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Seet RF, Chan PY, Sim CPC, Quek HC, Yu VSH, Lui JN. Pulp Survival of Cracked Teeth with Reversible Pulpitis after Orthodontic Banding and Coronal Coverage - a Prospective Cohort Study with One Year Follow Up. J Endod 2024:S0099-2399(24)00301-7. [PMID: 38782183 DOI: 10.1016/j.joen.2024.05.006] [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: 03/04/2024] [Revised: 05/12/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION The aim of this prospective study was to investigate the 1-year pulp survival of cracked teeth with reversible pulpitis managed with initial stabilization using orthodontic bands, followed by coronal coverage restorations. METHODS One-hundred-and-twenty-five patients with a cracked tooth with reversible pulpitis each were recruited. Pre-operative patient and tooth data were collected. After definitive pulp diagnoses were determined following an interim period of orthodontic banding, coronal coverage restorations were placed. Cox and logistic regression analyses were used to assess possible prognostic factors and to correlate initial time to pulp stabilization while in orthodontic bands with eventual outcome. Pulp survival was determined using both clinical and radiographic findings. RESULTS One-hundred-and-six cracked teeth were followed up at 1 year. Pulp survival based on clinical and radiographic findings was found in 81 teeth (76.4%). Out of 25 failures, 11 (44%) required root canal treatment (RCT) in the orthodontic band stage and 10 (40%) required RCT during the process of or after coronal coverage restorations. Four teeth (16%) had incidental findings of periapical radiolucencies at the one-year review without clinical symptoms. Teeth requiring RCT were found to have required longer periods in orthodontic bands prior to a definitive pulp diagnosis (p<0.05). CONCLUSION A step-by-step approach by using orthodontic banding to monitor pulp status may reduce the incidence of RCT required through definitive coronal coverage restorations for cracked teeth with reversible pulpitis.
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Affiliation(s)
- Rachel Fangying Seet
- Department of Restorative Dentistry, National Dental Centre of Singapore, Singapore.
| | - Pei Yuan Chan
- Department of Restorative Dentistry, National Dental Centre of Singapore, Singapore
| | | | - Heng Chuan Quek
- Department of Restorative Dentistry, National Dental Centre of Singapore, Singapore
| | - Victoria Soo Hoon Yu
- Faculty of Dentistry, National University of Singapore, Singapore; ORCHIDS: Oral Care Health Innovations and Designs Singapore, National University of Singapore, Singapore
| | - Jeen-Nee Lui
- Department of Restorative Dentistry, National Dental Centre of Singapore, Singapore
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Yap RC, Alghanem M, Martin N. A narrative review of cracks in teeth: Aetiology, microstructure and diagnostic challenges. J Dent 2023; 138:104683. [PMID: 37713950 DOI: 10.1016/j.jdent.2023.104683] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVES To summarize the available evidence of crack formation in teeth and to discuss the limitations of the current clinical diagnostic modalities for crack detection in teeth. BACKGROUND Cracks are a common clinical finding in teeth and yet clinicians still struggle to identify the full extent and orientation of cracks for their appropriate timely management. The biomechanics of crack development can be due to multiple factors and can differ from an unrestored tooth to a restored or endodontically treated tooth. DATA & SOURCES This narrative review has been designed following the guidelines published by Green et al. 2006 [1] Published literature in the English language that addresses the objectives of this review up to July 2022 was sourced from online databases and reference lists. The relevance of the papers was assessed and discussed by two reviewers. A total of 101 publications were included in this narrative review. CONCLUSIONS The initiation and development of cracks in teeth are likely linked to an interplay between the masticatory forces and fracture resistance of the remaining tooth structure. From the identified literature, the quality and quantity of remaining tooth structure in a restored or endodontically-treated tooth affects the biomechanics of crack development compared to an unrestored tooth. The extent, orientation, and size of the cracks do affect a clinician's ability to detect cracks in teeth. There is still a need to develop reliable diagnostic tools that will accurately identify cracks in teeth beneath restorations to enable effective monitoring of their propagation and provide appropriate interventions. CLINICAL SIGNIFICANCE The development and propagation of cracks in an unrestored tooth differ greatly from a restored and endodontically treated tooth; mainly linked to the quantity and quality of the remaining tooth structure and the forces acting on them. Identifying the extent of cracks in teeth remains challenging for early clinical intervention.
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Affiliation(s)
- Rei Chiel Yap
- DClinDent student, School of Clinical Dentistry, The University of Sheffield, S10 2TA, UK.
| | - Meshal Alghanem
- DClinDent student, School of Clinical Dentistry, The University of Sheffield, S10 2TA, UK.
| | - Nicolas Martin
- Professor of Restorative Dentistry, School of Clinical Dentistry, The University of Sheffield, S10 2TA, UK.
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Nagrani T, Kumar S, Haq MA, Dhanasekaran S, Gajjar S, Patel C, Sinha S, Haque M. Use of Injectable Platelet-Rich Fibrin Accompanied by Bone Graft in Socket Endurance: A Radiographic and Histological Study. Cureus 2023; 15:e46909. [PMID: 37841989 PMCID: PMC10569439 DOI: 10.7759/cureus.46909] [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: 10/12/2023] [Indexed: 10/17/2023] Open
Abstract
Background Ridge preservation became a crucial dental health issue and strategy to keep away from ridge defacement after post-tooth loss. The recent scientific evolution of platelet-rich fibrin (PRF) comprises a parenteral formulation of PRF. The combined allograft for socket preservation gives benefits. In this study, bone allografts, demineralized freeze-dried bone allografts (DFDBA) and freeze-dried bone allografts (FDBA) are used in a 30:70 ratio alone or in combination with injectable PRF (I-PRF) for socket preservation. Methods This study is a radiographic and histological examination conducted on 60 participants aged between 19-65 years. Participating patients agreed voluntarily that they would not bear any fixed prosthesis for the next nine months and plan for implanted teeth placement, including multi-rooted mandibular molars denticles. Both groups received atraumatic extraction; then, the socket was preserved with bone allograft alone in the control group and bone allograft mixed with I-PRF, forming sticky bone, in the experimental group. Clinical, radiological, and histological assessments were taken at the inception stage, three months, six months, and nine months. A multivariate regression model and a generalized estimating equation (GEE) model were used to analyse the effects of these changes on outcomes. Results In all the parameters, the test group indicated a good amount of bone growth with increasing intervals of time for bone height radiographically with statistically significant difference present (p<0.05) and histologically after nine months when socket site grafted with bone graft in combination with I-PRF. Conclusion This study's results demonstrated that I-PRF possesses the potential to regenerate and heal in the tooth-extracted socket. This study further recommends the implementation of I-PRF in safeguarding and conserving the raised rim of the tooth. Future research should take place on the osteogenic capability of I-PRF in more comprehensive ridge accession surgical procedures and additional expanding and improving capacities in periodontal reconstruction.
