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Jung MK, Jeon MJ, Kim JH, Son SA, Park JK, Seo DG. Comparison of the stress distribution in base materials and thicknesses in composite resin restorations. Heliyon 2024; 10:e25040. [PMID: 38333812 PMCID: PMC10850536 DOI: 10.1016/j.heliyon.2024.e25040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/10/2024] Open
Abstract
Resin-based composite materials are commonly used for restorations, but their dimensional changes during the polymerization could cause various clinical problems. This study evaluated the influence of a base of different materials and thicknesses on the stress magnitude and distribution in a second maxillary premolar with an MOD resin composite restoration using three-dimensional finite element analysis. A sound tooth without cavity was considered as the control group (ST), and another group was restored with composite resin without applying a base material in a MOD cavity (CR). The other three groups were restored with composite resin along with the following base materials: glass ionomer cement, low-viscosity resin, and tricalcium silicate, respectively (CR-GIC, CR-LR, and CR-TS). These three groups were further divided into two subgroups according to the thickness of the base layer: thin (0.5 mm) and thick (1.0 mm). The stress distribution was compared using the maximum principal stress after polymerization shrinkage and vertical loading with 600 N on the occlusal surface. Group ST showed the lowest stress value, and its stress propagation was confined to outer enamel surfaces only. Group CR demonstrated the highest stress distribution in the tooth-restoration interface with increased failure risk on marginal areas. The thin and thick subgroups of the three groups with a base layer had lower stress levels than Group CR. The base materials reduced the marginal stress caused by polymerization shrinkage of composite resin in MOD cavities. Different base materials and thicknesses did not affect the stress distribution.
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Affiliation(s)
- Min-Kwan Jung
- Department of Conservative Dentistry, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Mi-Jeong Jeon
- Department of Conservative Dentistry, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Conservative Dentistry, College of Dentistry, Gangnam Severance Hospital, Yonsei University, Seoul, Republic of Korea
| | - Jae-Hoon Kim
- Department of Dental Education, Dental Research Institute, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Sung-Ae Son
- Department of Conservative Dentistry, Dental Research Institute, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Jeong-Kil Park
- Department of Conservative Dentistry, Dental Research Institute, Dental and Life Science Institute, School of Dentistry, Pusan National University, Yangsan, Republic of Korea
| | - Deog-Gyu Seo
- Department of Conservative Dentistry, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
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Three Visual-Diagnostic Methods for the Detection of Enamel Cracks: An In Vitro Study. J Clin Med 2023; 12:jcm12030973. [PMID: 36769621 PMCID: PMC9917518 DOI: 10.3390/jcm12030973] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 01/31/2023] Open
Abstract
Tooth fractures are a common cause of tooth loss, frequently starting as enamel cracks. However, methods for the detection of enamel cracks are poorly investigated. The aim of the study was the validation of three clinical methods for the detection of enamel cracks: dental operating microscope (DOM), near-infrared transillumination (NIR), and fiber-optic transillumination (FOTI), with hard-tissue slices serving as controls. A total of 89 extracted teeth, set up as diagnostic models, were investigated, and the maximum crack depth was scored by two examiners. The actual crack depth was determined microscopically (25×) using horizontal sections. The accuracy of each method was analyzed using receiver operating characteristic (ROC) curves. Across all tooth surfaces, the area under the curve (AUC) amounted to 0.57 (DOM), 0.70 (FOTI), and 0.67 (NIR). For crack detection on vestibular/oral surfaces, the AUC was 0.61 (DOM), 0.78 (FOTI), and 0.74 (NIR); for proximal surfaces, it was 0.59 (DOM), 0.65 (FOTI), and 0.67 (NIR). However, the actual crack depth was underestimated with each method (p < 0.001). Under in vitro conditions, FOTI and NIR are suitable for detection of enamel cracks, especially on vestibular and oral tooth surfaces. However, an exact estimation of crack depth is not possible. Therefore, FOTI and NIR seem to be helpful for the clinical detection of enamel cracks.
