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Pu Y, Wang M, Hong Y, Bai J. Prognostic factors associated with pulp status in patients with cracked teeth treated with occlusal veneer: A 6- through 24-month prospective clinical study. J Am Dent Assoc 2024:S0002-8177(24)00075-8. [PMID: 38530693 DOI: 10.1016/j.adaj.2024.02.004] [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: 11/17/2023] [Revised: 01/30/2024] [Accepted: 02/01/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND The authors evaluated the prognostic factors associated with pulp status in patients with cracked teeth (CT) treated with occlusal veneer. METHODS An analysis of 80 CT (71 patients) with 1 or more crack lines (CLs) and normal pulp vitality or reversible pulpitis was performed. All patients received occlusal veneer and their demographic and clinical data were recorded. Pulp status and clinical features were recorded at 1 week and posttreatment at 1, 2, 3, 6, 12, 18, and 24 months. RESULTS Maxillary first molars were commonly involved (30 [38%]). The number of CLs on the finish line ranged from 1 through 7 and most had 3 CLs (24 [30%]). The number of CLs through preparation on the finish line ranged from 0 through 4, and 2 CLs (42 [53%]) were the most prevalent. During follow-up, 5 of 80 CT progressed to pulp disease, resulting in a success rate of 93.8%. Results of the Cox model and Kaplan-Meier analysis showed that probing depth greater than 6 mm, widening periodontal ligament of apical area, more than 4 CLs on finish line, and more than 2 CLs through preparation on the finish line were risk factors associated with pulp status (P < .05). CONCLUSIONS Occlusal veneer can protect CT without preventive root canal therapy. PRACTICAL IMPLICATIONS The success rate and risk factors of pulp disease in CT restored with occlusal veneer are reported.
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Hossain MI, Shams AB, Das Gupta S, Blanchard GJ, Mobasheri A, Hoque Apu E. The Potential Role of Ionic Liquid as a Multifunctional Dental Biomaterial. Biomedicines 2023; 11:3093. [PMID: 38002093 PMCID: PMC10669305 DOI: 10.3390/biomedicines11113093] [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: 09/06/2023] [Revised: 10/27/2023] [Accepted: 11/14/2023] [Indexed: 11/26/2023] Open
Abstract
In craniofacial research and routine dental clinical procedures, multifunctional materials with antimicrobial properties are in constant demand. Ionic liquids (ILs) are one such multifunctional intelligent material. Over the last three decades, ILs have been explored for different biomedical applications due to their unique physical and chemical properties, high task specificity, and sustainability. Their stable physical and chemical characteristics and extremely low vapor pressure make them suitable for various applications. Their unique properties, such as density, viscosity, and hydrophilicity/hydrophobicity, may provide higher performance as a potential dental material. ILs have functionalities for optimizing dental implants, infiltrate materials, oral hygiene maintenance products, and restorative materials. They also serve as sensors for dental chairside usage to detect oral cancer, periodontal lesions, breath-based sobriety, and dental hard tissue defects. With further optimization, ILs might also make vital contributions to craniofacial regeneration, oral hygiene maintenance, oral disease prevention, and antimicrobial materials. This review explores the different advantages and properties of ILs as possible dental material.
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Affiliation(s)
- Md Iqbal Hossain
- Department of Chemistry, Michigan State University, East Lansing, MI 48824, USA; (M.I.H.); (G.J.B.)
| | - Abdullah Bin Shams
- The Edward S. Rogers Sr. Department of Electrical Computer Engineering, University of Toronto, Toronto, ON M5S 3G4, Canada;
| | - Shuvashis Das Gupta
- Research Unit of Health Science and Technology, Faculty of Medicine, University of Oulu, 90220 Oulu, Finland; (S.D.G.); (A.M.)
| | - Gary J. Blanchard
- Department of Chemistry, Michigan State University, East Lansing, MI 48824, USA; (M.I.H.); (G.J.B.)
| | - Ali Mobasheri
- Research Unit of Health Science and Technology, Faculty of Medicine, University of Oulu, 90220 Oulu, Finland; (S.D.G.); (A.M.)
