The clinical findings and managements in 44 cases of cracked vital molars

Abstract

Background/purpose The aim of this study was to evaluate the associations between the clinical findings and managements in cracked vital molars that were caused by various factors including restoration and occlusion. Materials and methods The subjects' gender, age, chief complaint, type of tooth, percussion test results, pulp vitality, restoration material and cavity classification, clinical depth of the crack, evaluation of occlusion, depth of periodontal probing, and final management were recorded. Results A total of 44 vital cracked teeth (molars) were diagnosed in 40 patients. Regarding the type of tooth, a greater number of mandibular molars were affected than maxillary molars. Nonworking-side interference (NWI) was recognized in 38 cases (86.4%). Eight teeth (18.2%) had not been restored. Thirty-six teeth (81.8%) had been restored; 26 teeth (72.2%) with a metal inlay, 6 (16.7%) with an amalgam, and 4 (11.1%) with a composite resin. Regarding the final treatment in the endodontically-treated group, all 17 teeth were covered with a metal full crown. Regarding the final treatment in the pulp-reserved group, 19 teeth (70.4%) were covered with a metal full crown, and the other managements were as follows: occlusal adjustment (n = 4, 14.8%), composite resin (n = 2, 7.4%), and only follow-up without treatment (n = 2, 7.4%). All of the cases showed a good clinical prognosis. Conclusion The NWI group restored with 58% of metal inlay accounted for more than 86% of the cracked teeth. Thus, in order to achieve a good outcome, cracked teeth, particularly those originating due to occlusal interference should be protected with coverage-type restorations.

Effect of Root Canal Therapy Combined with Full Crown Restoration on the Level of Inflammatory Factors and Chewing Function in Patients with Cracked Teeth and Chronic Pulpitis

“…In severe cases, they may even lose their teeth, which greatly reduce the chewing function of patients and pose a serious threat to people's dental health [ 9 ]. It has been reported [ 10 ] that the maxillary molars always keep the passive impact state during the chewing movement. At the same time, the abrasion of the oblique ridge is more serious, which leads to the formation of the steeper oblique point.…”

Assessment of outcome of root canal treatment performed on an incomplete fracture non vital permanent first molar

“…On the other hand, it would result in better stress distribution in the cement and dentin and would prevent stress accumulation in the cement at the crack site. After 20 days a full porcelain fused to metal crown was placed and patient was advised to maintain regular follow up which may take one to two years as similar to studies by Kanamura J et al 11 Berman and Kuttler stated that necrotic teeth with longitudinal cracks should be preferably extracted. Also, teeth with deep periodontal pockets have a poor prognosis.…”

Treatment of cracked teeth: A comprehensive narrative review

“…The restorative status was another factor taken into consideration due to the hypothesis that cracks may be more superficial in heavily restored teeth compared to intact or minimally restored teeth since crack propagation was expected to follow a direction parallel to the cuspal incline (Homewood, 1998) with stresses concentrating at the restoration-tooth interface (Roh & Lee, 2006). In contrast, no difference has been reported between restored and unrestored cracked teeth in terms of pulp preservation (Kanamaru et al, 2017;Lee et al, 2021a).…”