Associations of types of pain with crack-level, tooth-level and patient-level characteristics in posterior teeth with visible cracks: Findings from the National Dental Practice-Based Research Network

Hilton, Thomas J.; Funkhouser, Ellen; Ferracane, Jack L.; Gordan, Valeria V.; Huff, Kevin; Barna, Julie; Mungia, Rahma; Marker, Timothy; Gilbert, Gregg H.

doi:10.1016/j.jdent.2017.12.014

Cited by 34 publications

(33 citation statements)

References 18 publications

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“…In a previous study, we showed that the predominant pain symptom for patients with a tooth with at least one external crack was cold sensitivity (6). In the current study, there was a strong association between pain and the presence of an internal crack, mainly due to biting pain, not to cold or spontaneous pain.…”

Section: Discussionsupporting

confidence: 60%

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Observable characteristics coincident with internal cracks in teeth

Ferracane¹,

Funkhouser²,

Hilton³

et al. 2018

The Journal of the American Dental Association

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Section: Discussionsupporting

confidence: 60%

“…The National Dental Practice-Based Research Network (4) provides the ideal research context for such a study. This work represents one of several studies investigating the association between the characteristics of teeth with cracks and a variety of conditions, such as tooth symptoms and crack progression (5,6).…”

Section: Introductionmentioning

confidence: 99%

Observable characteristics coincident with internal cracks in teeth

Ferracane¹,

Funkhouser²,

Hilton³

et al. 2018

The Journal of the American Dental Association

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“…Previous studies have reported a significant correlation between caries and radiographic evidence of a crack and pain in cracked teeth. 12,13 A strong correlation was found between radiographic evidence of a crack and the practitioner's decision to restore the tooth (OR=4.8), although the radiographic evidence of a crack was low and the risk difference was only 3%. However, when present, an evident crack on a radiograph strongly correlated with pain and often resulted in a recommendation from the practitioner to restore the tooth.…”

Section: Discussionmentioning

confidence: 99%

“…A variety of factors contribute to the decision to restore versus monitor a tooth, including caries, the quality of the remaining tooth structure, presence of a visible fracture line, sealing the tooth against bacterial ingress, protecting cusps against flexure under function, presence of an existing restoration, and whether or not the patient has dental insurance. [12][13][14][15][16][17][18][19][20][21] Evidence-based guidelines are needed for the treatment of cracked teeth. The purpose of this clinical study was to contribute to this evidential foundation by identifying and quantifying characteristics at the patient, tooth, and crack levels and their association with treating posterior teeth with visible cracks among patients enrolled in the National Dental Practice-Based Research Network.…”

mentioning

confidence: 99%

Recommended treatment of cracked teeth: Results from the National Dental Practice-Based Research Network

Hilton

Funkhouser

Ferracane

et al. 2020

The Journal of Prosthetic Dentistry

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Statement of problem. Despite the high prevalence of posterior cracked teeth, questions remain regarding the best course of action for managing these teeth. Purpose. The purpose of this clinical study was to identify and quantify the characteristics of visible cracks in posterior teeth and their association with treatment recommendations among patients in the National Dental Practice-Based Research Network. Material and methods. Network dentists enrolled patients with a single, vital posterior tooth with at least 1 observable external crack. Data were collected at the patient, tooth, and crack levels, including the presence and type of pain and treatment recommendations for subject teeth. Frequencies according to treatment recommendation were obtained, and odds ratios (ORs) comparing recommendations for the tooth to be restored versus monitored were calculated. Stepwise regressions were performed using generalized models to adjust for clustering; characteristics with P<.05 were retained. Results. A total of 209 dentists enrolled 2858 patients with a posterior tooth with at least 1 crack. Mean ±standard deviation patient age was 54 ±12 years; 1813 (63%) were female, 2394 (85%) were non-Hispanic white, 2213 (77%) had some dental insurance, and 2432 (86%) had some college education. Overall, 1297 (46%) teeth caused 1 or more of the following types of pain: 1055 sensitivity to cold, 459 biting, and 367 spontaneous. A total of 1040 teeth were recommended for 1 or more treatments: restoration (n=1018; 98%), endodontics (n=29; 3%), endodontic treatment and restoration (n=20; 2%), extraction (n=2; 0.2%), and noninvasive treatment, for example, occlusal device, desensitizing (n=11; 1%). The presence of caries (OR=67.3), biting pain (OR=7.3), and evidence of a crack on radiographs (OR=5.0) were associated with over 5-fold odds of recommending restoration. Spontaneous pain was associated with nearly 3-fold odds; pain to cold, having dental insurance, a crack that was detectable with an explorer or blocked transilluminated light, or connected with a restoration were each weakly associated with increased odds of recommending a restoration (OR<2.0). Conclusions. Approximately one-third of cracked teeth were recommended for restoration. The presence of caries, biting pain, and evidence of a crack on a radiograph were strong predictors of recommending a restoration, although the evidence of a crack on a radiograph only accounted for a 3% absolute difference (4% recommended treatment versus 1% recommended monitoring).

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“…Son aplicados igualmente los test de vitalidad, que en los dientes afectados suelen ser positivos, aunque con el tiempo puede ser negativo, debido a una progresiva degeneración de la pulpa (Hilton, 2018). En Cuba es empleado el vitalómetro o pulpavitalómetro.…”

Section: Salud Publicaunclassified

Síndrome del Diente Fisurado: una actualización imprescindible

Abreus

Batista

Ramírez

et al. 2021

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Introducción: El Síndrome del Diente Fisurado ha aumentado su incidencia a nivel mundial y constituye un desafío diagnóstico fundamental en la práctica clínica estomatológica. En Cuba no está incluido en la clasificación vigente de traumatología dental por lo que no se diagnostica ni se trata. Objetivo: describir el Síndrome del Diente Fisurado, como entidad estomatológica frecuente. Metodología: Se realizó una revisión bibliográfica teniendo en cuenta la literatura científica en idioma español e inglés, incluyéndose todos los artículos de investigación originales, artículos de revisión e informes de casos, utilizando las bases de datos Scielo, PubMed, Scopus. Se identificaron alrededor de 63 artículos, de los cuales fueron seleccionados 54 según los criterios académicos de la Escuela Estomatológica Cubana, de ellos el 50% actualizado. Se analizó e integró la información. Resultados: Topográficamente, los dientes del sector posterior resultaron ser los más afectados. Afecta fundamentalmente a adultos en el rango de edad de 30 a 60 años; mientras que el sexo no es una variable determinante en su incidencia. Su causa esencial es la fractura vertical incompleta o fisura en la dentina, que no suelen ser mostradas en la radiografía. Conclusiones: Se concluyó que a pesar de que este síndrome es una entidad clínica común y bien documentada en varios países como una de las afecciones traumáticas que puede evolucionar a una necrosis pulpar, en Cuba, no existe ningún protocolo que regule su identificación.

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Associations of types of pain with crack-level, tooth-level and patient-level characteristics in posterior teeth with visible cracks: Findings from the National Dental Practice-Based Research Network

Abstract: Although often considered the most reliable diagnosis for a cracked tooth, pain on biting is not the most common symptom of a tooth with a visible crack, but rather pain to cold.

Cited by 34 publications

References 18 publications

Observable characteristics coincident with internal cracks in teeth

Observable characteristics coincident with internal cracks in teeth

Recommended treatment of cracked teeth: Results from the National Dental Practice-Based Research Network

Síndrome del Diente Fisurado: una actualización imprescindible

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