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, 4000 Liège, Belgium
- State Research Institute Centre for Innovative Medicine, 08410 Vilnius, Lithuania
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Ehsanul Hoque Apu
- Research Unit of Health Science and Technology, Faculty of Medicine, University of Oulu, 90220 Oulu, Finland; (S.D.G.); (A.M.)
- Department of Biomedical Sciences, College of Dental Medicine, Lincoln Memorial University, Knoxville, TN 37923, USA
- Institute for Quantitative Health Science and Engineering, Department of Biomedical Engineering, Michigan State University, East Lansing, MI 48824, USA
- Division of Hematology and Oncology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI 48109, USA
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka 1207, Bangladesh
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Mahalil Amin SS, Keat Hon JC, Sabarudin MA, Wan Ali WNS, Mohamed N. Milled Crown on Post Crack Tooth Syndrome as the Denture Abutment Tooth: A Case Report. Cureus 2023; 15:e39380. [PMID: 37362455 PMCID: PMC10286527 DOI: 10.7759/cureus.39380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
This clinical case describes using a milled crown on a cracked tooth as the abutment for a removable partial denture. A 63-year-old male patient diagnosed with lipoma undergoing chemotherapy and radiotherapy presented with symptomatic crack tooth syndrome on tooth 36 and partial edentulism. Conservative treatment using a molar band to extracoronally splint the tooth was conducted to determine the prognosis of the crack line. A lower partial cobalt-chromium denture was constructed by incorporating the milled crown of tooth 36 as the abutment. After six months of follow-up, there were no crack tooth symptoms, and regular review was adopted to monitor the tooth. The construction of a milled crown of a cracked tooth presented good and promising clinical outcomes in preserving tooth vitality and preventing crack propagation in partially dentate dentition for the long term.
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Affiliation(s)
| | | | | | | | - Nusima Mohamed
- Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur, MYS
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Ferracane JL, Hilton TJ, Funkhouser E. Lessons learned from the Cracked Tooth Registry: A 3-year clinical study in the Nation's Network. J Am Dent Assoc 2023; 154:235-244. [PMID: 36690539 PMCID: PMC10686254 DOI: 10.1016/j.adaj.2022.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND This article reviews the most salient lessons learned from a large, multisite, 3-year observational study of posterior teeth with cracks conducted by The National Dental Practice-Based Research Network. TYPES OF STUDIES REVIEWED Eight articles published over a 6-year period (2017-2022) describing clinical characteristics of posterior teeth with cracks and their treatment and outcomes are reviewed and discussed to answer 3 common questions faced by oral health care clinicians: Which cracked teeth will get worse? When should practitioners intervene? What is the best treatment? RESULTS Although cracks in teeth are prevalent, few will fracture (3%) or show crack progression in 3 years (12%). Characteristics that guide the clinician to treatment include active caries, biting pain, and to a lesser degree, having a crack detectable with an explorer, connecting with a restoration, or blocking transilluminated light; the main treatment chosen is a complete crown. Of those teeth treated (36%), few (14%) will need retreatment but will still survive, despite having an internal crack as well. CONCLUSIONS AND PRACTICAL IMPLICATIONS Although cracked teeth often pose a dilemma to clinicians, clincians are generally good at deciding which teeth to treat and when and which to monitor.
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Diagnosis of cracked tooth: Clinical status and research progress. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:357-364. [PMID: 36425316 PMCID: PMC9678967 DOI: 10.1016/j.jdsr.2022.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 11/19/2022] Open
Abstract
Cracked tooth is a common dental hard tissue disease.The involvement of cracks directly affects the selection of treatment and restoration of the affected teeth.It is helpful to choose more appropriate treatment options and evaluate the prognosis of the affected tooth accurately to determine the actual involvement of the crack.However, it is often difficult to accurately and quantitatively assess the scope of cracks at present.So it is necessary to find a real method of early quantitative and non-destructive crack detection.This article reviews the current clinical detection methods and research progress of cracked tooth in order to provide a reference for finding a clinical detection method for cracked tooth.