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Kakka A, Gavriil D, Whitworth J. Treatment of cracked teeth: A comprehensive narrative review. Clin Exp Dent Res 2022; 8:1218-1248. [PMID: 35809233 PMCID: PMC9562569 DOI: 10.1002/cre2.617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/08/2022] [Accepted: 06/11/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES The term "cracked tooth" is used to describe an incomplete fracture initiated from the crown and progressing towards a subgingival direction. Despite the high prevalence of cracked teeth and their frequent association with symptoms and pulpal or periapical pathoses, there is still no consensus in the literature with regard to their restorative and endodontic management. Therefore, the aim of this narrative review was to evaluate the most relevant research and provide an up-to-date comprehensive overview regarding the treatment of cracked teeth. MATERIALS AND METHODS An electronic literature search was carried out in MEDLINE (via Ovid), Embase (via Ovid), Scopus, and Web of Science as well as several "Grey literature" sources up to February 22nd 2022 using a combination of pre-specified 'free-text' terms (keywords) and "subject headings." The search process was supplemented by handsearching in relevant dental journals and reference lists. This narrative review focused on clinical follow-up studies (observational or interventional studies, case series/reports), laboratory studies and systematic reviews written in English language that reported data on treatment of permanent cracked teeth. The selection of relevant studies was carried out by two reviewers (AK and DG) working independently in two consecutive stages: title/abstract screening and full-text retrieval. Any discrepancies in the study selection were resolved by discussion between the reviewers. RESULTS In total, 64 articles were selected for inclusion in this narrative review. CONCLUSIONS Cracked teeth with normal pulp or reversible pulpitis have exhibited high pulp and tooth survival rates by the provision of direct or indirect composite restorations. Besides, recent data favour monitoring, especially in the absence of symptoms or compromised tooth structure. When endodontic intervention is required, current evidence suggests that along with appropriate restorative management, outcomes of cracked teeth may be comparable to those of non-cracked root filled teeth.
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Affiliation(s)
- Angeliki Kakka
- Dental SchoolNational and Kapodistrian University of AthensAthensGreece
- Private PracticeAthensGreece
| | - Dimitrios Gavriil
- MClinDent Restorative DentistryNewcastle UniversityNewcastle upon TyneUK
- Private PracticeKorinthosGreece
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Recent Advances in the Diagnosis of Enamel Cracks: A Narrative Review. Diagnostics (Basel) 2022; 12:diagnostics12082027. [PMID: 36010379 PMCID: PMC9407313 DOI: 10.3390/diagnostics12082027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/08/2022] [Accepted: 08/13/2022] [Indexed: 11/17/2022] Open
Abstract
Cracked teeth can pose a diagnostic dilemma for a clinician as they can mimic several other conditions. The constant physiological stress along with any pathological strain like trauma or iatrogenic causes can lead to the development of microcracks in the teeth. Constant exposure to immense stress can cause the progression of these often-undiagnosed tooth cracks to cause tooth fractures. This review aims to outline the etiology of tooth cracks, their classification, and recent advances in the diagnosis of enamel cracks. Diagnosing a cracked tooth can be an arduous task as symptoms differ according to the location and extension of the incomplete fracture. Early detection is critical because restorative treatment can prevent fracture propagation, microleakage, pulpal or periodontal tissue involvement, and catastrophic cusp failure. Older methods of crack detection are not sensitive or specific. They include clinical examination, visual inspection, exploratory excavation, and percussion test. The dye test used blue or gentian violet stains to highlight fracture lines. Modern methods include transillumination, optical coherence tomography Swept-Source Optical Coherence Tomography (SSOCT), near-infrared imaging, ultrasonic system, infrared thermography, and near-infrared laser. These methods appear to be more efficacious than traditional clinical dental imaging techniques in detecting longitudinal tooth cracks. Clinically distinguishing between the various types of cracks can be difficult with patient-reported signs and symptoms varying according to the location and extension of the incomplete fracture. Cracks are more common in restored teeth. Technological advances such as transillumination allow for early detection and enhanced prognosis.
