Elsevier

Journal of Endodontics

Volume 47, Issue 2, February 2021, Pages 215-220
Journal of Endodontics

Clinical Research
Factors Related to the Outcomes of Cracked Teeth after Endodontic Treatment

https://doi.org/10.1016/j.joen.2020.11.024Get rights and content

Abstract

Introduction

Cracked teeth are a common clinical finding; however, their presence renders diagnosis and prognosis unreliable. The purpose of this research was to assess the correlations of multiple factors on the prognosis of cracked teeth that had undergone endodontic treatment.

Methods

A total of 3680 patients who received endodontic treatment by an advanced postdoctoral education program in endodontics with follow-up records of at least 1 year were assessed. From this sample, 62 patients met the inclusion criteria and were included in the final analysis. The factors being evaluated included demographics, clinical symptoms and signs, radiographic findings, and restoration type. Statistical analysis was then completed using the chi-square and Fisher exact tests.

Results

The mean follow-up period was 23.3 months, with an overall tooth success rate of 75.8%. The success rates differed significantly when the patient had an existing preoperative periapical lesion, lacked a proper permanent restoration on the treated tooth, or had a post placed after root canal treatment. Data analysis showed that restoring the tooth after endodontic treatment was the single most important factor for prognosis. In fact, the endodontically treated teeth with definitive full-coverage restorations had a 2-year success rate of 93.6%.

Conclusion

Full-coverage restorations should be considered an important part of the treatment plan for cracked teeth treated endodontically.

Section snippets

Materials and Methods

The study was approved by Boston University’s Institutional Review Board committee (institutional review board no: H-36879). A data set that contained root canal treatments performed at the Boston University Goldman School of Dental Medicine’s postgraduate clinic and that had at least 1-year recall examination data was obtained for the time period of January 1, 2010, through December 31, 2017. However, an exception was made to include any immediate failure that occurred within 1 year. The

Results

Sixty-two samples met the inclusion criteria and were included in this study. The mean age of the collected sample was 51.2 years old (standard deviation = 11.5 years), consisting of 27 men and 35 women. The most commonly observed teeth were molars (85%). Most of the samples were previously restored, with amalgam being the most common restoration material (Table 1). The most common pulpal and periapical diagnosis in cracked teeth was pulpal necrosis with symptomatic apical periodontitis

Discussion

A literature review revealed that multiple factors are related to higher incidence rates of cracked teeth including large restorations, posterior teeth, older populations, and excursive interferences, among others4, 5, 6. In the present study, cracked teeth were most commonly found in molars (85.5%) and within the age group of 41–60 years old (67.7%). The number of female samples was slightly higher (56.5%) than males (43.5%). Almost all (90.3%) of the samples had been previously restored, and

CRediT authorship contribution statement

Yen-Tung Chen: Conceptualization, Methodology, Investigation, Writing - original draft. Tun-Yi Hsu: Writing - review & editing. Hongsheng Liu: Writing - review & editing. Sami Chogle: Conceptualization, Methodology, Writing - review & editing, Supervision.

Acknowledgments

The authors deny any conflicts of interest related to this study.

References (30)

  • V.A. Wanderley et al.

    Detection of incomplete root fractures in endodontically treated teeth using different high-resolution cone-beam computed tomographic imaging protocols

    J Endod

    (2017)
  • S.A. Aquilino et al.

    Relationship between crown placement and the survival of endodontically treated teeth

    J Prosthet Dent

    (2002)
  • A.J. Hunter et al.

    Effects of post placement on endodontically treated teeth

    J Prosthet Dent

    (1989)
  • K.V. Krell et al.

    12-month success of cracked teeth treated with orthograde root canal treatment

    J Endod

    (2018)
  • E.M. Rivera et al.

    Cracking the cracked tooth code: detection and treatment of various longitudinal tooth fractures

  • Cited by (13)

    • Red fluorescence for assessing longitudinal tooth fractures

      2022, Photodiagnosis and Photodynamic Therapy
    • The Correlation of Crack Lines and Definitive Restorations with the Survival and Success Rates of Cracked Teeth: A Long-term Retrospective Clinical Study

      2022, Journal of Endodontics
      Citation Excerpt :

      The treatment plan for CTs usually involves immediate and definitive treatment1,4. Previous studies suggest that immediate treatment is needed to immobilize the CLs, relieve symptoms, and prevent their spread4,20,24,26,27. Orthodontic bands, temporary restorations, and direct composite-resin restorations with cusp coverage are commonly used19,20,27.

    • Cracked teeth: Distribution and survival at 6 months, 1 year and 2 years after treatment

      2022, Journal of the Formosan Medical Association
      Citation Excerpt :

      steep cuspal inclination, bruxism, clenching, attrition and abrasion), pronounced intra-oral temperature fluctuation or iatrogenic (ie. poor cavity design of restoration, wrong selection of restorative materials, historic application of rotary instruments and access cavity preparation).7–9 Cracks may be associated with dietary habits.

    View all citing articles on Scopus

    Supported in part by Resident Research Grants from the American Association of Endodontists Foundation.

    View full text