Skip to main content
Top
Published in: Clinical Oral Investigations 1/2020

01-01-2020 | Root Canal Debridement | Original Article

Outcomes of endodontically treated cracked teeth: a systematic review and meta-analysis

Authors: Dephne Jack Xin Leong, Nurun Nisa de Souza, Rehena Sultana, Adrian Ujin Yap

Published in: Clinical Oral Investigations | Issue 1/2020

Login to get access

Abstract

Objective

Systematic review analyzing the treatment outcomes of cracked teeth that received endodontic treatment is unavailable. The purpose of this study was to examine the treatment outcome of cracked teeth that received root canal treatment and to determine factors that influenced outcome.

Materials and methods

The specific PIO questions were as follows: Population: patients who were healthy individuals ≥ 18 years old and required root canal treatment due to cracked tooth; Intervention: root canal treatment with at least 1 year in occlusal function; Outcomes: survival rate and pre-operative factors. Ovid, PubMed, and Cochrane databases were searched in conjunction with hand searching. Pooled survival rates were determined from a meta-analysis of the data retrieved from the articles. All statistics were performed by the Comprehensive Meta-Analysis software.

Results

Four articles met the inclusion criteria. The overall tooth survival at 60 months was 84.1% (95%CI, 72.3–91.5%). Although no pre-operative factors had statistical significance, 4 factors had possible clinical significance. Teeth with single crack and teeth with cracks contained within crowns exhibited lower extraction risk, while teeth with pre-treatment periodontal probing > 3 mm and teeth that were terminal abutments showed a greater risk of extraction.

Conclusion

This systematic review determined the survival rate of endodontically treated cracked teeth to be moderately high. More studies in this area are, however, warranted before definitive conclusions can be derived.