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Park S, Kim JH, Lee MK, Ihm JJ, Ahn JS, Park JK, Seo DG. In vivo real-time temperature measurement on the surface of intact and gold-restored teeth during consumption of hot and cold drinks. Eur J Oral Sci 2022; 130:e12870. [PMID: 35490397 DOI: 10.1111/eos.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/11/2022] [Indexed: 11/28/2022]
Abstract
This study aimed to measure real-time temperature changes in gold-restored teeth compared with intact teeth during the intake of hot and cold drinks. Sixteen molars, including eight natural intact teeth and eight restored teeth with gold inlays, were selected from the participants. Custom-made thermocouple sensors were attached to the coronal third of the buccal surface of teeth. Participants consecutively consumed hot and cold drinks according to a standardized regimen. Resting, maximum, and minimum temperatures; time to reach peak temperatures; and heating and cooling velocities were obtained. Statistical analysis was performed using independent two-sample t-test. Teeth with gold restorations showed a significantly higher maximum temperature (44.7 °C [SD 2.9]) than did natural teeth (40.5 °C [SD 1.2]) during hot water drinking and showed a lower minimum temperature (25.0 °C [SD 4.9]) than did natural teeth (31.5 °C [SD 3.1]) during cold water drinking. The heating and cooling rates for the teeth with gold restorations were two and three times higher than those of the natural teeth. Gold-restored teeth showed greater temperature change than intact teeth in terms of magnitude and velocity in response to temperature changes induced by hot and cold drinks.
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Affiliation(s)
- Soojin Park
- Seoulbombom Dental Clinic, Seoul, Republic of Korea
| | - Jae-Hoon Kim
- Department of Dental Education, Dental and Life Science Institute, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Republic of Korea
| | - Min-Kyung Lee
- Department of Conservative Dentistry, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jung-Joon Ihm
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jin-Soo Ahn
- Department of Dental Biomaterials Science, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
| | - Jeong-Kil Park
- Department of Conservative Dentistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Republic of Korea
| | - Deog-Gyu Seo
- Department of Conservative Dentistry, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Republic of Korea
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Roberts WE, Mangum JE, Schneider PM. Pathophysiology of Demineralization, Part I: Attrition, Erosion, Abfraction, and Noncarious Cervical Lesions. Curr Osteoporos Rep 2022; 20:90-105. [PMID: 35129809 PMCID: PMC8930910 DOI: 10.1007/s11914-022-00722-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE OF THE REVIEW Compare pathophysiology for infectious and noninfectious demineralization disease relative to mineral maintenance, physiologic fluoride levels, and mechanical degradation. RECENT FINDINGS Environmental acidity, biomechanics, and intercrystalline percolation of endemic fluoride regulate resistance to demineralization relative to osteopenia, noncarious cervical lesions, and dental caries. Demineralization is the most prevalent chronic disease in the world: osteoporosis (OP) >10%, dental caries ~100%. OP is severely debilitating while caries is potentially fatal. Mineralized tissues have a common physiology: cell-mediated apposition, protein matrix, fluid logistics (blood, saliva), intercrystalline ion percolation, cyclic demineralization/remineralization, and acid-based degradation (microbes, clastic cells). Etiology of demineralization involves fluid percolation, metabolism, homeostasis, biomechanics, mechanical wear (attrition or abrasion), and biofilm-related infections. Bone mineral density measurement assesses skeletal mass. Attrition, abrasion, erosion, and abfraction are diagnosed visually, but invisible subsurface caries <400μm cannot be detected. Controlling demineralization at all levels is an important horizon for cost-effective wellness worldwide.
