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Published in: BMC Oral Health 1/2017

Open Access 01-12-2017 | Research article

Analysis of the characteristics of cracked teeth and evaluation of pulp status according to periodontal probing depth

Authors: Sung-Eun Yang, A-Ra Jo, Hye-Jin Lee, Sin-Young Kim

Published in: BMC Oral Health | Issue 1/2017

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Abstract

Background

The purpose of this study was to analyze the characteristics of cracked teeth and to evaluate pulp status according to periodontal probing depth (PPD).

Methods

A total of 182 cracked teeth were included. The location and type of the cracked teeth, age and gender of the patients, restoration type, pulp status, PPD, and radiographic findings were analyzed.

Results

Mandibular second molars (25.3%) were the most frequently involved teeth, followed by mandibular first molars (22.5%), maxillary first molars (22.0%), and maxillary second molars (17.6%). The patient age was most frequently 50–59 years. Cracks occurred mainly in nonbonded restorations, such as gold (26.9%), and were usually found in intact teeth (37.9%). A total of 103 teeth (56.6%) had an initial PPD of less than 3 mm, while 40 (22.0%) had a PPD of 4–6 mm, and 39 (21.4%) had PPD of 7 mm or more. A total of 33 cracked teeth (18.1%) were diagnosed with pulp necrosis, 40 (22.0%) with irreversible pulpitis, and 97 (53.3%) with reversible pulpitis. The incidence of pulp necrosis was 31.8% among cracked teeth with a PPD of 4–6 mm, and 28.6% among those with a PPD of 7 mm or more.