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Affiliation(s)
- Tanya Nagrani
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Santosh Kumar
- Periodontology and Implantology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Md Ahsanul Haq
- Bio-Statistics, Infectious Diseases Division, icddr, b, Dhaka, BGD
| | | | - Shreya Gajjar
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Chandni Patel
- Periodontology, Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
| | - Susmita Sinha
- Physiology, Khulna City Medical College and Hospital, Khulna, BGD
| | - Mainul Haque
- Karnavati Scientific Research Center (KSRC), Karnavati School of Dentistry, Karnavati University, Gandhinagar, IND
- Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS
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Sun J, Jiang J, Xue Z, Ma H, Pan J, Qian K. Mechanical properties of cracked teeth with different dental materials and crown parameters: An in vitro proof-of-concept. J Mech Behav Biomed Mater 2023; 145:106045. [PMID: 37506569 DOI: 10.1016/j.jmbbm.2023.106045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 07/23/2023] [Indexed: 07/30/2023]
Abstract
OBJECTIVE This work analyzed and compared the mechanical properties of identical cracked tooth models treated with different materials and crown parameters. Thus, to provide dentists with a more structured way to select materials and geometric parameters and determine the strongest restoration model for cracked teeth. METHODS This work used finite element analysis (FEA). We applied 25 restorative models, including five restorative materials, and three preparation parameters. Seven mechanical properties of the cracked tooth preparation were analyzed using correlation analysis. RESULTS The highest lifetime of the cracked preparation was obtained for crowns with a 5° of polymerization, width = 0.8 mm, and a length offset of 0.2 mm. The highest lifetime was obtained with ZC crown material, but the least deformation of the cracked tip was obtained with LU material. SIGNIFICANCE The results showed that the larger MOE material for the crown and a reasonable increase in the thickness and length of the crown is a favorable method to prevent further cracks to extend. This FEA study, thereby forming a novel basis for clinical guidance as to preparation of dental crowns applicable to cracked teeth.
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Affiliation(s)
- Jianpeng Sun
- Key Laboratory of Advanced Manufacturing and Intelligent Technology, Ministry of Education, Harbin University of Science and Technology, Harbin, 150080, Heilongjiang, PR China
| | - Jingang Jiang
- Key Laboratory of Advanced Manufacturing and Intelligent Technology, Ministry of Education, Harbin University of Science and Technology, Harbin, 150080, Heilongjiang, PR China.
| | - Zhonghao Xue
- Key Laboratory of Advanced Manufacturing and Intelligent Technology, Ministry of Education, Harbin University of Science and Technology, Harbin, 150080, Heilongjiang, PR China
| | - Hongyuan Ma
- Key Laboratory of Advanced Manufacturing and Intelligent Technology, Ministry of Education, Harbin University of Science and Technology, Harbin, 150080, Heilongjiang, PR China
| | - Jie Pan
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School of Stomatology, Beijing, 100081, PR China; Peking University School of Stomatology, Peking, 100081, PR China
| | - Kun Qian
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School of Stomatology, Beijing, 100081, PR China; Peking University School of Stomatology, Peking, 100081, PR China
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Jiang J, Sun J, Ma H, Zhou S. In silico fatigue performance of molars restored with full crowns under alternating cyclic loadings. J Mech Behav Biomed Mater 2023; 144:105946. [PMID: 37369171 DOI: 10.1016/j.jmbbm.2023.105946] [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: 04/21/2023] [Revised: 05/27/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVE In this study, a preclinical approach was used to analyze and directly compare the fatigue performance (fatigue life and damage percentage) and maximum principal stresses (Max. Ps) of prepared models treated with different materials and geometric parameters. METHODS Four groups of preparative parameters (crown width, crown length, degree of polymerization and material) were selected, each with five variables. An alternating cyclic occlusal load with an amplitude of 300 N was applied to the ball part along the longitudinal axis. The fatigue properties of the preparations and Max.Ps were analyzed. RESULTS A shoulder width of 0.8 mm, a shoulder height offset of 0.2 mm, a degree of polymerization of 5°, and a crown material of ZC resulted in the smallest percentage of damage. In contrast, the effect of different modulus of elasticity (MOE) on Max.Ps was not significant (p = 0.609). CONCLUSION The results suggest that the selection of larger modulus of elasticity MOE and larger Poisson's ratio material's, preparation of larger shoulder widths within safety, reasonable increase in crown length, and selection of larger degree of polymerization are favorable methods to protect the preparation.
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Affiliation(s)
- Jingang Jiang
- Robotics & Its Engineering Research Center, Harbin University of Science and Technology, Harbin, 150080, PR China; Key Laboratory of Advanced Manufacturing and Intelligent Technology, Ministry of Education, Harbin University of Science and Technology, Harbin, 150080, Heilongjiang, PR China.
