RESUMEN
OBJECTIVES: This study investigated the distribution of longitudinal tooth fractures (LTFs) according to the patient's age and analyzed the association between visual detection methods and the types of LTFs. METHODS: Patients with symptomatic teeth with LTFs were examined at the department of conservative dentistry in a dental hospital from September 1, 2009 to March 31, 2014. Naked eye examination, staining with a dye, operating microscopy, transillunimation, and periapical radiography were used to identify the fracture lines. Diagnostic surgery was performed to visualize the fracture line in some cases with vertical root fractures. The final diagnosis was based on the American Association of Endodontists (AAE) classification: cracked tooth, fractured cusp, split tooth, and vertical root facture. The probability density function for each type of LTF was calculated to assess the risks of LTF development according to age. The association between the detection methods and types of LTFs was identified using the association plot. RESULTS: A total of 245 teeth with LTFs were enrolled. Overall, 71.8% of LTFs was observed in patients aged 40-69 years, and 65.7% of LTFs were diagnosed as cracked teeth. The mean age in patients with cracked teeth was 49.3 years, while the mean age in patients with fractured cusps was 59.1 years. A significant association was observed between the detection method and type of LTF (pâ¯<â¯0.001). CONCLUSIONS: Cracked tooth was the most common type of LTF. The probability of occurrence of cracked teeth peaked in patients aged approximately 50 years, while the probability of occurrence of fractured cusps peaked in patients aged approximately 60 years. Cracked teeth were detected most often using transillumination. CLINICAL SIGNIFICANCE: LTFs occurred mostly in patients aged 40 years and older. Transillumination is useful for the diagnosis of cracked teeth.
Asunto(s)
Síndrome de Diente Fisurado , Fracturas de los Dientes , Adulto , Anciano , Síndrome de Diente Fisurado/diagnóstico por imagen , Síndrome de Diente Fisurado/epidemiología , Humanos , Persona de Mediana Edad , Tratamiento del Conducto Radicular , Fracturas de los Dientes/diagnóstico por imagenRESUMEN
INTRODUCTION: The purpose of the present study was to evaluate the frequency of dentinal microcracks observed after root canal preparation with XP-endo Shaper (XP), Reciproc Blue (RB), and ProTaper Universal (PTU) instruments using micro-computed tomographic (µCT) analysis. METHODS: Thirty extracted mandibular first and second molars with mesial roots having 2 separate canals with an angle between 10°and 20° were randomly assigned to 3 experimental groups (n = 10) according to the different nickel-titanium systems used for root canal preparation: XP, RB, and PTU. The specimens were scanned using µCT imaging before and after root canal preparation. Then, preoperative and postoperative cross-sectional images of the teeth were evaluated to identify the presence of dentinal defects. For each group, the number of microcracks was determined as a percentage rate. The McNemar test was used to determine significant differences before and after instrumentation. The level of significance was set at P ≤ .05. RESULTS: No new dentinal microcracks were observed in the XP and RB groups. The PTU system significantly increased the percentage rate of microcracks compared with preoperative specimens (P < .05). CONCLUSIONS: Root canal preparations with XP and RB systems might not induce the formation of new dentinal microcracks on the mesial roots of mandibular molars. Further assessments are suggested for the examination of the morphology of microcracks after the use of these instruments.
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Síndrome de Diente Fisurado/diagnóstico por imagen , Síndrome de Diente Fisurado/etiología , Diente Molar/diagnóstico por imagen , Preparación del Conducto Radicular/efectos adversos , Preparación del Conducto Radicular/instrumentación , Síndrome de Diente Fisurado/epidemiología , Humanos , Mandíbula , Radiografía Dental , Microtomografía por Rayos XRESUMEN
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.
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Síndrome de Diente Fisurado/epidemiología , Necrosis de la Pulpa Dental/diagnóstico , Pulpitis/diagnóstico , Adulto , Distribución por Edad , Anciano , Síndrome de Diente Fisurado/diagnóstico , Pulpa Dental/diagnóstico por imagen , Restauración Dental Permanente/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice Periodontal , Radiografía Dental , Adulto JovenRESUMEN
INTRODUCTION: The aims of this study were to analyze the distribution and characteristic features of cracked teeth and to evaluate the outcome of root canal treatments (RCTs) for cracked teeth. The prognostic factors for tooth survival were investigated. METHODS: Over the 5-year study period, 175 teeth were identified as having cracks. Data were collected regarding the patients' age, sex, tooth type, location and direction of cracks, probing depth, pulp vitality, type of restoration, cavity classification, opposing teeth, and previous endodontic treatment history. Cracked teeth were managed via various treatment methods, and the 2-year survival rate after RCT was analyzed using the Kaplan-Meier method in which significance was identified using the log-rank test. Possible prognostic factors were investigated using Cox multivariate proportional hazards modeling. RESULTS: One hundred seventy-five teeth were diagnosed with cracks. Most of the patients were aged 50-60 years (32.0%) or over 60 (32.6%). The lower second molar was the most frequently (25.1%) affected tooth. Intact teeth (34.3%) or teeth with class I cavity restorations (32.0%) exhibited a higher incidence of cracks. The 2-year survival rate of 88 cracked teeth after RCT was 90.0%. A probing depth of more than 6 mm was a significant prognostic factor for the survival of cracked teeth restored via RCT. The survival rate of root-filled cracked teeth with a probing depth of more than 6 mm was 74.1%, which is significantly lower than that of teeth with probing depths of less than 6 mm (96.8%) (P = .003). CONCLUSIONS: Cracks were commonly found in lower second molars and intact teeth. RCT was a reliable treatment for cracked teeth with a 2-year survival rate of 90.0%. Deep probing depths were found to be a significant clinical factor for the survival of cracked teeth treated with RCT.
