Switch to Dark theme

References

Guthrie RC, DiFiore PM. Treating the cracked tooth with a full crown. J Am Dent Assoc. 1991; 122:71-73
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; 34:808-811
Davis R, Overton JD. Efficacy of bonded and nonbonded amalgam in the treatment of teeth with incomplete fractures. J Am Dent Assoc. 2000; 131:469-478
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; 20:609-616
Abbott P, Leow N. Predictable management of cracked teeth with reversible pulpitis. Aust Dent J. 2009; 54:306-315
Krell KV, Rivera EM. A six year evaluation of cracked teeth diagnosed with reversible pulpitis: treatment and prognosis. J Endod. 2007; 33:1405-1407
Kang SH, Kim BS, Kim Y. Cracked teeth: distribution, characteristics, and survival after root canal treatment. J Endod. 2016; 42:557-562
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; 39:449-452
Banerji S, Mehta SB, Kamran T, Kalakonda M, Millar BJ. A multi-centred clinical audit to describe the efficacy of direct supra-coronal splinting – a minimally invasive approach to the management of cracked tooth syndrome. J Dent. 2014; 42:862-871
Tan L, Chen NN, Poon CY, Wong HB. Survival of root filled cracked teeth in a tertiary institution. Int Endod J. 2006; 39:886-889
Kontakiotis EG, Filippatos CG, Stefopoulos S, Tzanetakis GN. A prospective study of the incidence of asymptomatic pulp necrosis following crown preparation. Int Endod J. 2015; 48:512-517
Valderhaug J, Jokstad A, Ambjornsen E, Norheim PW. Assessment of the periapical and clinical status of crowned teeth over 25 years. J Dent. 1997; 25:97-105
Alley BS, Gray Kitchens G, Alley LW, Eleazer PD. A comparison of survival of teeth following endodontic treatment performed by general dentists or by specialists. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 98:115-118
Alkhalifah S, Alkandari H, Sharma PN, Moule AJ. Treatment of cracked teeth. J Endod. 2017; 43:1579-1586
Hood JA. Biomechanics of the intact, prepared and restored tooth: some clinical implications. Int Dent J. 1991; 41:25-32
Ricucci D, Siqueira JF, Loghin S, Berman LH. The cracked tooth: histopathologic and histobacteriologic aspects. J Endod. 2015; 41:343-352
Eltit F, Ebacher V, Wang R. Inelastic deformation and microcracking process in human dentin. J Struct Biol. 2013; 183:141-148
Forster A, Braunitzer G, Toth M, Szabo BP, Frater M. In vitro fracture resistance of adhesively restored molar teeth with different MOD cavity dimensions. J Prosthodont. 2019; 28:e325-e331
De Munck J, Van Meerbeek B, Yoshida Y, Inoue S, Vargas M, Suzuki K Four-year water degradation of totaletch adhesives bonded to dentin. J Dent Res. 2003; 82:136-140
Tezvergil-Mutluay A, Pashley D, Mutluay MM. Long-term durability of dental adhesives. Curr Oral Health Rep. 2015; 2:174-181
Panahandeh N, Torabzadeh H, Ziaee N, Mahdian M, Tootiaee B, Ghasemi A. The effect of composite thickness on the stress distribution pattern of restored premolar teeth with cusp reduction. J Prosthodont. 2017; 26:440-445
Lee MR, Cho BH, Son HH, Um CM, Lee IB. Influence of cavity dimension and restoration methods on the cusp deflection of premolars in composite restoration. Dent Mater. 2007; 23:288-295
Feilzer AJ, De Gee AJ, Davidson CL. Setting stress in composite resin in relation to configuration of the restoration. J Dent Res. 1987; 66:1636-1639
Kois DE, Chaiyabutr Y, Kois JC. Comparison of load-fatigue performance of posterior ceramic onlay restorations under different preparation designs. Compend Contin Educ Dent. 2012; 33:(2)2-9
Coulter J, McCracken G. Complications in managing tooth wear; exploring a potential pitfall of using the Dahl approach – a case study. Dent Update. 2018; 45:320-326
Banerji S, Mehta SB, Millar BJ. The management of cracked tooth syndrome in dental practice. Br Dent J. 2017; 222:659-666
Clark D, Khademi J. Modern molar endodontic access and directed dentin conservation. Dent Clin North Am. 2010; 54:249-273
Lertchirakarn V, Palamara JE, Messer HH. Patterns of vertical root fracture: factors affecting stress distribution in the root canal. J Endod. 2003; 29:523-528
Mitov G, Anastassova-Yoshida Y, Nothdurft FP, von See C, Pospiech P. Influence of the preparation design and artificial aging on the fracture resistance of monolithic zirconia crowns. J Adv Prosthodont. 2016; 8:30-36
Fennis WM, Kuijs RH, Kreulen CM, Verdonschot N, Creugers NH. Fatigue resistance of teeth restored with cuspal-coverage composite restorations. Int J Prosthodont. 2004; 17:313-317
Majd H, Viray J, Porter JA, Romberg E, Arola D. Degradation in the fatigue resistance of dentin by bur and abrasive air-jet preparations. J Dent Res. 2012; 91:894-899
Ivancik J, Neerchal NK, Romberg E, Arola D. The reduction in fatigue crack growth resistance of dentin with depth. J Dent Res. 2011; 90:1031-1036
Mujdeci A, Gokay O. The effect of airborne-particle abrasion on the shear bond strength of four restorative materials to enamel and dentin. J Prosthet Dent. 2004; 92:245-249
Rosatto CMP, Bicalho AA, Verissimo C, Braganca GF, Rodrigues MP, Tantbirojn D Mechanical properties, shrinkage stress, cuspal strain and fracture resistance of molars restored with bulk-fill composites and incremental filling technique. J Dent. 2015; 43:1519-1528
Ilie N, Bucuta S, Draenert M. Bulk-fill resin-based composites: an in vitro assessment of their mechanical performance. Oper Dent. 2013; 38:618-625
Abouelleil H, Pradelle N, Villat C, Attik N, Colon P, Grosgogeat B. Comparison of mechanical properties of a new fiber reinforced composite and bulk filling composites. Restor Dent Endod. 2015; 40:262-270
Mamoun JS, Napoletano D. Cracked tooth diagnosis and treatment: An alternative paradigm. Eur J Dent. 2015; 9:293-303
Kuijs RH, Fennis WM, Kreulen CM, Roeters FJ, Verdonschot N, Creugers NH. A comparison of fatigue resistance of three materials for cusp-replacing adhesive restorations. J Dent. 2006; 34:19-25
Yamamoto T, Nakamura Y, Nishide A, Kubota Y, Momoi Y. Contraction stresses in direct and indirect composite restorations compared by crack analysis. J Adhes Dent. 2013; 15:47-54
Fennis WM, Kuijs RH, Barink M, Kreulen CM, Verdonschot N, Creugers NH. Can internal stresses explain the fracture resistance of cusp-replacing composite restorations?. Eur J Oral Sci. 2005; 113:443-448
Meriwether LA, Blen BJ, Benson JH, Hatch RH, Tantbirojn D, Versluis A. Shrinkage stress compensation in composite-restored teeth: relaxation or hygroscopic expansion?. Dent Mater. 2013; 29:573-579
Heintze SD, Rousson V. Clinical effectiveness of direct class II restorations – a meta-analysis. J Adhes Dent. 2012; 14:407-431
Tjaderhane L. Dentin bonding: can we make it last?. Oper Dent. 2015; 40:4-18
Peumans M, De Munck J, Van Landuyt KL, Poitevin A, Lambrechts P, Van Meerbeek B. Eight-year clinical evaluation of a 2-step selfetch adhesive with and without selective enamel etching. Dent Mater. 2010; 26:1176-1184
Van Meerbeek B, Yoshihara K, Yoshida Y, Mine A, De Munck J, Van Landuyt KL. State of the art of selfetch adhesives. Dent Mater. 2011; 27:17-28
Pashley DH, Tay FR, Breschi L, Tjaderhane L, Carvalho RM, Carrilho M State of the art etch-and-rinse adhesives. Dent Mater. 2011; 27:1-16
Cardoso MV, de Almeida Neves A, Mine A, Coutinho E, Van Landuyt K, De Munck J Current aspects on bonding effectiveness and stability in adhesive dentistry. Aust Dent J. 2011; 56:31-44
Lynch CD, McConnell RJ. The cracked tooth syndrome. J Can Dent Assoc. 2002; 68:470-475