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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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Funkhouser E, Ferracane JL, Hilton TJ, Gordan VV, Gilbert GH, Mungia R, Burton V, Meyerowitz C, Kopycka-Kedzierawski DT. Onset and resolution of pain among treated and untreated posterior teeth with a visible crack: Three-year findings from the national dental practice-based research network. J Dent 2022; 119:104078. [PMID: 35227834 PMCID: PMC8988449 DOI: 10.1016/j.jdent.2022.104078] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Cracked teeth may be associated with pain, especially biting pain, and to a lesser degree cold and spontaneous pain. Described are how commonly these pains remain constant, develop, or resolve over time, none of which have been well-described, especially among untreated cracked teeth. METHODS Cracked teeth from the Cracked Tooth Registry (CTR) study were followed for 3 years. Assessments of cold, biting, and spontaneous pain and treatments performed were completed at enrollment (Y0) and at each annual recall visit. RESULTS 209 practitioners enrolled 2,858 patients, each with a visible crack on a posterior tooth; 2601 (91%) patients attended at least one recall visit. Overall, 960 (37%) were treated, primarily with crowns. Among both treated and untreated cracked teeth with biting pain or spontaneous pain at Y0, the vast majority (92-99%) had their pain resolved by the time of a recall visit and 85-93% remained pain-free after initial resolution. The observations for cold pain were similar: 68% (untreated) and 78% (treated) became free of cold pain at some point during follow-up, and 84% of these stayed free of cold pain after initial resolution. Few teeth developed biting or spontaneous pain (4-8%) and 44-67% of these had pain resolution during the follow-up period. CONCLUSION In this study, treatment resolved a preponderance of pain associated with a cracked tooth. Pain was also resolved for most untreated cracked teeth, especially biting pain, and to a lesser degree spontaneous and cold pain, although not to the same degree as with the treated cracked teeth.
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Affiliation(s)
- Ellen Funkhouser
- School of Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL 35294-0007, United States.
| | - Jack L Ferracane
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, 2730 S.W. Moody Ave. Portland, OR 97201-5042, United States
| | - Thomas J Hilton
- Alumni Centennial Professor in Operative Dentistry, School of Dentistry, Oregon Health & Science University, 2730 S.W. Moody Ave. Portland, OR 97201-5042, United States
| | - Valeria V Gordan
- Department of Restorative Dental Sciences, University of Florida, 1600 SW Archer Rd. Gainesville, FL 32610, United States
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL 35294, United States
| | - Rahma Mungia
- Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive; MC 8258, San Antonio, TX 78229, United States
| | - Vanessa Burton
- HealthPartners, 5901 John Martin Dr. Brooklyn Center, MN 55430, United States
| | - Cyril Meyerowitz
- Eastman Institute for Oral Health, University of Rochester, 601 Elmwood Avenue, Box 686. Rochester, NY 14642, United States
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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: 6] [Impact Index Per Article: 2.0] [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: 3] [Impact Index Per Article: 1.0] [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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Nguyen Thi W, Jansson L. Survival rate after endodontic treatment in general dentistry for cracked teeth with different coronal restorations. Acta Odontol Scand 2021; 79:256-261. [PMID: 33103524 DOI: 10.1080/00016357.2020.1834615] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE The aim of this study was to analyse the survival rate of cracked teeth after endodontic treatment. The secondary aim was to compare the survival rate of cracked teeth restored with composite filling/crown and those restored with a full crown. MATERIALS AND METHODS The study was conducted retrospectively from three general dental clinics in Stockholm, which are all part of the national dental service organisation. Two-hundred patients with teeth receiving endodontic treatment due to symptomatic cracks were included. The patient data range from year 2001 to 2016. RESULTS The mean age of the patients was 48 years (range 29-69). Fifty-five per cent had cracks located above the pulpal cavity, 11% within the pulpal cavity and 3% located in the root canal. The cracks were located most commonly on the proximal surfaces. The survival rate for teeth with cracks was 68% and 54% after 5 and 10 years, respectively. The survival rate was significantly higher (97%) for cracked teeth receiving a full crown after endodontic treatment compared to teeth restored with either a composite filling or composite crown. CONCLUSION The overall survival rate for cracked teeth was 68% after 5 years, while it was significantly higher for cracked teeth restored with a full crown. The results suggest within the limitations of this study that cracked teeth should be restored with a full crown after endodontic treatment.