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Affiliation(s)
- W. Eugene Roberts
- grid.257413.60000 0001 2287 3919Indiana University & Purdue University at Indianapolis, 8260 Skipjack Drive, Indianapolis, IN 46236 USA
| | - Jonathan E. Mangum
- grid.1008.90000 0001 2179 088XDepartment of Biochemistry and Pharmacology, Dentistry and Health Sciences, University of Melbourne, Corner Grattan Street and Royal Parade, Parkville, Victoria 3010 Australia
| | - Paul M. Schneider
- grid.1008.90000 0001 2179 088XMelbourne Dental School, University of Melbourne, 720 Swanston St, Melbourne, Victoria 3010 Australia
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HAN W, KIM JH, KWON HB, PARK JK, SEO DG. Effect of cyclic thermal stress on the fatigue life of teeth restored with gold inlay. Dent Mater J 2022; 41:567-572. [DOI: 10.4012/dmj.2021-306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
| | - Jae-Hoon KIM
- Department of Dental Education, Dental and Life Science Institute, School of Dentistry, Pusan National University, Dental Research Institute
| | - Ho-Beom KWON
- Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University
| | - Jeong-Kil PARK
- Department of Conservative Dentistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Dental Research Institute
| | - Deog-Gyu SEO
- Department of Conservative Dentistry and Dental Research Institute, School of Dentistry, Seoul National University
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Review of Cracked Tooth Syndrome: Etiology, Diagnosis, Management, and Prevention. Pain Res Manag 2021; 2021:3788660. [PMID: 34956432 PMCID: PMC8694987 DOI: 10.1155/2021/3788660] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/27/2021] [Accepted: 11/29/2021] [Indexed: 01/28/2023]
Abstract
Cracked tooth syndrome refers to a series of symptoms caused by cracked teeth. This article reviews the current literature on cracked tooth syndrome from four aspects, etiology, diagnosis, management, and prevention, to provide readers integrated information about this. The article begins with an introduction to the odontiatrogenic factors and then covers the noniatrogenic factors that induce cracked tooth syndrome. While the former discusses inappropriate root canal therapy and improper restorative procedures, the latter covers the topics such as the developmental and functional status of cracked tooth syndrome. This is then followed by the description of common clinical diagnosis methods, the prospects of new technologies, and summaries of current clinical management methods, including immediate management and direct and indirect restoration. In the final section, preventive methods and their importance are proposed, with the aim of educating the common population.
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A method of crack detection based on digital image correlation for simulated cracked tooth. BMC Oral Health 2021; 21:539. [PMID: 34666731 PMCID: PMC8524926 DOI: 10.1186/s12903-021-01897-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 10/07/2021] [Indexed: 11/21/2022] Open
Abstract
Background Early clinical cracked tooth can be a perplexing disorder to diagnose and manage. One of the key problems for the diagnosis of the cracked tooth is the detection of the location of the surface crack. Methods This paper proposes an image-based method for the detection of the micro-crack in the simulated cracked tooth. A homemade three-axis motion platform mounted with a telecentric lens was built as an image acquisition system to observe the surface of the simulated cracked tooth, which was under compression with a magnitude of the masticatory force. By using digital image correlation (DIC), the deformation map for the crown surface of the cracked tooth was calculated. Through image analysis, the micro-crack was quantitatively visualized and characterized. Results The skeleton of the crack path was successfully extracted from the image of the principal strain field, which was further verified by the image from micro-CT. Based on crack kinematics, the crack opening displacement was quantitatively calculated to be 2–10 µm under the normal mastication stress, which was in good agreement with the value reported in the literature. Conclusions The crack on the surface of the simulated cracked tooth could be detected based on the proposed DIC-based method. The proposed method may provide a new solution for the rapid clinical diagnosis of cracked teeth and the calculated crack information would be helpful for the subsequent clinical treatment of cracked teeth. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01897-2.
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Son SA, Kim JH, Park JK. The Effectiveness of a Quantitative Light-induced Fluorescent Device for the Diagnosis of a Cracked Tooth: A Case Report. J Endod 2021; 47:1796-1800. [PMID: 34437880 DOI: 10.1016/j.joen.2021.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 08/03/2021] [Accepted: 08/16/2021] [Indexed: 12/29/2022]
Abstract
Diagnosing a cracked tooth is a challenge for dental clinicians. This report describes the use of a quantitative light-induced fluorescent (QLF) device that detects fluorescence reactions with visible light (405 nm) to visually identify microscopic tooth cracks during the diagnosis and treatment of cracked teeth that caused pulp disease. Fluorescence images of the occlusal surface, before and after removal of the restoration, and inside of the access cavity for root canal treatment were obtained using an intraoral capture-type QLF device (Q-ray penC; AIOBIO, Seoul, Korea). The device provided visual information such as enhanced magnification and fluorescent images to identify cracks on the exterior of the tooth, around restorations, and inside the cavity after removal of the restoration by a simple image capture process. The device was able to demonstrate the existence of the crack line and to predict the depth of cracks during treatment.The QLF device showed a potential benefit in the diagnosis and characterization, including the location and depth, of tooth cracks.
