Analysis of 154 cases of teeth with cracks

By Roh BD, Lee YE.

Date: 01/2006
Journal: Dental Traumatology

Purpose:

To analyze the cracks of teeth encountered in a year in one dental hospital, and to find out the characteristic features of cracked teeth

Materials/Methods:

  • N= 154 teeth from 141 patients
  • Identification of a crack was carried out utilizing transillumination, dye application, or a bite test with a tooth sleuth or roll of rubber dam. Those diagnosed as cracked teeth were double-checked during treatment sessions. Once a crack was identified, the following information was collected about the patient: Age, gender, tooth number, restorative material, cavity classification, pulp vitality, mobility, rate of wear, direction of crack, percussion and bite tests, periodontal probing, nature of occluding tooth, chewing habit, favorite food type, direction of crack line, and treatment results.

Results:

Restorative:

  • No restoration; 60.4 %
  • Class I: 29.2 %, Class II: 9.1 %
  • 40- 50 yrs= 58%, 20s= 12.3 %, <20 no cracks
  • 77.9 % were in occlusion with intact teeth without restorations

53.9 % M:46.1 % F

Treatment:

  • 42.2 % no RCT and full veneer crown
  • 42.2 % RCT and full veneer crown
  • 13.6 % had to be extracted

Tooth:

  • 56% Max molars (33.8 % 1st and 23.4 % 2nd )
  • 36% mand molars (20.1 % 1st and 16.2 % 2nd )
  • Premolars: 4.5 % MX, 2 % MD

Clinical tests:

  • 96.1 % bite test, 57.1 % percussion positive, 44.8 % mod-severe sensitivity to ice test
  • 29.2 % ≥6 mm pocket, 29.2 % 3- 6 mm pocket, 41.6 % normal periodontal tissues; Severe wear facets in 6 teeth
  • 70.1 % M-D crack, 18.8 % B-L crack, 17 % cracked both directions

Clinical Significance:

Cracks are frequently found in non-restored or restored with minimal tooth structure removal, so all teeth must be checked for cracks carefully. The bite test is highly diagnostic.