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Affiliation(s)
- Winnie Nguyen Thi
- Department of Endodontology, Public Dental Service at Eastmaninstitutet, Stockholm County Council, Stockholm, Sweden
| | - Leif Jansson
- Department of Periodontology, Public Dental Service at Eastmaninstitutet, Stockholm County Council, Stockholm, Sweden
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Gao A, Cao D, Lin Z. Diagnosis of cracked teeth using cone-beam computed tomography: literature review and clinical experience. Dentomaxillofac Radiol 2021; 50:20200407. [PMID: 33237813 DOI: 10.1259/dmfr.20200407] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Cone-beam computed tomography (CBCT) has been widely used in diagnosis of vertical root fractures (VRFs) in recent years. According to the American Association of Endodontists (AAE) classification, there are five types of cracked teeth and VRF is one of them. Due to the variability and overlapping of the cracks and fractures, some narrow fractures on the roots of VRFs could not be detected by CBCT, and some wide cracks on the crown of cracked teeth could be detected by CBCT. In this review, we firstly discussed the value of CBCT in the diagnosis of the AAE five types of cracked teeth and presented CBCT manifestations of some typical cases. Secondly, we summarized the factors influencing the diagnosis of cracks/fractures using CBCT, namely, CBCT device-related factors, patient-related factors, and evaluator-related factors. The possible strategies to improve the diagnostic accuracy in the clinic practice are also discussed in this part. Finally, we compared the differences of root fractures with lateral canals and external root resorption on CBCT images.
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Affiliation(s)
- Antian Gao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Dantong Cao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Zitong Lin
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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Liao WC, Tsai YL, Chen KL, Blicher B, Chang SH, Yeung SY, Chang MC, Jeng JH. Cracked teeth: Distribution and survival at 6 months, 1 year and 2 years after treatment. J Formos Med Assoc 2021; 121:247-257. [PMID: 33858736 DOI: 10.1016/j.jfma.2021.03.020] [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: 02/17/2021] [Revised: 03/15/2021] [Accepted: 03/22/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/PURPOSE The unpredictable condition of cracked teeth warrants further investigation and clinical experiences. The purpose of this study was to collect and record data on demographics, clinical characteristics, different treatment modalities and survival of cracked teeth at 6-month, 1-year and 2-year recalls. METHODS 77 cracked teeth from 65 patients were included. Data on demographics, clinical parameters, treatment modalities and recall were collected. Binomial, multinomial and chi square tests were used for statistical analysis. RESULTS Most cracked teeth occurred in patients greater than 40 years old (p < 0.01). Cracked teeth themselves were most often molars (79.22%; p < 0.01), a non-terminal tooth in the arch (62.34%; p < 0.05) and nonendodontically-treated teeth (94.81%; p < 0.01). Cracked teeth exhibited pain to percussion (63.64%, p < 0.05) or biting (74.03%; p < 0.01), and no or only positive mobility (76.62%; p < 0.01). Cracks were most often oriented in the mesiodistal direction (68.83%; p < 0.01). Higher survival rates were noted in cracked teeth lacking pre-operative pain to palpation or spontaneous pain, and with no or only positive mobility at 6-month and 1-year recalls. In vital cracked teeth, higher survival rates were noted in teeth lacking pre-operative pain to palpation and with no or only positive mobility at 2-year recalls. CONCLUSION The absence of pre-operative palpation discomfort, spontaneous pain and minimal mobility, as well as the presence of pulp vitality were associated with higher survival rates of cracked teeth at all recall times. Results are useful for diagnosis and outcomes-based treatment planning of cracked teeth.