| | - Jianpeng Sun
- Robotics & Its Engineering Research Center, Harbin University of Science and Technology, Harbin, 150080, PR China
| | - Hongyuan Ma
- Harbin Branch of Taili Communication Technology Limited, China Electronics Technology Group Corporation, Harbin, 150080, Heilongjiang, PR China
| | - Shan Zhou
- The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, PR China
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Jiang J, Sun J, Ma H, Wang J, Huang Z, Zhou S. Stress intensity factor of a cracked molar restored with different materials and designs: A 3D-FEA. J Mech Behav Biomed Mater 2023; 142:105818. [PMID: 37068432 DOI: 10.1016/j.jmbbm.2023.105818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/26/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE This work used 3D finite element analysis (FEA) to analyze and directly compare the stress intensity factor (SIF) and stress distribution at the crack tip of identical cracked tooth models restored with different materials and crown parameters. METHODS A 3D model of the cracked tooth was generated. Then, we applied 25 restorative models, including three parameters (shoulder height, width, and degree of polymerization), five restorative materials (GC, IPS, LU, ZC, VE), and two combinations of types of cement (RMGIC and GIC). An occlusal load of 800N was applied to the spherical part along the longitudinal axis. The stress distribution of the preparation and the SIF of the crack tip was analyzed. RESULTS The crack tip SIF was minimal for a shoulder height offset of 0.8 mm (P = 0.032), a shoulder width of 0.6 mm (P = 0.045), a crown material of ZC (P < 2e-16), and a cement material of RMGIC (P < 0.05), respectively. In contrast, the effect of different polymerization degrees on SIF was insignificant (P = 0.95). CONCLUSION Our results suggest that the selection of a larger modulus of elasticity (MOE) material for the crown, the preparation of a smaller shoulder width within a safe range, a reasonable increase in the crown length, and the selection of adhesive materials with high fracture toughness are favorable methods to prevent further crack extension.
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Affiliation(s)
- Jingang Jiang
- Key Laboratory of Advanced Manufacturing and Intelligent Technology, Ministry of Education, Harbin University of Science and Technology, Harbin, 150080, Heilongjiang, PR China; Robotics & Its Engineering Research Center, Harbin University of Science and Technology, Harbin, 150080, China.
| | - Jianpeng Sun
- Robotics & Its Engineering Research Center, Harbin University of Science and Technology, Harbin, 150080, China
| | - Hongyuan Ma
- Harbin Branch of Taili Communication Technology Limited, China Electronics Technology Group Corporation, Harbin, 150080, Heilongjiang, People's Republic of China
| | - Jingchao Wang
- The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, PR China
| | - Zhiyuan Huang
- State Key Laboratory of Robotics and System, Harbin Institute of Technology, Harbin, 150001, Heilongjiang, PR China
| | - Shan Zhou
- The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, Heilongjiang, PR China.
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Evaluation of the clinical efficacy of quantitative light-induced fluorescence technology in diagnosing cracked teeth. Photodiagnosis Photodyn Ther 2023; 41:103299. [PMID: 36693456 DOI: 10.1016/j.pdpdt.2023.103299] [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: 11/05/2022] [Revised: 01/02/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
BACKGROUND This retrospective study evaluated the clinical efficacy of quantitative light-induced fluorescence (QLF) technology for crack detection and the diagnosis of cracked teeth and assessed the possibility of a quantitative evaluation of cracks using QLF technology. METHODS Patients who were clinically diagnosed with cracked teeth over a 1-year period were included. The QLF images of the corresponding symptomatic cracked teeth and asymptomatic contralateral teeth with crack lines were taken with Qraypen C (AIOBIO, Seoul, Korea). Fluorescence loss (ΔF), maximum fluorescence loss (ΔFmax), red fluorescence (ΔR), and maximum red fluorescence (ΔRmax) of the crack line were analyzed. The correlation between these parameters and sex, age, tooth position (1st premolar, 2nd premolar, 1st molar, 2nd molar), spontaneous pain (+/-), percussion test (+/-), cold test (++/+/-), and bite test (+/-) were statistically analyzed. RESULTS A total of 66 patients were included. Twenty-four patients had asymptomatic contralateral teeth with apparent crack lines; thus, 90 teeth were analyzed. The crack lines in 84 teeth observed as red fluorescent lines on the QLF images showed ΔR values higher than the cut-off value set by the analysis program used. The patient's age and the ∣ΔF∣ and ΔR values were positively correlated. However, there was no statistically significant difference in the QLF parameters between the same patient's symptomatic tooth and the contralateral tooth. CONCLUSIONS QLF technology is a useful assistive diagnostic device for diagnosing cracked teeth.
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Automatic Detection of Cracks in Cracked Tooth Based on Binary Classification Convolutional Neural Networks. Appl Bionics Biomech 2022; 2022:9333406. [PMID: 36245930 PMCID: PMC9553657 DOI: 10.1155/2022/9333406] [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: 08/10/2022] [Accepted: 08/23/2022] [Indexed: 11/18/2022] Open
Abstract
Cracked tooth syndrome is a commonly encountered disease in dentistry, which is often accompanied by dramatic painful responses from occlusion and temperature stimulation. Current clinical diagnostic trials include traditional methods (such as occlusion test, probing, cold stimulation, etc.) and X-rays based medical imaging (periapical radiography (PR), cone-beam computed tomography (CBCT), etc.). However, these methods are strongly dependent on the experience of the clinicians, and some inconspicuous cracks are also extremely easy to be overlooked by visual observation, which will definitely affect the subsequent treatments. Inspired by the achievements of applying deep convolutional neural networks (CNNs) in crack detection in engineering, this article proposes an image-based crack detection method using a deep CNN classifier in combination with a sliding window algorithm. A CNN model is designed by modifying the size of the input layer and adding a fully connected layer with 2 units based on the ResNet50, and then, the proposed CNN is trained and validated with a self-prepared cracked tooth dataset including 20,000 images. By comparing validation accuracy under seven different learning rates, 10−5 is chosen as the best learning rate for the following testing process. The trained CNN is tested on 100 images with 1920 × 1080-pixel resolutions, which achieves an average accuracy of 90.39%. The results show that the proposed method can effectively detect cracks in images under various conditions (stained, overexplosion, images affected by other diseases). The proposed method in this article provides doctors with a more intelligent diagnostic solution, and it is not only suitable for optical photographs but also for automated diagnosis of other medical imaging images.
