Authors : Reetu Shrestha

Volume/Issue : Volume 9 - 2024, Issue 10 - October

Google Scholar : https://tinyurl.com/3af5szu8

Scribd : https://tinyurl.com/2ujk8a54

DOI : https://doi.org/10.38124/ijisrt/IJISRT24OCT1663

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Abstract : Cracks are defects on the tooth surface. The aim of the study is to treat those cracked teeth that are asymptomatic or have symptoms of reversible pulpitis by removal of the crack line and restoration with direct bonded composite resin to prevent further crack propagation and thus splitting of the tooth. A total of 30 patients having 45 mesio-distally oriented cracked teeth were included in the study. During the treatment the teeth were classified into three groups according to the depth of the prepared cavity. Group A included teeth with cavity depth 0.5 to1mm into dentin (n=12); Group B included teeth with prepared cavity depth 1.1 to 1.5mm into dentin (n=15); and Group C included teeth with prepared cavity depth 1.6 to 2mm into dentin (n=18). Group C was further sub-divided into two groups depending upon the presence (Group C-I) (n=10) or absence (Group C-II) (n=8) of visible crack line at the base of the cavity. All the teeth were restored with light cure posterior composite resin restorative material. Only the teeth in Group C-I were lined with light cure calcium hydroxide lining before restoration. High point corrections were done and final finishing and polishing of the restoration was done. The patients were recalled at 6 months and12 months, and the condition of restoration, tooth and signs and symptoms evaluated and recorded. Statistical package for social science (SPSS) version 22 was used for statistical analysis. A total of 45 teeth in 30 patients diagnosed with reversible pulpitis due to cracks were included in this study. There was significant difference between the depth of the crack (p=0.033) and failure. However, there was no significant difference (p=0.388) between the treatment outcome for absence or presence of crack line at the base of the cavity of depth 2mm into dentin. Posterior incomplete cracked teeth can be managed successfully in about 91.2% cases with direct composite resin restorative material for at least a period of 12months.

References :

1. Ellis S G. Incomplete tooth fracture - proposal for anew definition. Br Dent J 2001; 190: 424-8.
2. Cameron C E. Cracked tooth syndrome. J Am DentAssoc 1964; 68: 405-11.
3. American Association of Endodontists. ‘‘Cracking the cracked tooth code’’. Colleagues for Excellence 1997, Fall ⁄ Winter. URL: ‘http://www.aae.org/NR/rdonlyres/7D73B05C-FEE4-4B00-AB37-086056F163BC/0/fw97ecfe.pdf’.
4. Kakka A, Gavriil D, Whitworth J. Treatment of cracked teeth: A comprehensive narrative review. Clin Exp Dent Res. 2022 Oct;8(5):1218-48.
5. Adolphi G, Zehnder M, Bachmann LM, Göhring TN. Direct resin composite restorations in vital versus root-filled posterior teeth: a controlled comparative long-term follow-up. Oper Dent. 2007 Sep-Oct;32(5):437-42.
6. Bader JD, Shugars DA, Martin JA. Risk indicators for posterior tooth fracture.J Am Dent Assoc 2004;135;883-92
7. Roh BD, Lee YE. Analysis of 154 cases of teeth with cracks. Dent Traumatol 2006;22:118–23
8. Lagouvardos P, Sourai P, Douvitsas G. Coronal fractures in posterior teeth. Oper Dent 1989;14:28–32.
9. Udoye CI, Jafarzadeh H. Cracked tooth syndrome: Characteristics and distribution among adults in a Nigerian teaching hospital. J of Endod 2009; 35: 334-6.
10. Krell KV, Rivera EM. A six year evaluation of cracked teeth diagnosed with reversible pulpitis: treatment and prognosis. J Endod 2007: 33: 1405–7.
11. Arnold M. Bruxism and the occlusion. Dent Clin North Am 1981; 25: 395-407.
12. Cameron CE. The cracked tooth syndrome:additional findings. J Am Dent Assoc 1976;93:971–5.
13. Homewood CI. Cracked tooth syndrome- incidence, clinical findings and treatment. Aust Dent J 1998;43:217-22
14. Banava S, Salehyar S. In vitro comparative study of compressive strength of different types of composite resins in different periods of time. Irn J Phar Sci 2008; 4:69-74.
15. Unemori M, Matsuya Y, Akashi A, Goto Y, Akamine A. Composite resin restoration and postoperative sensitivity: clinical follow-up in an undergraduate program.J Dent 2001; 29:7-13.
16. Lynch CD, McConnel RJ. The cracked tooth syndrome. J Can Dent Assoc 2002; 68: 470-5.
17. Opdam N J, Roeters J J. The effectiveness of bonded composite restorations in the treatment of painful,cracked teeth: six month evaluation. Oper Dent 2003; 28: 327-33.
18. Geurtsen W, Garcia-Godov F. Bonded restorations for the prevention and treatment of the cracked tooth syndrome. Am J Dent 1999; 11: 266-70.
19. Guthrie RC, DiFiore PMJ. Treating the cracked tooth with a full crown. Am Dent Assoc1991;122(9):71-3
20. Kahler B, Moule A, Stenzel D. Bacterial contamination of cracks in symptomatic vital teeth. Aust Endod J 2000;26:115-8.