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Affiliation(s)
- Wan-Chuen Liao
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Ling Tsai
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Kuan-Liang Chen
- Department of Dentistry, Chi-Mei Medical Center, Tainan, Taiwan
| | | | - Shu-Hui Chang
- School of Public Health, National Taiwan University, Taipei, Taiwan
| | - Sin-Yuet Yeung
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Mei-Chi Chang
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan; Chang Gung University of Science and Technology, Kwei-Shan, Taoyuan, Taiwan.
| | - Jiiang-Huei Jeng
- School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan; School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
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13
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Kohli D, Thomas DC. Orofacial pain: Time to see beyond the teeth. J Am Dent Assoc 2020; 152:954-961. [PMID: 32950209 DOI: 10.1016/j.adaj.2020.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 10/23/2022]
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Fracture strength of non-invasively reinforced MOD cavities on endodontically treated teeth. Odontology 2020; 109:368-375. [PMID: 32886263 PMCID: PMC7954736 DOI: 10.1007/s10266-020-00552-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/23/2020] [Indexed: 11/24/2022]
Abstract
The purpose of this in-vitro study was to evaluate the fracture resistance and failure mode of non-invasively reinforced endodontically treated mandibular molars. Sixty freshly extracted defect-free mandibular molars were divided into four experimental groups with extensive MOD cavities on endodontically treated teeth with different restoration types and one control group with intact teeth (n = 12). The groups were as follows: “Normal”: direct resin composite; “Ring”: glass fiber-reinforced strip (Dentapreg) wrapped around buccal and lingual walls followed by direct resin composite; “Inlay”: indirect CAD/CAM resin composite inlay; “Onlay”: indirect CAD/CAM resin composite onlay; “Intact”: Intact teeth (Control). Tetric EvoCeram and Adhese Universal (Ivoclar Vivadent) were used for direct restorations and Tetric CAD (Ivoclar Vivadent) adhesively luted with Adhese Universal and Variolink Esthetic LC (Ivoclar Vivadent) were used for indirect restorations. All teeth were submitted to thermo-mechanical cyclic loading. All samples were then submitted to a compressive load until fracture. Fracture load was noted and teeth were analyzed to classify the failure mode as either catastrophic (C) or non-catastrophic (NC). No statistically significant difference was found between fracture strength of the five groups when all specimens were considered (p = 0.1461). Intact group showed the lowest percentage of catastrophic failures (41.67%). Ring group presents less catastrophic failures (75%) than Normal group (83.34%), and failures of indirect restorations—Inlay and Onlay—were almost all catastrophic (91.67% and 100%, respectively).
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15
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Li Z, Holamoge YV, Li Z, Zaid W, Osborn ML, Ramos A, Miller JT, Li Y, Yao S, Xu J. Detection and analysis of enamel cracks by ICG-NIR fluorescence dental imaging. Ann N Y Acad Sci 2020; 1475:52-63. [PMID: 32519363 DOI: 10.1111/nyas.14374] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 04/13/2020] [Accepted: 04/28/2020] [Indexed: 01/01/2023]
Abstract
Cracked teeth are the third most common cause of tooth loss, but there is no reliable imaging tool for the diagnosis of cracks. Here, we demonstrate the feasibility of indocyanine green near-infrared fluorescence (ICG-NIRF) dental imaging for the detection of enamel cracks and enamel-dentin cracks in vitro in the first (ICG-NIRF-I, 700-950 nm) and second (ICG-NIRF-II, 950-1700 nm) imaging windows with transmission excitation light, and compared ICG-NIRF with conventional NIR illumination-II (NIRi-II) and X-ray imaging. Dentin cracks were detected by CT scan, while most enamel cracks, undetectable under X-ray imaging, were clearly visible in NIR images. We found that ICG-NIRF-II detected cracks more effectively than NIRi-II, and that light orientation is an important factor for crack detection: an angled exposure obtained better image contrast of cracks than parallel exposure, as it created a shadow under the crack. Crack depth could be evaluated from the crack shadow in ICG-NIRF and NIRi-II images; from this shadow we could determine crack depth and discriminate enamel-dentin cracks from craze lines. Cracks could be observed clearly from ICG-NIRF images with 1-min ICG tooth immersion, although longer ICG immersion produced images with greater contrast. Overall, our data show that ICG-NIRF dental imaging is a useful tool for diagnosing cracked teeth at an early stage.