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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] [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 School National and Kapodistrian University of Athens Athens Greece
- Private Practice Athens Greece
| | - Dimitrios Gavriil
- MClinDent Restorative Dentistry Newcastle University Newcastle upon Tyne UK
- Private Practice Korinthos Greece
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Guo J, Wu Y, Chen L, Long S, Chen D, Ouyang H, Zhang C, Tang Y, Wang W. A perspective on the diagnosis of cracked tooth: imaging modalities evolve to AI-based analysis. Biomed Eng Online 2022; 21:36. [PMID: 35706023 PMCID: PMC9202175 DOI: 10.1186/s12938-022-01008-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/03/2022] [Indexed: 11/10/2022] Open
Abstract
Despite numerous clinical trials and pre-clinical developments, the diagnosis of cracked tooth, especially in the early stages, remains a challenge. Cracked tooth syndrome is often accompanied by dramatic painful responses from occlusion and temperature stimulation, which has become one of the leading causes for tooth loss in adults. Current clinical diagnostical approaches for cracked tooth have been widely investigated based on X-rays, optical light, ultrasound wave, etc. Advances in artificial intelligence (AI) development have unlocked the possibility of detecting the crack in a more intellectual and automotive way. This may lead to the possibility of further enhancement of the diagnostic accuracy for cracked tooth disease. In this review, various medical imaging technologies for diagnosing cracked tooth are overviewed. In particular, the imaging modality, effect and the advantages of each diagnostic technique are discussed. What's more, AI-based crack detection and classification methods, especially the convolutional neural network (CNN)-based algorithms, including image classification (AlexNet), object detection (YOLO, Faster-RCNN), semantic segmentation (U-Net, Segnet) are comprehensively reviewed. Finally, the future perspectives and challenges in the diagnosis of the cracked tooth are lighted.
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Affiliation(s)
- Juncheng Guo
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Yuyan Wu
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Lizhi Chen
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Shangbin Long
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Daqi Chen
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Haibing Ouyang
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Chunliang Zhang
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China
| | - Yadong Tang
- School of Biomedical and Pharmaceutical Sciences, Guangdong University of Technology, Guangzhou, 510006, China
| | - Wenlong Wang
- School of Mechanical and Electrical Engineering, Guangzhou University, Guangzhou, 510006, China.
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Infrared Clinical Enamel Crack Detector Based on Silicon CCD and Its Application: A High-Quality and Low-Cost Option. J Imaging 2021; 7:jimaging7120259. [PMID: 34940726 PMCID: PMC8703581 DOI: 10.3390/jimaging7120259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 11/28/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022] Open
Abstract
Enamel cracks generated in the anterior teeth not only affect the function but also the aesthetics of the teeth. Chair-side tooth enamel crack detection is essential for clinicians to formulate treatment plans and prevent related dental disease. This study aimed to develop a dental imaging system using a near-IR light source to detect enamel cracks and to investigate the relationship between anterior enamel cracks and age in vivo. A total of 68 subjects were divided into three groups according to their age: young, middle, and elderly. Near-infrared radiation of 850 nm was used to identify enamel cracks in anterior teeth. The results of the quantitative examination showed that the number of enamel cracks on the teeth increased considerably with age. For the qualitative examination, the results indicated that there was no significant relationship between the severity of the enamel cracks and age. So, it can be concluded that the prevalence of anterior cracked tooth increased significantly with age in the young and middle age. The length of the anterior enamel cracks tended to increase with age too; however, this result was not significant. The silicon charge-coupled device (CCD) with a wavelength of 850 nm has a good performance in the detection of enamel cracks and has very good clinical practicability.
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Crubézy E, Duchesne S, Razafindrazaka H, Romanova L, Gérard P, Alcouffe A, Esclassan R, Melnichuk O, Ushnitsky I, Ludes B, Telmon N, Tegel W, Dabernat H, Zvenigorosky V, Prados-Frutos JC. Sucrose Is Not the Whole Story: Risk Factors and Oral Health at the Contact (Yakutia, Siberia-16th/19th). BIOLOGY 2021; 10:biology10100974. [PMID: 34681073 PMCID: PMC8533550 DOI: 10.3390/biology10100974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 11/16/2022]
Abstract
Simple Summary We have studied the dental epidemiology of 96 frozen bodies from north-eastern Siberia (Yakuts) before and after the contact—with an accurate chronology–between Autochthonous and European populations. The peculiarities of the Yakut population are the rarity of cavities and the relative frequency of dental pathologies leading to death. Dental health evolves only two centuries after the contact; assimilation into the Russian Orthodox culture has decreased tooth wear and increased tooth loss. A comparison with historical data suggests that this evolution is not linked to the increasing importance of sucrose, but to the combined action of the substitution of dendrophagia with cereal flour; a decrease in immunity associated with the development of chronic infectious diseases; smoking as well as the mandibular torus: a risk factor favoring apical cysts. Abstract (1) Background: contact between indigenous and European populations has often resulted in changes in oral health attributed to the introduction of sucrose. Most studies are per tooth over considerable periods and with few ethnological references. (2) Aim: dental epidemiology of 96 autochthonous frozen bodies from Yakutia between the early 17th century and the late 19th century; comparisons with historical texts and ethnographic data. (3) Material and methods: we use descriptive statistics and discriminant factorial analyses to identify dominant variables in the dataset and compare periods and subjects, considering all variables. (4) Results: the peculiarities of the population are the rarity of cavities and the relative frequency of dental pathologies leading to death. Assimilation into the Russian Orthodox culture has led to decreased tooth wear and an increase in tooth loss. Dental health evolves only two centuries after the contact. (5) Conclusions: the confrontation with historical data suggests that changes are not related to the growing importance of sucrose but to a combined action: the substitution of dendrophagy by cereal flour; the decrease in immunity linked to the development of chronic infectious diseases; tobacco addiction and the mandibular torus: a risk factor promoting apical cysts.
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Affiliation(s)
- Eric Crubézy
- Centre d’Anthropobiologie et de Génomique de Toulouse, Faculté de Médecine Purpan, Université Paul Sabatier Toulouse III, 37 Allées Jules Guesde, 31073 Toulouse, France; (S.D.); (P.G.); (A.A.); (R.E.); (N.T.); (H.D.)
- Laboratoire International Associé CNRS/Fédération de Russie COSIE, 31073 Toulouse, France; (L.R.); (O.M.); (B.L.); (V.Z.)
