Analysis of Factors Associated with Cracked Teeth

By Seo DG, Yi YA, Shin SJ, Park JW

Date: 01/2012
Journal: JOE

Purpose:

To analyze the characteristics, distribution, and associated factors of longitudinal fractured teeth according to AAE criteria

 

Materials/Methods:

  • N= 107 teeth from 103 pts with longitudinal cracks (vital teeth) or fractures (endo-treated).
  • Testing with Tooth Sleuth, roll of rubber, or a cotton roll and ice stick. Naked eye examination, transillumination, dye staining, microscopy, and diagnostic surgery used to diagnose fractures. Diagnoses confirmed during treatment. Also noted: Age, sex, gender, signs and symptoms, tooth number, arch, filling materials, size and classification of restoration, crack direction, pulp vitality, previous RCT, wear facets, probing depths. Final Tx processes and hx of ext were recorded for a year after treatment completion. AAE categories (fractured cusp, cracked tooth, split tooth, and vertical root fracture (VRF).

Results:

  1. Diagnostic techniques: naked eye (48 %), transillumination (18 %), dye staining (17 %), microscope examination (9 %), and diagnostic surgery (8 %). 82.2 % positive bite test. 49% normal pocket depth.
  2. Cracked tooth: 81.3 %, VRF 13.1 %, split tooth 3.7 %, fractured cusp 1.9 %
  3. MX first molar 28.0 %, the MD first molar 25.2 %, MD second molar 20.6 %, and MX second molar 16.8 %. Mostly in the age of 40s (29 %). M=F. 44 % M-D, 34 % B-L, 22 % both.
  4. 72 % had restorations: gold 20.5 %, amalgam 18.7 %, resin 4.7 %, porcelain 0.9 %
  5. 51 % experienced bite pain, and 82.2 % bite test positive
  6. 56.1 % negative to percussion, 33.6 % mod-sev cold sensitivity
  7. 48.6 % had normal pocket depth, 31.7 % 3- 6 mm, 19.6 % ≥6 mm. Only 12.1 % had an occlusal facet
  8. 30.8 % RCT, direct filling 23.4 %, indirect restoration 21.5 %, crown 21.5 % or not treated at all 38.0 %

Clinical Significance:

Bite test is most reliable for reproducing symptoms; multiple diagnostic modalities recommended for detecting cracks.