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Affiliation(s)
- Zhongqiang Li
- Division of Electrical and Computer Engineering, College of Engineering, Louisiana State University, Baton Rouge, Louisiana
| | - Yoshita V Holamoge
- Division of Electrical and Computer Engineering, College of Engineering, Louisiana State University, Baton Rouge, Louisiana
| | - Zheng Li
- Division of Electrical and Computer Engineering, College of Engineering, Louisiana State University, Baton Rouge, Louisiana
| | - Waleed Zaid
- Oral and Maxillofacial Surgery, School of Dentistry, Louisiana State University Health Science Center, Baton Rouge, Louisiana
| | - Michelle L Osborn
- Department of Comparative Biomedical Science, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - Alexandra Ramos
- Department of Comparative Biomedical Science, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - Jacob T Miller
- Division of Electrical and Computer Engineering, College of Engineering, Louisiana State University, Baton Rouge, Louisiana
| | - Yanping Li
- School of Environment and Sustainability, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Shaomian Yao
- Department of Comparative Biomedical Science, School of Veterinary Medicine, Louisiana State University, Baton Rouge, Louisiana
| | - Jian Xu
- Division of Electrical and Computer Engineering, College of Engineering, Louisiana State University, Baton Rouge, Louisiana
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Soares de Toubes KM, Moreira Maia L, Cota Goulart L, de Freitas Teixeira T, Silva NRFA, Isaías Seraidarian P, Silveira FF. Optimization of Results for Cracked Teeth Using CAD-CAM System: A Case Series. IRANIAN ENDODONTIC JOURNAL 2020; 15:57-63. [PMID: 36704316 PMCID: PMC9723217 DOI: 10.22037/iej.v15i1.26731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Revised: 10/08/2019] [Accepted: 10/25/2019] [Indexed: 01/28/2023]
Abstract
Different restorative techniques have been proposed for the treatment of posterior teeth affected by cracked tooth syndrome (CTS). However, the literature is scarce in protocols of how to solve CTS using ceramic restorations made by computer aided design-computer aided manufacturing (CAD-CAM) system. CAD-CAM provides a fast and efficient restorative treatment usually in a single visit, reducing the risk of contamination and micro-infiltration of the cracked line. The objective of this work was to describe 3 clinical cases of cracked teeth, which presented vertical fracture lines in different directions and extension through the pulp, restored by CAD-CAM system, with 5-year follow-up. Patients with short-term spontaneous masticatory pain, cold sensibility and restored teeth without cuspal coverage were selected. Digital radiographs (DR) were taken to confirm the pulp and periapical status. Periodontal probing depth, sensitivity, percussion, and occlusion tests were performed. The fracture lines with their direction and extension were identified under dental optical microscope (DOM). The treatment plan was performed in two stages: immediate treatment to stabilize the tooth and minimize pain, and final restorative treatment by CAD-CAM system to stabilize the crack. Patients were between the ages of 37 and 45 years. Most of the studied teeth presented extensive restorations without cuspal coverage. The presence of occlusal interference, in lateral movement, was a constant finding. Endodontic treatment was performed in cases of irreversible pulpitis or pulpal necrosis. In all three cases, cavity preparation was performed for full coverage restorations, as the fracture lines extended in several directions, requiring a re-enforcement of the cervical region of the teeth in question. The survival rate of the reported cases was 100% with 5-year clinical and radiographic follow-up, suggesting that CAD-CAM system may be a promising alternative treatment in the management of CTS, improving tooth longevity.