- Correspondence: (E.C.); (J.C.P.-F.)
| | - Sylvie Duchesne
- Centre d’Anthropobiologie et de Génomique de Toulouse, Faculté de Médecine Purpan, Université Paul Sabatier Toulouse III, 37 Allées Jules Guesde, 31073 Toulouse, France; (S.D.); (P.G.); (A.A.); (R.E.); (N.T.); (H.D.)
- Institut National de Recherches Archéologiques Préventives (INRAP), 13 Rue du Négoce, 31650 Saint-Orens-de-Gameville, France
| | | | - Liubomira Romanova
- Laboratoire International Associé CNRS/Fédération de Russie COSIE, 31073 Toulouse, France; (L.R.); (O.M.); (B.L.); (V.Z.)
- Institute of Modern Languages and Regional Studies, North-Eastern Federal University, 58 Belinskogo Street, 677000 Yakutsk, Russia
| | - Patrice Gérard
- Centre d’Anthropobiologie et de Génomique de Toulouse, Faculté de Médecine Purpan, Université Paul Sabatier Toulouse III, 37 Allées Jules Guesde, 31073 Toulouse, France; (S.D.); (P.G.); (A.A.); (R.E.); (N.T.); (H.D.)
- Laboratoire International Associé CNRS/Fédération de Russie COSIE, 31073 Toulouse, France; (L.R.); (O.M.); (B.L.); (V.Z.)
| | - Ameline Alcouffe
- Centre d’Anthropobiologie et de Génomique de Toulouse, Faculté de Médecine Purpan, Université Paul Sabatier Toulouse III, 37 Allées Jules Guesde, 31073 Toulouse, France; (S.D.); (P.G.); (A.A.); (R.E.); (N.T.); (H.D.)
| | - Rémi Esclassan
- Centre d’Anthropobiologie et de Génomique de Toulouse, Faculté de Médecine Purpan, Université Paul Sabatier Toulouse III, 37 Allées Jules Guesde, 31073 Toulouse, France; (S.D.); (P.G.); (A.A.); (R.E.); (N.T.); (H.D.)
| | - Olga Melnichuk
- Laboratoire International Associé CNRS/Fédération de Russie COSIE, 31073 Toulouse, France; (L.R.); (O.M.); (B.L.); (V.Z.)
- Institute of Modern Languages and Regional Studies, North-Eastern Federal University, 58 Belinskogo Street, 677000 Yakutsk, Russia
| | - Innokenty Ushnitsky
- Medical Institute of the North-Eastern Federal University, Ammosov North-Eastern Federal University, 58 Belinskogo Street, 677000 Yakutsk, Russia;
| | - Bertrand Ludes
- Laboratoire International Associé CNRS/Fédération de Russie COSIE, 31073 Toulouse, France; (L.R.); (O.M.); (B.L.); (V.Z.)
- BABEL, CNRS UMR 2029, Université Paris V Descartes, 75006 Paris, France
| | - Norbert Telmon
- Centre d’Anthropobiologie et de Génomique de Toulouse, Faculté de Médecine Purpan, Université Paul Sabatier Toulouse III, 37 Allées Jules Guesde, 31073 Toulouse, France; (S.D.); (P.G.); (A.A.); (R.E.); (N.T.); (H.D.)
| | - Willy Tegel
- Faculty of Environment and Natural Resources, Albert-Ludwigs Universität, 79098 Freiburg, Germany;
| | - Henri Dabernat
- Centre d’Anthropobiologie et de Génomique de Toulouse, Faculté de Médecine Purpan, Université Paul Sabatier Toulouse III, 37 Allées Jules Guesde, 31073 Toulouse, France; (S.D.); (P.G.); (A.A.); (R.E.); (N.T.); (H.D.)
| | - Vincent Zvenigorosky
- Laboratoire International Associé CNRS/Fédération de Russie COSIE, 31073 Toulouse, France; (L.R.); (O.M.); (B.L.); (V.Z.)
- BABEL, CNRS UMR 2029, Université Paris V Descartes, 75006 Paris, France
| | - Juan Carlos Prados-Frutos
- Department of Medical Specialties and Public Health (Forensic and Legal Medicine Area), Faculty of Health Sciences, Rey Juan Carlos University, Avenida de Atenas s/n, 28933 Madrid, Spain
- Correspondence: (E.C.); (J.C.P.-F.)
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13
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Pyo CY, Kim TH, Kim DH. Association between masticatory muscle activity and oral conditions in young female college students. Anat Cell Biol 2021; 54:479-488. [PMID: 34552039 PMCID: PMC8693132 DOI: 10.5115/acb.21.107] [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: 05/25/2021] [Revised: 07/12/2021] [Accepted: 07/26/2021] [Indexed: 11/27/2022] Open
Abstract
The purpose of this study was to determine the characteristics of masticatory muscle activity and various oral condition factors, and to analyze their associations in order to improve the prevention and diagnosis of masticatory muscle-related diseases. This study included 30 Korean females (mean age of 20 years, age range of 19-21 years). Participants were instructed to complete a self-written questionnaire on factors that may affect their muscle activity. Surface electromyography was used to measure the activity of the masseter and temporalis muscles. We also observed the buccal mucosa ridge, tongue indentation, tooth cracks and fractures, and mandibular tori in the oral cavity. Spearman correlation analysis and the nonparametric Mann-Whitney U test were applied to the data. When subjects had temporomandibular disorder, the right temporalis muscle exhibited significantly lower activity (P<0.05). Those who had received orthodontic treatment within the previous 2 years showed significantly lower activity of the left masseter muscle (P<0.05). Those who had a left buccal mucosa ridge exhibited lower activity of the left masseter muscle and higher activity of the right temporalis muscle compared with those without such a ridge (P<0.05). Participants with no tongue indentation showed significantly higher activity in the left masseter muscle (P<0.05). These results indicate that there are relationships between masticatory muscle activity and various factors related to the oral condition.