Conclusions

Cracks occurred mainly in molar teeth, and were commonly found in intact teeth with no restoration. Patients with cracked teeth were most frequently aged 50–59 years. Cracked teeth showing a PPD of more than 4 mm were more likely to show pulp necrosis.
Literature
1.
go back to reference Hiatt WH. Incomplete crown-root fracture in pulpal-periodontal disease. J Periodontol. 1973;44:369–79.CrossRefPubMed Hiatt WH. Incomplete crown-root fracture in pulpal-periodontal disease. J Periodontol. 1973;44:369–79.CrossRefPubMed
2.
go back to reference Kang SH, Kim BS, Kim Y. Cracked teeth: distribution, characteristics, and survival after root canal treatment. J Endod. 2016;42:557–62.CrossRefPubMed Kang SH, Kim BS, Kim Y. Cracked teeth: distribution, characteristics, and survival after root canal treatment. J Endod. 2016;42:557–62.CrossRefPubMed
3.
go back to reference Kim SY, Kim SH, Cho SB, Lee GO, Yang SE. Different treatment protocols for different pulpal and periapical diagnoses of 72 cracked teeth. J Endod. 2013;39:449–52.CrossRefPubMed Kim SY, Kim SH, Cho SB, Lee GO, Yang SE. Different treatment protocols for different pulpal and periapical diagnoses of 72 cracked teeth. J Endod. 2013;39:449–52.CrossRefPubMed
4.
go back to reference Seo DG, Yi YA, Shin SJ, Park JW. Analysis of factors associated with cracked teeth. J Endod. 2012;38:288–92.CrossRefPubMed Seo DG, Yi YA, Shin SJ, Park JW. Analysis of factors associated with cracked teeth. J Endod. 2012;38:288–92.CrossRefPubMed
5.
6.
go back to reference Banerji S, Mehta SB, Millar BJ. Cracked tooth syndrome. Part 1: aetiology and diagnosis. Br Dent J. 2010;208:459–63.CrossRefPubMed Banerji S, Mehta SB, Millar BJ. Cracked tooth syndrome. Part 1: aetiology and diagnosis. Br Dent J. 2010;208:459–63.CrossRefPubMed
7.
go back to reference Krell KV, Rivera EM. A six year evaluation of cracked teeth diagnosed with reversible pulpitis: treatment and prognosis. J Endod. 2007;33:1405–7.CrossRefPubMed Krell KV, Rivera EM. A six year evaluation of cracked teeth diagnosed with reversible pulpitis: treatment and prognosis. J Endod. 2007;33:1405–7.CrossRefPubMed
8.
go back to reference Brännström M. The hydrodynamic theory of dentinal pain: sensation in preparations, caries, and the dentinal crack syndrome. J Endod. 1986;12:453–7.CrossRefPubMed Brännström M. The hydrodynamic theory of dentinal pain: sensation in preparations, caries, and the dentinal crack syndrome. J Endod. 1986;12:453–7.CrossRefPubMed
9.
go back to reference Brännström M, Astrom A. The hydrodynamics of the dentine; its possible relationship to dentinal pain. Int Dent J. 1972;22:219–27.PubMed Brännström M, Astrom A. The hydrodynamics of the dentine; its possible relationship to dentinal pain. Int Dent J. 1972;22:219–27.PubMed
10.
go back to reference Ehrmann EH, Tyas MJ. Cracked tooth syndrome: diagnosis, treatment and correlation between symptoms and post-extraction findings. Aust Dent J. 1990;35:105–12.CrossRefPubMed Ehrmann EH, Tyas MJ. Cracked tooth syndrome: diagnosis, treatment and correlation between symptoms and post-extraction findings. Aust Dent J. 1990;35:105–12.CrossRefPubMed
11.
go back to reference Opdam NJ, Roeters JJ, Loomans BA, Bronkhorst EM. Seven-year clinical evaluation of painful cracked teeth restored with a direct composite restoration. J Endod. 2008;34:808–11.CrossRefPubMed Opdam NJ, Roeters JJ, Loomans BA, Bronkhorst EM. Seven-year clinical evaluation of painful cracked teeth restored with a direct composite restoration. J Endod. 2008;34:808–11.CrossRefPubMed
12.
go back to reference Turp JC, Gobetti JP. The cracked tooth syndrome: an elusive diagnosis. J Am Dent Assoc. 1996;127:1502–7.CrossRefPubMed Turp JC, Gobetti JP. The cracked tooth syndrome: an elusive diagnosis. J Am Dent Assoc. 1996;127:1502–7.CrossRefPubMed
13.
go back to reference Cohen S, Blanco L, Berman L. Vertical root fractures: clinical and radiographic diagnosis. J Am Dent Assoc. 2003;134:434–41.CrossRefPubMed Cohen S, Blanco L, Berman L. Vertical root fractures: clinical and radiographic diagnosis. J Am Dent Assoc. 2003;134:434–41.CrossRefPubMed
15.
go back to reference Berman LH, Kuttler S. Fracture necrosis: diagnosis, prognosis assessment, and treatment recommendations. J Endod. 2010;36:442–6.CrossRefPubMed Berman LH, Kuttler S. Fracture necrosis: diagnosis, prognosis assessment, and treatment recommendations. J Endod. 2010;36:442–6.CrossRefPubMed
16.
go back to reference Lustig JP, Tamse A, Fuss Z. Pattern of bone resorption in vertically fractured, endodontically treated teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:224–7.CrossRefPubMed Lustig JP, Tamse A, Fuss Z. Pattern of bone resorption in vertically fractured, endodontically treated teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:224–7.CrossRefPubMed
17.
go back to reference Walton RE, Michelich RJ, Smith GN. The histopathogenesis of vertical root fractures. J Endod. 1984;10:48–56.CrossRefPubMed Walton RE, Michelich RJ, Smith GN. The histopathogenesis of vertical root fractures. J Endod. 1984;10:48–56.CrossRefPubMed
18.