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Affiliation(s)
| | | | | | | | | | | | - Frank Ferreira Silveira
- Pontificial Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil;, Itaúna University, Itaúna, Minas Gerais, Brazil ,Corresponding author: Frank Ferreira Silveira, Department of Dentistry, Pontificial Catholic University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil, Avenida Dom José Gaspar 500 / Prédio 46, Coração Eucarístico, Belo Horizonte, Minas Gerais, Brazil. ZIP CODE 30535610. Tel: +55-31 33194414, E-mail:
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17
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Kim SY, Kang MK, Kang SM, Kim HE. Effects of ultrasonic instrumentation on enamel surfaces with various defects. Int J Dent Hyg 2018. [DOI: 10.1111/idh.12339] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S-Y Kim
- Gachon University Graduate School of Public Health; Incheon Korea
| | - M-K Kang
- Department of Dental Hygiene; Hanseo University; Seosan Korea
| | - S-M Kang
- Department of Preventive Dentistry & Public Oral Health; College of Dentistry; Yonsei University; Seoul Korea
| | - H-E Kim
- Gachon University Graduate School of Public Health; Incheon Korea
- Department of Dental Hygiene; Gachon University College of Health Science; Incheon Korea
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18
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Hilton TJ, Funkhouser E, Ferracane JL, Gordan VV, Huff KD, Barna J, Mungia R, Marker T, Gilbert GH. Associations of types of pain with crack-level, tooth-level and patient-level characteristics in posterior teeth with visible cracks: Findings from the National Dental Practice-Based Research Network. J Dent 2017; 70:67-73. [PMID: 29289728 DOI: 10.1016/j.jdent.2017.12.014] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/01/2017] [Accepted: 12/27/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVES The objective of this study was to determine which patient traits, behaviors, external tooth and/or crack characteristics correlate with the types of symptoms that teeth with visible cracks exhibit, namely pain on biting, pain due to cold stimuli, or spontaneous pain. METHODS Dentists in the National Dental Practice-Based Research Network enrolled a convenience sample of subjects each of whom had a single, vital posterior tooth with at least one observable external crack (cracked teeth); 2858 cracked teeth from 209 practitioners were enrolled. Data were collected at the patient-, tooth-, and crack-level. Generalized estimating equations were used to obtain significant (p < .05) independent odds ratios (OR) associated with teeth that were painful for 10 outcomes based on types of pain and combinations thereof. RESULTS Overall, 45% of cracked teeth had one or more symptoms. Pain to cold was the most common symptom, which occurred in 37% of cracked teeth. Pain on biting (16%) and spontaneous pain (11%) were less common. Sixty-five percent of symptomatic cracked teeth had only one type of symptom, of these 78% were painful only to cold. No patient-, tooth- or crack-level characteristic was significantly associated with pain to cold alone. Positive associations for various combinations of pain symptoms were present with cracks that: (1) were on molars; (2) were in occlusion; (3) had a wear facet through enamel; (4) had caries; (5) were evident on a radiograph; (6) ran in more than one direction; (7) blocked transilluminated light; (8) connected with another crack; (9) extended onto the root; (10) extended in more than one direction; or (11) were on the distal surface. Persons who were <65 yo or who clench, grind, or press their teeth together also were more likely to have pain symptoms. Pain was less likely in teeth with stained cracks or exposed roots, or in non-Hispanic whites. CONCLUSIONS Although pain to cold was the most commonly noted pain associated with symptomatic cracked teeth, no patient-, tooth- or crack-level characteristic was significantly associated with pain to cold alone. Characteristics were only associated with pain on biting and/or spontaneous pain with or without pain to cold. CLINICAL SIGNIFICANCE Although often considered the most reliable diagnosis for a cracked tooth, pain on biting is not the most common symptom of a tooth with a visible crack, but rather pain to cold.