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Affiliation(s)
| | - Tae-Hoon Kim
- Department of Occupational Therapy, Division of Health Sciences, Dongseo University, Busan, Korea
| | - Da-Hye Kim
- Department of Dental Hygiene, Division of Health Sciences, Dongseo University, Busan, Korea
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14
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Malentacca A, Zaccheo F, Scialanca M, Fordellone F, Rupe C, Lajolo C. Repair of teeth with cracks in crowns and roots: An observational clinical study. Int Endod J 2021; 54:1738-1753. [PMID: 34291470 DOI: 10.1111/iej.13598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 07/20/2021] [Indexed: 11/26/2022]
Abstract
AIM This retrospective observational study investigated the survival rate of teeth with radicular cracks that were restored using composite materials. METHODOLOGY The study was approved by the Ethical Committee of Sistema Sanitario Nazionale (prot. N°2370CELazio1), Clinicaltrials.gov identifier: NCT04430205. Between 1991 and 2019, 87 teeth with radicular cracks (87 patients [46 men, 41 women, mean age 50.2 years]) were treated with adhesive composite restorations. Forty-five cracks were observed in the maxillary posterior teeth (molars and premolars), 40 in the mandibular posterior teeth and only two cracks in the anterior teeth, both in maxilla. Based on the depth of the crack, teeth were categorized as proximal radicular cracked teeth (PRCT), in which the fracture line was restricted within the pulpal floor or the coronal one-third of the root and deep radicular cracked teeth (DRCT), in which the fracture line extended to the middle and apical thirds of the root canal up to the apex. Bone loss/recovery was evaluated radiographically at 1-year follow-up. All patients were treated using surgical microscopy by the same operator. Logistic regression analysis was performed to determine independent predictors of extraction. Kaplan-Meier survival curves were used to analyse PRCT and DRCT. RESULTS Among 87 cracked teeth, 66 were molars, 19 premolars and 2 incisors. Fifty-two were DRCT, 35 were PRCT, 46 had a periodontal probing defect. Patients were followed up for a mean of 66.9 months (standard deviation 44.6, min 1 to max 172). Lack of probing depth was a significant protective factor against extraction (odds ratio [OR] 0.027, 95% confidence interval [CI] 0.003-0.27, p < .05), whereas further bone loss (OR 10.63, 95% CI 2.08-54.36, p < .05) was a risk factor for extraction. More than 50% of teeth treated with the adhesive protocol were functional (46 of 87 teeth [χ2 test], p < .05) at 5-year follow-up. Among the PRCT group, a 78% survival rate at 5 years was found, while among the DRCT group, a 58% survival rate was found. CONCLUSION Composite resin restorations resulted in tooth survival in >50% of patients; 85.4% of PRCT and 61.5% of DRCT were functional after 5 years of follow-up.
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Affiliation(s)
| | | | | | | | - Cosimo Rupe
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS" - Università Cattolica del Sacro Cuore, Rome, Italy
| | - Carlo Lajolo
- Head and Neck Department, "Fondazione Policlinico Universitario A. Gemelli - IRCCS" - Università Cattolica del Sacro Cuore, Rome, Italy
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15
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X-ray dark-field tomography reveals tooth cracks. Sci Rep 2021; 11:14017. [PMID: 34234228 PMCID: PMC8263584 DOI: 10.1038/s41598-021-93393-4] [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: 01/04/2021] [Accepted: 05/12/2021] [Indexed: 11/11/2022] Open
Abstract
Cracked tooth syndrome (CTS) is a common clinical finding for teeth, it affects about 5% of all adults each year. The finding of CTS is favored by several risk factors such as restorations, bruxism, occlusion habits, and age. Treatment options range, depending on the severity, from no treatment at all to tooth extraction. Early diagnosis of CTS is crucial for optimal treatment and symptom reduction. There is no standard procedure for an evidence-based diagnosis up to date. The diagnosis is a challenge by the fact that the symptoms, including pain and sensitivity to temperature stimuli, cannot be clearly linked to the disease. Commonly used visual inspection does not provide in-depth information and is limited by the resolution of human eyes. This can be overcome by magnifying optics or contrast enhancers, but the diagnosis will still strongly rely on the practicians experience. Other methods are symptom reproduction with percussions, thermal pulp tests or bite tests. Dental X-ray radiography, as well as computed tomography, rarely detect cracks as they are limited in resolution. Here, we investigate X-ray dark-field tomography (XDT) for the detection of tooth microcracks. XDT simultaneously detects X-ray small-angle scattering (SAXS) in addition to the attenuation, whereas it is most sensitive to the micrometer regime. Since SAXS originates from gradients in electron density, the signal is sensitive to the sample morphology. Microcracks create manifold interfaces which lead to a strong signal. Therefore, it is possible to detect structural changes originating from subpixel-sized structures without directly resolving them. Together with complementary attenuation information, which visualizes comparatively large cracks, cracks are detected on all length-scales for a whole tooth in a non-destructive way. Hence, this proof-of principle study on three ex-vivo teeth shows the potential of X-ray scattering for evidence-based detection of cracked teeth.
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16
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Lee TY, Yang SE, Kim HM, Kye MJ. Characteristics, Treatment, and Prognosis of Cracked Teeth: A Comparison with Data from 10 Years Ago. Eur J Dent 2021; 15:694-701. [PMID: 34171933 PMCID: PMC8630975 DOI: 10.1055/s-0041-1728842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objectives
The purpose of this study was to analyze and to compare retrospectively the characteristics, the treatment process, and the prognosis of cracked teeth by comparing recent data with data from 10 years ago.
Materials and Methods
Sixty-eight cracked teeth from March 2009 to June 2010 (2009 data) and 185 cracked teeth from March 2019 to June 2020 (2019 data) were analyzed. The characteristics of cracked teeth and the treatment method depending on probing depth, caries, and symptoms, and prognosis depending on pocket depth and apical lesions were analyzed using R version 3.3.3 (R Foundation for Statistical Computing, Vienna, Austria) and T&F version 3.0 (YooJin BioSoft, Korea). To compare proportions, the two-sample proportion test was performed. The distribution of proportions within the samples from 2009 and 2019 data was analyzed using the Chi-square test or binomial test. A
p
-value <0.05 was considered to indicate statistical significance.
Results
Significantly fewer cracked teeth received root canal treatment before crown in 2019 than in 2009 (
p
= 0.032). In both 2009 and 2019, symptomatic cracked teeth and those with deep periodontal pockets (>6 mm) were significantly more likely to receive root canal treatment. In both years, cracked teeth with a probing depth less than 6 mm or without an apical lesion were significantly more likely to be asymptomatic at 3-month and 6-month follow-ups (
p
< 0.001).
