and caries removal are performed consequently the most important factors upon restoring ETT become the maximum preservation and conservation of enamel, dentin and the dentinoenamel junction. Hence, bonded partial restorations are always preferred over full coverage cementable crowns. More clinical studies comparing adhesive crowns bonded to postless build-ups or post and -core build-ups are needed for a better understanding of postless approaches in biomimetic restorative dentistry. Keywords: Endodontically treated teeth, Crown, cores, post, etc.

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Cracked tooth syndrome. Part 2: restorative options for the management of cracked tooth syndrome

Cited by 50 publications

References 34 publications

Recommended treatment of cracked teeth: Results from the National Dental Practice-Based Research Network

Recommended treatment of cracked teeth: Results from the National Dental Practice-Based Research Network

Cracked tooth diagnosis and treatment: An alternative paradigm

Restoration of Endodontically Treated Teeth With Different Crowns: A Comparative Study

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