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Affiliation(s)
- Thomas J Hilton
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, 2730 S.W. Moody Ave., Portland, OR 97201-5042, United States.
| | - Ellen Funkhouser
- School of Medicine, University of Alabama, 1720 2nd Avenue South, Birmingham, AL 35294-0007, United States
| | - Jack L Ferracane
- Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, 2730 S.W. Moody Ave., Portland, OR 97201-5042, United States
| | - Valeria V Gordan
- Dept of Restorative Dental Sciences, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, United States
| | - Kevin D Huff
- Private Practice, 217 W 4th St, Dover, OH 44622, United States
| | - Julie Barna
- Private Practice, 222 JPM Rd, Lewisburg, PA 17837, United States
| | - Rahma Mungia
- Department of Periodontics, School of Dentistry, University of Texas Health San Antonio, 7703 Floyd Curl Drive, MC 8258, San Antonio, TX, 78229-3900, United States
| | - Timothy Marker
- Private Practice, 2210 Kulshan View Rd., Mount Vernon, WA 98273, United States
| | - Gregg H Gilbert
- Department of Clinical and Community Sciences, School of Dentistry, University of Alabama, Birmingham, AL, United States
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Chen M, Fu K, Qiao F, Zhang X, Fan Y, Wang L, Li P, Wu Z, Wu L. Predicting extension of cracks to the root from the dimensions in the crown: A preliminary in vitro study. J Am Dent Assoc 2017. [PMID: 28624073 DOI: 10.1016/j.adaj.2017.05.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In this study, the authors investigated whether extension of a tooth crack into the root can be predicted by the appearance of the crack in the crown in vitro. METHODS The authors obtained 22 cracked teeth from 22 patients who underwent extraction, and they scanned the teeth using microcomputed tomography. The length and width of the crack on the occlusal surface (LOS and WOS, respectively) and the length of the crack on the proximal surface (LCPS) were measured on 3-dimensional reconstruction images. The pulp chamber roof was penetrated and removed. A crack line visible under the microscope only on the access cavity wall rather than extending to the bottom of the pulp chamber was termed a "nonroot crack." A crack seen at the bottom of the pulp chamber or root wall was termed a "root crack." The authors analyzed the data using Pearson correlation coefficients and receiver operating characteristic curves. RESULTS There was a significant correlation between the LOS and LCPS (correlation coefficient, 0.782; P < .001) and between the WOS and LCPS (correlation coefficient, 0.651; P < .05). The LCPS increased by 1.195 millimeters for every 1-mm increase in the LOS. The area under the receiver operating characteristic curve was 0.839 (95% confidence interval, 0.659 to 1.000) for LOS and 0.760 (95% confidence interval, 0.557 to 0.964) for WOS. CONCLUSIONS The extent of a crown crack may indicate how far the crack extends to the root. Both the LOS and WOS may be valuable for assessing whether a crack involves the root, although the LOS seems to be more useful. PRACTICAL IMPLICATIONS The dimensions of a crack in a crown provide a helpful approach for predicting the depth of the crack and its likely prognosis.
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Qiao F, Chen M, Hu X, Niu K, Zhang X, Li Y, Wu Z, Shen Z, Wu L. Cracked Teeth and Poor Oral Masticatory Habits: A Matched Case-control Study in China. J Endod 2017; 43:885-889. [DOI: 10.1016/j.joen.2017.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/01/2017] [Accepted: 01/08/2017] [Indexed: 11/30/2022]
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Tan ASJ, Bennett GW, Tan JCW, Abbott PV. Diagnostic procedures employed by dental practitioners in Australia with a focus on endodontic diagnostic procedures. Aust Dent J 2017; 62:337-344. [DOI: 10.1111/adj.12511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 11/28/2022]
Affiliation(s)
- ASJ Tan
- School of Dentistry; The University of Western Australia; Nedlands Western Australia USA
| | - GW Bennett
- School of Dentistry; The University of Western Australia; Nedlands Western Australia USA
| | - JCW Tan
- School of Dentistry; The University of Western Australia; Nedlands Western Australia USA
| | - PV Abbott
- School of Dentistry; The University of Western Australia; Nedlands Western Australia USA
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Daher R, Feilzer AJ, Krejci I. Novel non-invasive reinforcement of MOD cavities on endodontically treated teeth. J Dent 2016; 54:77-85. [DOI: 10.1016/j.jdent.2016.09.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 09/03/2016] [Accepted: 09/20/2016] [Indexed: 10/21/2022] Open
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