Conclusion
Cracked teeth with a deep periodontal pocket or symptoms had a higher likelihood of endodontic treatment, and the presence of a deep periodontal pocket or apical lesion was associated with a higher risk of persistent symptoms. Therefore, clinicians should consider these factors when planning treatment and predicting patients’ prognosis.
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Affiliation(s)
- Tae Yeon Lee
- Department of Conservative Dentistry, College of Medicine, Yeouido ST. Mary's Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung Eun Yang
- Department of Conservative Dentistry, College of Medicine, Seoul St. Mary's Dental Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hye Min Kim
- Department of Conservative Dentistry, College of Medicine, Seoul St. Mary's Dental Hospital, The Catholic University of Korea, Seoul, Republic of Korea
| | - Min Joo Kye
- Department of Conservative Dentistry, College of Medicine, Seoul St. Mary's Dental Hospital, The Catholic University of Korea, Seoul, Republic of Korea
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17
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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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18
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Abstract
Examining the nature of stress distribution within the intact tooth can aid in understanding how natural tooth structures are able to resist mechanical forces during masticatory function. Identification of potential fractures in teeth on clinical examination is essential for correct diagnosis, particularly if there is pulpal involvement. This discussion will consider the different types of fracture, their identification and management. This paper will highlight management of tooth fractures, including identifying prognostic indicators, which are largely dependent on the extent of the fracture within the tooth structure.
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Affiliation(s)
- Sanjeev Bhanderi
- Specialist in Endodontics, Senior Lecturer, University of Liverpool Dental School; ENDO61 Specialist practice, Manchester
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19
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Root fractures in seniors: Consequences of acute embrittlement of dentin. Dent Mater 2020; 36:1464-1473. [DOI: 10.1016/j.dental.2020.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 07/03/2020] [Accepted: 08/29/2020] [Indexed: 12/17/2022]
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20
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Association between longitudinal tooth fractures and visual detection methods in diagnosis. J Dent 2020; 101:103466. [DOI: 10.1016/j.jdent.2020.103466] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/23/2020] [Accepted: 08/28/2020] [Indexed: 11/19/2022] Open
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21
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Diagnosis of root fractures using cone-beam computed tomography: difference of vertical and horizontal root fracture. Oral Radiol 2020; 37:305-310. [PMID: 32524232 DOI: 10.1007/s11282-020-00453-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the occurrence of vertical and horizontal root fractures using cone-beam computed tomography (CBCT). METHODS We reviewed the CBCT images of 51 patients who were examined by CBCT for the diagnosis of root fracture. The occurrences of vertical and horizontal root fractures were investigated concerning the pulpal vitality and the kind of tooth, and analyzed by cross-tabulation. The fracture direction of vertical root fracture and the fracture angle were also investigated, and analyzed by cross-tabulation and Kruskal-Wallis test, respectively. RESULTS The occurrence of vertical and horizontal root fractures was statistically significantly different between vital tooth and non-vital tooth (p = 0.044). The occurrence of vertical and horizontal root fractures was also different among anterior, premolar, and molar teeth (p = 0.004). The kind of tooth on traumatized tooth was only anterior teeth and the number was larger on horizontal root fracture. The occurrence of vertical and horizontal root fractures on non-traumatized tooth was different among the kind of tooth (p = 0.007), and the number of vertical root fracture was larger than that of horizontal root fracture on premolar teeth. Fracture direction was not different, but the fracture angle was different among the kind of tooth on vertical root fracture (p = 0.027). CONCLUSIONS The results suggested that the number of vertical root fracture was larger on non-vital tooth and that of horizontal root fracture was larger on vital tooth. The number of vertical root fracture was larger on premolar teeth.
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22
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Rosen E, Volmark Y, Beitlitum I, Nissan J, Nemcovsky CE, Tsesis I. Dental implant placement is a possible risk factor for the development of multiple cracks in non-endodontically treated teeth. Sci Rep 2020; 10:8527. [PMID: 32444845 PMCID: PMC7244581 DOI: 10.1038/s41598-020-65408-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/30/2020] [Indexed: 11/30/2022] Open
Abstract
The objective of this study was to evaluate potential risk factors, including the placement of dental implants, for the development of tooth cracks. A series of 212-patients, who were referred for endodontic treatment, were retrospectively screened, of which 72 (34%) patients had been diagnosed with 80-cracked teeth confirmed with an operating microscope. These patients had an average age of 53-years and were equally distributed between genders. Forty-one percent of the cracked teeth were diagnosed after the placement of dental implants, with an average of 3-implants per patient. Seventy percent of the cracks were diagnosed more than 1-year after implant loading. Implant placement was associated with higher odds of having multiple cracks (OR = 9.78, CI:2.320, 41.216)(p < 0.05). The proportion of cracked premolars was relatively high (30%), and most cracked teeth (79%) were vital and with a normal periapical diagnosis (86%). Most cracked teeth (71%) had an amalgam restoration, and teeth restored with amalgam were at a higher risk of having multiple cracks (p < 0.05). Clinicians should be aware of a common profile of endodontic patients with multiple cracks in a non-endodontically treated premolar, restored with an amalgam restoration, which was diagnosed with the cracks more than 1-year after reconstruction utilizing multiple implants.