Clinical relevance

In view of the relatively high survival rate, endodontic treatment rather than extraction should be considered for cracked teeth.
Literature
1.
go back to reference Hilton T, Mancl L, Coley Y, Baltuck C, Ferracane J, Peterson J, NW PRECEDENT (2011) Initial treatment recommendations for cracked teeth in Northwest PRECEDENT. J Dent Res 91(A) abst 2387 Hilton T, Mancl L, Coley Y, Baltuck C, Ferracane J, Peterson J, NW PRECEDENT (2011) Initial treatment recommendations for cracked teeth in Northwest PRECEDENT. J Dent Res 91(A) abst 2387
2.
go back to reference American Association of Endodontists (2015) Glossary of endodontic terms Ninth Edition American Association of Endodontists (2015) Glossary of endodontic terms Ninth Edition
3.
go back to reference Cameron CE (1976) The cracked tooth syndrome: additional findings. J Am Dent Assoc 93(5):971–975CrossRef Cameron CE (1976) The cracked tooth syndrome: additional findings. J Am Dent Assoc 93(5):971–975CrossRef
4.
go back to reference Hiatt WH (1973) Incomplete crown-root fracture in pulpal-periodontal disease. J Periodontol 44(6):369–379CrossRef Hiatt WH (1973) Incomplete crown-root fracture in pulpal-periodontal disease. J Periodontol 44(6):369–379CrossRef
5.
go back to reference Seo DG, Yi YA, Shin SJ, Park JW (2012) Analysis of factors associated with cracked teeth. J Endod 38(3):288–292CrossRef Seo DG, Yi YA, Shin SJ, Park JW (2012) Analysis of factors associated with cracked teeth. J Endod 38(3):288–292CrossRef
6.
go back to reference Ehrmann EH, Tyas MJ (1990) Cracked tooth syndrome: diagnosis, treatment and correlation between symptoms and post-extraction findings. Aust Dent J 35(2):105–112CrossRef Ehrmann EH, Tyas MJ (1990) Cracked tooth syndrome: diagnosis, treatment and correlation between symptoms and post-extraction findings. Aust Dent J 35(2):105–112CrossRef
7.
go back to reference Berman LH, Kuttler S (2010) Fracture necrosis: diagnosis, prognosis assessment, and treatment recommendations. J Endod 36(3):442–446CrossRef Berman LH, Kuttler S (2010) Fracture necrosis: diagnosis, prognosis assessment, and treatment recommendations. J Endod 36(3):442–446CrossRef
8.
go back to reference Lynch CD, McConnell RJ (2002) The cracked tooth syndrome. J Can Dent Assoc 68(8):470–475PubMed Lynch CD, McConnell RJ (2002) The cracked tooth syndrome. J Can Dent Assoc 68(8):470–475PubMed
9.
go back to reference Lubisich EB, Hilton TJ, Ferracane J (2010) Cracked teeth: a review of the literature. J Esthet Restor Dent 22(3):158–167CrossRef Lubisich EB, Hilton TJ, Ferracane J (2010) Cracked teeth: a review of the literature. J Esthet Restor Dent 22(3):158–167CrossRef
10.
go back to reference Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L (2017) Chapter 3: Systematic reviews of effectiveness. In: Aromataris E, Munn Z (eds) Joanna Briggs Institute Reviewer’s Manual, 1st edn. The Joanna Briggs Institute, Adelaide Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L (2017) Chapter 3: Systematic reviews of effectiveness. In: Aromataris E, Munn Z (eds) Joanna Briggs Institute Reviewer’s Manual, 1st edn. The Joanna Briggs Institute, Adelaide
11.
go back to reference Tan L, Chen NN, Poon CY, Wong HB (2006) Survival of root filled cracked teeth in a tertiary institution. Int Endod J 39(11):886–889CrossRef Tan L, Chen NN, Poon CY, Wong HB (2006) Survival of root filled cracked teeth in a tertiary institution. Int Endod J 39(11):886–889CrossRef
12.
go back to reference Sim IG, Lim TS, Krishnaswamy G, Chen NN (2016) Decision making for retention of endodontically treated posterior cracked teeth: a 5-year follow-up study. J Endod 42(2):225–229CrossRef Sim IG, Lim TS, Krishnaswamy G, Chen NN (2016) Decision making for retention of endodontically treated posterior cracked teeth: a 5-year follow-up study. J Endod 42(2):225–229CrossRef
13.
go back to reference Kang SH, Kim BS, Kim Y (2016) Cracked teeth: distribution, characteristics, and survival after root canal treatment. J Endod 42(4):557–562CrossRef Kang SH, Kim BS, Kim Y (2016) Cracked teeth: distribution, characteristics, and survival after root canal treatment. J Endod 42(4):557–562CrossRef
14.
go back to reference Krell KV, Caplan DJ (2018) 12-month success of cracked teeth treated with orthograde root canal treatment. J Endod 44(4):543–548CrossRef Krell KV, Caplan DJ (2018) 12-month success of cracked teeth treated with orthograde root canal treatment. J Endod 44(4):543–548CrossRef
15.
go back to reference Iqbal MK, Kim S (2007) For teeth requiring endodontic treatment, what are the differences in outcomes of restored endodontically treated teeth compared to implant-supported restorations? Int J Oral Maxillofac Implants 22(suppl):96–116PubMed Iqbal MK, Kim S (2007) For teeth requiring endodontic treatment, what are the differences in outcomes of restored endodontically treated teeth compared to implant-supported restorations? Int J Oral Maxillofac Implants 22(suppl):96–116PubMed
16.
go back to reference Ørstavik D (1996) Time-course and risk analyses of the development and healing of chronic apical periodontitis in man. Int Endod J 29(3):150–155CrossRef Ørstavik D (1996) Time-course and risk analyses of the development and healing of chronic apical periodontitis in man. Int Endod J 29(3):150–155CrossRef
17.
go back to reference Friedman S (2002) Prognosis of initial endodontic therapy. Endod Topics 2(1):59–88CrossRef Friedman S (2002) Prognosis of initial endodontic therapy. Endod Topics 2(1):59–88CrossRef