Cracked Tooth Syndrome Management Part 2: Integrating the Old with the New

From Volume 47, Issue 7, July 2020 | Pages 570-582

Authors

Oliver Bailey

BDS(Hons), MFDS RCSEd, PGCert Implant, FHEA

Clinical Fellow, Newcastle University School of Dental Sciences; GDP North East

Articles by Oliver Bailey

Abstract

This article follows on from Part 1 which looked at the pathogenesis and diagnosis of cracked tooth syndrome (CTS). It combines a review of the available evidence with a discussion of established and more modern concepts of management, aiming to provide a clear, rational approach to the predictable management of CTS with the aid of case studies and a decision-tree.

CPD/Clinical Relevance: Allows the clinician to manage CTS predictably.

Article

There are no universally accepted guidelines for managing cracked tooth syndrome (CTS). Contemporary approaches are quite diverse and have included operative crack removal, mechanical encirclement of the tooth, adhesive intra-coronal splinting, or splinting with extra-coronal coverage retained either adhesively or mechanically. In addition, restorations have been fabricated either in the mouth (directly), or in the laboratory (indirectly).1,2,3,4,5 Understandably, choosing the best option can be confusing.

Treatment of CTS aims to predictably restore and maintain a functional asymptomatic tooth, with a vital pulp, by stabilizing the crack, or cracks.

The evidence base on management options for CTS is limited, with much experimental data missing.

A study involving 41 patients with CTS compared direct composite placed either intra-coronally, or overlaying the affected cusp following its reduction.2 In the overlay group (n = 21), 0% required pulpectomy and restoration survival was 100% at 7 years follow-up. In the intra-coronal group (n = 20), three teeth required pulpectomy (15%), two within 6 months and one at 7 years. Two of these teeth subsequently required extraction due to vertical fractures. Eighty-five percent of restorations survived in this group and the failures were non-catastrophic. Excluding the teeth requiring pulpectomy, a minority of teeth suffered from residual thermal sensitivity in both groups, but pain on biting resolved in all teeth.

Register now to continue reading

Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Up to 2 free articles per month
  • New content available

Already have an account? Sign in here