go back to reference Banerji S, Mehta SB, Millar BJ. Cracked tooth syndrome. Part 2: restorative options for the management of cracked tooth syndrome. Br Dent J. 2010;208:503–14.CrossRefPubMed Banerji S, Mehta SB, Millar BJ. Cracked tooth syndrome. Part 2: restorative options for the management of cracked tooth syndrome. Br Dent J. 2010;208:503–14.CrossRefPubMed
19.
go back to reference Signore A, Benedicenti S, Covani U, Ravera G. A 4- to 6-year retrospective clinical study of cracked teeth restored with bonded indirect resin composite onlays. Int J Prosthodont. 2007;20:609–16.PubMed Signore A, Benedicenti S, Covani U, Ravera G. A 4- to 6-year retrospective clinical study of cracked teeth restored with bonded indirect resin composite onlays. Int J Prosthodont. 2007;20:609–16.PubMed
20.
go back to reference Geurtsen W. The cracked-tooth syndrome: clinical features and case reports. Int J Periodontics Restorative Dent. 1992;12:395–405.PubMed Geurtsen W. The cracked-tooth syndrome: clinical features and case reports. Int J Periodontics Restorative Dent. 1992;12:395–405.PubMed
21.
go back to reference Lubisich EB, Hilton TJ, Ferracane J. Cracked teeth: a review of the literature. J Esthet Restor Dent. 2010;22:158–67.CrossRefPubMed Lubisich EB, Hilton TJ, Ferracane J. Cracked teeth: a review of the literature. J Esthet Restor Dent. 2010;22:158–67.CrossRefPubMed
22.
go back to reference Bajaj D, Sundaram N, Nazari A, Arola D. Age, dehydration and fatigue crack growth in dentin. Biomaterials. 2006;27:2507–17.CrossRefPubMed Bajaj D, Sundaram N, Nazari A, Arola D. Age, dehydration and fatigue crack growth in dentin. Biomaterials. 2006;27:2507–17.CrossRefPubMed
23.
24.
go back to reference Ausiello P, Apicella A, Davidson CL. Effect of adhesive layer properties on stress distribution in composite restorations--a 3D finite element analysis. Dent Mater. 2002;18:295–303.CrossRefPubMed Ausiello P, Apicella A, Davidson CL. Effect of adhesive layer properties on stress distribution in composite restorations--a 3D finite element analysis. Dent Mater. 2002;18:295–303.CrossRefPubMed
25.
go back to reference Ricucci D, Siqueira JF Jr, Loghin S, Berman LH. The cracked tooth: histopathologic and histobacteriologic aspects. J Endod. 2015;41:343–52.CrossRefPubMed Ricucci D, Siqueira JF Jr, Loghin S, Berman LH. The cracked tooth: histopathologic and histobacteriologic aspects. J Endod. 2015;41:343–52.CrossRefPubMed
26.
go back to reference Abbott P, Leow N. Predictable management of cracked teeth with reversible pulpitis. Aust Dent J. 2009;54:306–15.CrossRefPubMed Abbott P, Leow N. Predictable management of cracked teeth with reversible pulpitis. Aust Dent J. 2009;54:306–15.CrossRefPubMed
27.
go back to reference Kahler W. The cracked tooth conundrum: terminology, classification, diagnosis, and management. Am J Dent. 2008;21:275–82.PubMed Kahler W. The cracked tooth conundrum: terminology, classification, diagnosis, and management. Am J Dent. 2008;21:275–82.PubMed
28.
go back to reference Kahler B, Moule A, Stenzel D. Bacterial contamination of cracks in symptomatic vital teeth. Austalian Endod J. 2000;26:115–8.CrossRef Kahler B, Moule A, Stenzel D. Bacterial contamination of cracks in symptomatic vital teeth. Austalian Endod J. 2000;26:115–8.CrossRef
29.
go back to reference Bernardes RA, de Moraes IG, Hungaro Duarte MA, Azevedo BC, de Azevedo JR, Bramante CM. Use of cone-beam volumetric tomography in the diagnosis of root fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:270–7.CrossRefPubMed Bernardes RA, de Moraes IG, Hungaro Duarte MA, Azevedo BC, de Azevedo JR, Bramante CM. Use of cone-beam volumetric tomography in the diagnosis of root fractures. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:270–7.CrossRefPubMed
30.
31.
go back to reference Cohen S, Berman LH, Blanco L, Bakland L, Kim JS. A demographic analysis of vertical root fractures. J Endod. 2006;32:1160–3.CrossRefPubMed Cohen S, Berman LH, Blanco L, Bakland L, Kim JS. A demographic analysis of vertical root fractures. J Endod. 2006;32:1160–3.CrossRefPubMed
32.
go back to reference Clark LL, Caughman WF. Restorative treatment for the cracked tooth. Oper Dent. 1984;9:136–42.PubMed Clark LL, Caughman WF. Restorative treatment for the cracked tooth. Oper Dent. 1984;9:136–42.PubMed
33.
go back to reference Nguyen V, Palmer G. A review of the diagnosis and management of the cracked tooth. Dent Update. 2009;36:338–40. 42, 45-6 passimCrossRefPubMed Nguyen V, Palmer G. A review of the diagnosis and management of the cracked tooth. Dent Update. 2009;36:338–40. 42, 45-6 passimCrossRefPubMed
34.
go back to reference Geurtsen W, Schwarze T, Gunay H. Diagnosis, therapy, and prevention of the cracked tooth syndrome. Quintessence Int. 2003;34:409–17.PubMed Geurtsen W, Schwarze T, Gunay H. Diagnosis, therapy, and prevention of the cracked tooth syndrome. Quintessence Int. 2003;34:409–17.PubMed
35.
Metadata
Title
Analysis of the characteristics of cracked teeth and evaluation of pulp status according to periodontal probing depth
Authors
Sung-Eun Yang
A-Ra Jo
Hye-Jin Lee
Sin-Young Kim
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2017
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-017-0434-x

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