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Síndrome de Diente Fisurado/epidemiología , Síndrome de Diente Fisurado/terapia , Tratamiento del Conducto Radicular/estadística & datos numéricos , Adulto , Anciano , Síndrome de Diente Fisurado/diagnóstico , Síndrome de Diente Fisurado/etiología , Cavidad Pulpar/lesiones , Restauración Dental Permanente , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , República de Corea/epidemiología , Tratamiento del Conducto Radicular/efectos adversos , Tratamiento del Conducto Radicular/métodos , Factores Sexuales , Tasa de Supervivencia , Extracción Dental , Raíz del Diente/lesiones , Resultado del TratamientoRESUMEN
Symptomatic, incompletely fractured posterior teeth can be a great source of anxiety for both the dental patient and dental operator. For the latter, challenges associated with deriving an accurate diagnosis together with the efficient and time effective management of cases of cracked tooth syndrome are largely accountable for the aforementioned problem. The aim of this series of two articles is to provide the reader with an in-depth insight into this condition, through the undertaking of a comprehensive literature review of contemporarily available data. The first article will provide details relating to the background of cracked tooth syndrome including the epidemiology, patho-physiology, aetiology and diagnosis of the syndrome, together with a consideration of factors which may influence the prognostic outcome of teeth affected by incomplete, symptomatic fractures. The second article will focus on the immediate and intermediate management of cracked teeth, and also provide a detailed account of the application of both direct and indirect restorations and restorative techniques used respectively in the management of teeth affected by this complex syndrome.
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Síndrome de Diente Fisurado , Síndrome de Diente Fisurado/diagnóstico , Síndrome de Diente Fisurado/epidemiología , Síndrome de Diente Fisurado/etiología , Humanos , PronósticoRESUMEN
This study highlighted the characteristics and distribution of cracked tooth syndrome (CTS) and the associated factors in adult attendees in the University of Nigeria Teaching Hospital. Three hundred seventy patients aged 18 years to 77 years with CTS-like conditions were included and studied over 12 months. The following information was recorded: suspected tooth and the dental arch, restorative status of the tooth, age and sex of the patient, results of bite test and transillumination, and the pulpal and periapical status of the tooth. CTS was seen most often in the 41 to 50 years age band (36.4%), in molars (63.6%), and in the maxillary arch (51.5%). Also, it was more frequent in men (55.8%). About 82% of CTS occurred in amalgam-restored teeth. All cases had a positive response to the bite test and a normal response to the electric pulp test. Only 10% gave a positive history of masticatory accident as against none with history of bruxism habits. It was concluded that patients with unexplained pain in a vital, amalgam-restored tooth (especially in maxillary molars), with or without a history of a masticatory accident, may have a cracked or fractured tooth.
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Síndrome de Diente Fisurado , Adolescente , Adulto , Distribución por Edad , Anciano , Síndrome de Diente Fisurado/complicaciones , Síndrome de Diente Fisurado/epidemiología , Síndrome de Diente Fisurado/etiología , Síndrome de Diente Fisurado/patología , Amalgama Dental/efectos adversos , Restauración Dental Permanente/efectos adversos , Restauración Dental Permanente/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Estudios Prospectivos , Distribución por Sexo , Odontalgia/etiología , Adulto JovenRESUMEN
It is well known that cracked teeth occur most frequently in the mandibular molars with large or poor restorations, in those over 50 years of age. However, with increasing knowledge and experience with cracks of teeth, cracks appear to be found frequently in intact teeth without restorations. The aim of this study is to analyze the cases of tooth cracks in a dental hospital in a year, and to find out the characteristic features of cracks of teeth. For 1 year, each tooth that were identified as a cracked tooth was recorded and analyzed in terms of the classification of cavity and restorative material, the nature of opposing tooth, the location in the arch, the age and gender, and the clinical signs and symptoms, and treatment result. Cracked teeth were observed most frequently in the teeth with no restorations (60.4%) and with class I restorations (29.2%). The most prevalent age was in those over 40 years of age (31.2% in their 40s, 26.6% in their 50s) and the prevalence was similar in men (53.9%) and women (46.1%). Cracked teeth were found most frequently in the maxillary molars (33.8% in first molar, 23.4% in second molar) than in the mandibular molars (20.1% in first molar, 16.2% in second molar). 96.1% of the cracked teeth responded to the bite test, and 81.1% of the cracked teeth were observed in the mesiodistal direction. The prevalence of cracked tooth was highest in the intact teeth with no restoration, in maxillary molars, and in those over 40 years of age. When examining a intact maxillary posterior tooth that is sensitive to a bite and thermal change, crack in the mesiodistal direction need to be considered one of the causes.