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Affiliation(s)
- Sung-Ae Son
- Department ofConservative Dentistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Republic of Korea
| | - Jae-Hoon Kim
- Department ofDental Education, Dental and Life Science Institute, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Republic of Korea
| | - Jeong-Kil Park
- Department ofConservative Dentistry, Dental and Life Science Institute, School of Dentistry, Pusan National University, Dental Research Institute, Yangsan, Republic of Korea.
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Yap EXY, Chan PY, Yu VSH, Lui JN. Management of Cracked Teeth: Perspectives of General Dental Practitioners and Specialists. J Dent 2021; 113:103770. [PMID: 34363892 DOI: 10.1016/j.jdent.2021.103770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 07/26/2021] [Accepted: 07/29/2021] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES The main aim of this study was to compare how general dental practitioners (GDPs), endodontists and prosthodontists diagnose, prognosticate, and treat cracked teeth. The secondary aim was to highlight factors influencing GDPs' referral practices of cracked teeth to specialists. MATERIALS AND METHODS Questionnaires were used to collect information from GDPs, prosthodontists, and endodontists, on their use of diagnostic methods to identify cracked teeth, prognostication, and their management and referral practices for cracked teeth. Descriptive statistics were used to summarize the quantitative data. Pearson's Chi-Square test or Fisher's Exact test was applied to categorical variables while Kruskal-Wallis or Spearman's correlation coefficient was applied to continuous variables (p <0.05). Content analysis was performed for qualitative data. RESULTS 207 dentists responded, resulting in a response rate of 83.5%. Endodontists used more diagnostic tools as compared to prosthodontists and GDPs. For pulpally involved cracked teeth, endodontists were more likely to recommend root canal treatment (RCT) and cuspal coverage compared to extraction, followed by prosthodontists then GDPs. Main reasons for referral of cracked teeth to specialists include uncertainty in diagnosis, difficulty in crack visualization after endodontic access, and cracked teeth indicated for RCT. CONCLUSION GDPs, prosthodontists, and endodontists differ in terms of their diagnosis, prognostication, and treatment of cracked teeth. GDPs refer cracked teeth to specialists due to challenges faced in diagnosis and treatment. Future research and education are required to provide evidence-based guidelines in the management of cracked teeth so that patients with cracked teeth can receive standardized care.
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Affiliation(s)
- Elyssa Xiang Ying Yap
- Endodontic Unit, Department of Restorative Dentistry, National Dental Centre Singapore, Department of Restorative Dentistry, National Dental Centre of Singapore, 5 Second Hospital Avenue, Singapore 168938
| | - Pei Yuan Chan
- Consultant, Endodontic Unit, Department of Restorative Dentistry, National Dental Centre Singapore, Address: Department of Restorative Dentistry, National Dental Centre of Singapore, 5 Second Hospital Avenue, Singapore 168938
| | - Victoria Soo Hoon Yu
- Associate Professor, Vice Dean Graduate Studies, Graduate Endodontics Residency Training Programme Director, Course Director, Undergraduate Endodontics, Faculty of Dentistry, National University of Singapore, Singapore, Senior Consultant, National University Hospital Singapore, Faculty of Dentistry, National University of Singapore, Singapore, 9 Lower Kent Ridge Rd, Singapore 119085
| | - Jeen-Nee Lui
- Head, Department of Restorative Dentistry, Senior Consultant, Endodontic Unit, Department of Restorative Dentistry, National Dental Centre Singapore, Address: Department of Restorative Dentistry, National Dental Centre of Singapore, 5 Second Hospital Avenue, Singapore 168938
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