18.
go back to reference Sanderson S, Tatt ID, Higgins JP (2007) Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. Int J Epidemiol 36(3):666–676CrossRef Sanderson S, Tatt ID, Higgins JP (2007) Tools for assessing quality and susceptibility to bias in observational studies in epidemiology: a systematic review and annotated bibliography. Int J Epidemiol 36(3):666–676CrossRef
19.
go back to reference Quigley JM, Thompson JC, Halfpenny NJ, Scott DA (2019) Critical appraisal of nonrandomized studies-a review of recommended and commonly used tools. J Eval Clin Pract 25(1):44–52CrossRef Quigley JM, Thompson JC, Halfpenny NJ, Scott DA (2019) Critical appraisal of nonrandomized studies-a review of recommended and commonly used tools. J Eval Clin Pract 25(1):44–52CrossRef
20.
go back to reference Andrews J, Guyatt G, Oxman AD, Alderson P, Dahm P, Falck-Ytter Y, Nasser M, Meerpohl J, Post PN, Kunz R, Brozek J, Vist G, Rind D, Akl EA, Schünemann HJ (2013) GRADE guidelines: 14. Going from evidence to recommendations: the significance and presentation of recommendations. J Clin Epidemiol 66(7):719–725CrossRef Andrews J, Guyatt G, Oxman AD, Alderson P, Dahm P, Falck-Ytter Y, Nasser M, Meerpohl J, Post PN, Kunz R, Brozek J, Vist G, Rind D, Akl EA, Schünemann HJ (2013) GRADE guidelines: 14. Going from evidence to recommendations: the significance and presentation of recommendations. J Clin Epidemiol 66(7):719–725CrossRef
21.
go back to reference Salehrabi R, Rotstein I (2004) Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study. J Endod 30(12):846–850CrossRef Salehrabi R, Rotstein I (2004) Endodontic treatment outcomes in a large patient population in the USA: an epidemiological study. J Endod 30(12):846–850CrossRef
22.
go back to reference Chen SC, Chueh LH, Hsiao CK, Tsai MY, Ho SC, Chiang CP (2007) An epidemiologic study of tooth retention after nonsurgical endodontic treatment in a large population in Taiwan. J Endod 33(3):226–229CrossRef Chen SC, Chueh LH, Hsiao CK, Tsai MY, Ho SC, Chiang CP (2007) An epidemiologic study of tooth retention after nonsurgical endodontic treatment in a large population in Taiwan. J Endod 33(3):226–229CrossRef
23.
go back to reference Eakle WS, Maxwell EH, Braly BV (1986) Fractures of posterior teeth in adults. J Am Dent Assoc 112(2):215–218CrossRef Eakle WS, Maxwell EH, Braly BV (1986) Fractures of posterior teeth in adults. J Am Dent Assoc 112(2):215–218CrossRef
24.
go back to reference Gher ME Jr, Dunlap RM, Anderson MH, Kuhl LV (1987) Clinical survey of fractured teeth. J Am Dent Assoc 114(2):174–177CrossRef Gher ME Jr, Dunlap RM, Anderson MH, Kuhl LV (1987) Clinical survey of fractured teeth. J Am Dent Assoc 114(2):174–177CrossRef
25.
go back to reference Krell KV, Rivera EM (2007) A six year evaluation of cracked teeth diagnosed with reversible pulpitis: treatment and prognosis. J Endod 33(12):1405–1407CrossRef Krell KV, Rivera EM (2007) A six year evaluation of cracked teeth diagnosed with reversible pulpitis: treatment and prognosis. J Endod 33(12):1405–1407CrossRef
26.
go back to reference Abbott P, Leow N (2009) Predictable management of cracked teeth with reversible pulpitis. Aust Dent J 54(4):306–315CrossRef Abbott P, Leow N (2009) Predictable management of cracked teeth with reversible pulpitis. Aust Dent J 54(4):306–315CrossRef
27.
go back to reference Gutmann JL, Rakusin H (1994) Endodontic and restorative management of incompletely fractured molar teeth. Int Endod J 27(6):343–348CrossRef Gutmann JL, Rakusin H (1994) Endodontic and restorative management of incompletely fractured molar teeth. Int Endod J 27(6):343–348CrossRef
28.
go back to reference Kim SY, Kim SH, Cho SB, Lee GO, Yang SE (2013) Different treatment protocols for different pulpal and periapical diagnoses of 72 cracked teeth. J Endod 39(4):449–452CrossRef Kim SY, Kim SH, Cho SB, Lee GO, Yang SE (2013) Different treatment protocols for different pulpal and periapical diagnoses of 72 cracked teeth. J Endod 39(4):449–452CrossRef
29.
go back to reference Hattori Y, Satoh C, Seki S, Watanabe Y, Ogino Y, Watanabe M (2003) Occlusal and TMJ loads in subjects with experimentally shortened dental arches. J Dent Res 82(7):532–536CrossRef Hattori Y, Satoh C, Seki S, Watanabe Y, Ogino Y, Watanabe M (2003) Occlusal and TMJ loads in subjects with experimentally shortened dental arches. J Dent Res 82(7):532–536CrossRef
30.
go back to reference Palmqvist S, Söderfeldt B (1994) Multivariate analyses of factors influencing the longevity of fixed partial dentures, retainers, and abutments. J Prosthet Dent 71(3):245–250CrossRef Palmqvist S, Söderfeldt B (1994) Multivariate analyses of factors influencing the longevity of fixed partial dentures, retainers, and abutments. J Prosthet Dent 71(3):245–250CrossRef
31.
go back to reference Ng YL, Mann V, Gulabivala K (2011) A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J 44(7):610–625CrossRef Ng YL, Mann V, Gulabivala K (2011) A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J 44(7):610–625CrossRef
Metadata
Title
Outcomes of endodontically treated cracked teeth: a systematic review and meta-analysis
Authors
Dephne Jack Xin Leong
Nurun Nisa de Souza
Rehena Sultana
Adrian Ujin Yap
Publication date
01-01-2020
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 1/2020
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-019-03139-w

Other articles of this Issue 1/2020

Clinical Oral Investigations 1/2020 Go to the issue