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Síndrome de Diente Fisurado/diagnóstico , Síndrome de Diente Fisurado/terapia , Adulto , Distribución por Edad , Fuerza de la Mordida , Síndrome de Diente Fisurado/epidemiología , Síndrome de Diente Fisurado/etiología , Coronas , Restauración Dental Permanente/efectos adversos , Análisis del Estrés Dental , Femenino , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia , Tratamiento del Conducto Radicular , Distribución por Sexo , Extracción DentalRESUMEN
Many morphologic, physical, and iatrogenic factors, such as deep grooves, pronounced intraoral temperature fluctuation, poor cavity preparation design, and wrong selection of restorative materials, may predispose posterior teeth to an incomplete fracture. The resulting cracked tooth syndrome is frequently associated with bizarre symptoms that may complicate diagnosis and can persist for many years. Epidemiologic data reveal that splits or fractures are the third most common cause of tooth loss in industrialized countries, primarily affecting maxillary molars and premolars and mandibular molars. This finding indicates that the cracked tooth syndrome is of high clinical importance. Thus, at-risk teeth should be reinforced early, for instance by castings with cusp coverage or by internal splinting with adhesive ceramic restorations.
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Síndrome de Diente Fisurado , Diente Premolar/lesiones , Fuerza de la Mordida , Síndrome de Diente Fisurado/diagnóstico , Síndrome de Diente Fisurado/epidemiología , Síndrome de Diente Fisurado/etiología , Síndrome de Diente Fisurado/prevención & control , Coronas , Análisis del Estrés Dental , Humanos , Incrustaciones , Diente Molar/lesiones , Férulas (Fijadores) , Corona del Diente/lesionesRESUMEN
Cracked tooth syndrome (CTS) is a common occurrence in modern general practice. This article reviews the forces placed on the human dentition and the effect restorative dentistry has on the strength of tooth structure. The study reports on the incidence of CTS in a general practice, finding a far higher incidence in teeth which have had the marginal ridge restored than those which have not. The various types of treatment modalities advocated and their relative merits are discussed.
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Síndrome de Diente Fisurado , Síndrome de Diente Fisurado/epidemiología , Síndrome de Diente Fisurado/etiología , Síndrome de Diente Fisurado/terapia , Amalgama Dental , Preparación de la Cavidad Dental/efectos adversos , Restauración Dental Permanente/métodos , Análisis del Estrés Dental , Femenino , Humanos , Incidencia , Incrustaciones , Masculino , Diente Molar/lesiones , Retratamiento , Odontalgia/etiología , Victoria/epidemiologíaRESUMEN
This review paper discusses the recognised factors which predispose to cracked-tooth syndrome. In addition, common presenting symptoms and the various methods to aid clinical diagnosis of this problem are examined. The incidence of the condition is reported and the prognosis of the various forms of fracture, as suggested by clinical presentation, are outlined with reference to the available literature. Benefits and relative demerits of traditional and more modern treatment options are presented and recommendations made for future research.
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Síndrome de Diente Fisurado/diagnóstico , Síndrome de Diente Fisurado/terapia , Síndrome de Diente Fisurado/epidemiología , Coronas , Restauración Dental Permanente , Dentadura Parcial Provisoria , Humanos , Incidencia , Aparatos Ortodóncicos , Pronóstico , Tratamiento del Conducto Radicular , Férulas (Fijadores)RESUMEN
The purpose of this study was to compare the frequency of canal and intradentin cracks after intraradicular post removal using ultrasonic instrumentation or the Gonan post removal system. Sixty cadaver teeth were divided into 4 groups of 15 teeth each: group 1, ultrasonic removal; group 2, Gonan post removal system; group 3, cemented posts not removed; and group 4, no posts. Groups 1 and 2 were contralateral matched pairs. Para Posts were placed in groups 1, 2, and 3 to 7 mm apical to the cementoenamel junction and luted with ZnPO4 cement. The time required for post removal in groups 1 and 2 was recorded. The teeth were extracted, sectioned, and examined. Canal and intradentin cracks were mapped, and their frequency was recorded at each level. There were statistically more cracks present in the ultrasonic group than the no post group. There were no other differences that reached statistical significance. It took significantly longer for post removal using the ultrasonic tip versus the Gonan system.