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Affiliation(s)
- Eyal Rosen
- Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
- Tel Aviv University Center for Nanoscience and Nanotechnology, Tel Aviv, Israel.
| | - Yael Volmark
- Department of Prosthodontics, Hebrew University - Hadassah, School of Dental Medicine, Jerusalem, Israel
| | - Ilan Beitlitum
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joseph Nissan
- Oral-Rehabilitation & Implant-Prosthodontics, Rabin Medical-Center, Belinson Hospital, Petah-Tikva, Israel
- Department of Oral-Rehabilitation, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Carlos E Nemcovsky
- Department of Periodontology and Implant Dentistry, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Igor Tsesis
- Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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23
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Olivieri JG, Elmsmari F, Miró Q, Ruiz XF, Krell KV, García-Font M, Durán-Sindreu F. Outcome and Survival of Endodontically Treated Cracked Posterior Permanent Teeth: A Systematic Review and Meta-analysis. J Endod 2020; 46:455-463. [DOI: 10.1016/j.joen.2020.01.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/18/2019] [Accepted: 01/07/2020] [Indexed: 12/24/2022]
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24
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Outcomes of endodontically treated cracked teeth: a systematic review and meta-analysis. Clin Oral Investig 2019; 24:465-473. [DOI: 10.1007/s00784-019-03139-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 10/29/2019] [Indexed: 02/07/2023]
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25
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Sheets CG, Zhang L, Wu JC, Earthman JC. Ten-year retrospective study of the effectiveness of quantitative percussion diagnostics as an indicator of the level of structural pathology in teeth. J Prosthet Dent 2019; 123:693-700. [PMID: 31653402 DOI: 10.1016/j.prosdent.2019.05.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 05/29/2019] [Accepted: 05/30/2019] [Indexed: 11/29/2022]
Abstract
STATEMENT OF PROBLEM Conventional dental diagnostic aids are only partially effective in diagnosing structural defects such as cracks in teeth. A more predictable diagnostic for structural instability in the mouth is needed. PURPOSE The purpose of this clinical study with an increased population size was to evaluate the effectiveness of diagnosing structural instability by using the quantitative percussion diagnostics (QPD) system and to evaluate the influence of independent variables on the relationship between normal fit error (NFE) and observed structural instability found during the clinical disassembly of teeth. MATERIAL AND METHODS Twenty-two participants with 264 sites needing restoration were enrolled in an institutional review board-approved 10-year retrospective clinical study. Each site had been tested with the QPD system before being disassembled microscopically with video documentation, and the clinical disassembly results were recorded on a defect-assessment sheet. The NFE data were separately recorded from the preexisting records. The classification of structural pathology based on the disassembly observations for each of the 264 sites was conducted by the clinical researcher (C.G.S.) who was blinded to the NFE values. RESULTS The 264 sites from 22 patients were classified as 8 in the none group, 87 in the moderate group, and 169 in the severe group based on the disassembly findings. The NFE data for the sites were analyzed by using the predefined NFE cutoffs that were independently generated from the previous cumulative logistic regression and decision tree model. For the cumulative logistic regression, 235 out of 264 sites were correctly classified with an agreement of 0.89 (adjusted 95% CI: 0.83-0.95). The number of correctly classified sites for the decision tree model was 234, and the agreement was also 0.89 (adjusted 95% CI: 0.83-0.94). For both cumulative logistic regression and decision tree models, the overall misclassification rate was less than 20% for any restoration material or restoration type. Therefore, the overall performance of NFE classification was consistently good, regardless of restoration material or type. In addition, the sensitivity of the severe category was above 90% for any restoration material or type for the decision tree model. CONCLUSIONS The QPD system was found to be a reliable diagnostic aid for classifying structural damage in the categories of none, moderate, or severe based on clinical disassembly findings under the clinical microscope and NFE values. Furthermore, it was determined that restoration type and restoration design were not significant factors in correlating structural pathology with NFE.
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Affiliation(s)
- Cherilyn G Sheets
- Co-Executive Director, Newport Coast Oral-Facial Institute, Newport Beach, Calif.
| | - Lishi Zhang
- Senior Biostatistician, Institute for Clinical and Translational Science, University of California, Irvine, Calif
| | - Jean C Wu
- Co-Executive Director, Newport Coast Oral-Facial Institute, Newport Beach, Calif
| | - James C Earthman
- Professor, Departments of Materials Science and Engineering, and Biomedical Engineering, University of California, Irvine, Calif
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26
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Schuurmans TJ, Nixdorf DR, Idiyatullin DS, Law AS, Barsness BD, Roach SH, Gaalaas L. Accuracy and Reliability of Root Crack and Fracture Detection in Teeth Using Magnetic Resonance Imaging. J Endod 2019; 45:750-755.e2. [PMID: 31056300 DOI: 10.1016/j.joen.2019.03.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 02/19/2019] [Accepted: 03/13/2019] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) has the potential to aid in determining the presence and extent of cracks/fractures in teeth because of better contrast without ionizing radiation. The objectives were to develop MRI criteria for root crack/fracture identification and to establish reliability and accuracy in their detection. METHODS MRI-based criteria for crack/fracture appearance was developed by an MRI physicist and a panel of 6 dentists. Twenty-nine human adult teeth previously extracted after a clinical diagnosis of a root crack/fracture were frequency matched to 29 controls. Samples were scanned using an in vivo MRI protocol and the reference standard (ie, ex vivo limited field of view cone-beam computed tomographic [CBCT] imaging). A blinded, 4-member panel evaluated the images with a proportion randomly retested to establish intrarater reliability. Overall observer agreement, sensitivity, and specificity were computed for each imaging modality. RESULTS Subjectively, MRI has increased crack/fracture contrast and is less prone to artifacts from radiodense materials relative to CBCT imaging. Intrarater reliability for MRI was fair to excellent (κ = 0.38-1.00), and for CBCT imaging, it was moderate to excellent (κ = 0.66-1.00). Sensitivity for MRI was 0.59 (95% confidence interval [CI], 0.39-0.76; P = .46), and for CBCT imaging, it was 0.59 (95% CI, 0.59-0.76; P = .46). Specificity for MRI was 0.83 (95% CI, 0.64-0.94; P < .01), and for CBCT imaging, it was 0.90 (95% CI, 0.73-0.98; P < .01). CONCLUSIONS Despite advantages of increased contrast and the absence of artifacts from radiodense materials in MRI, comparable measures of sensitivity and specificity (to limited field of view CBCT imaging) suggest MRI quality improvements are needed, specifically in image acquisition and postprocessing parameters. Given the early stage of technology development, there may be a use for MRI in detecting cracks/fractures in teeth.
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Affiliation(s)
- Tyler J Schuurmans
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota; Private Practice, Endodontic Specialists of Colorado, Colorado Springs, Colorado.
| | - Donald R Nixdorf
- Division of TMD and Orofacial Pain, School of Dentistry, University of Minnesota, Minneapolis, Minnesota; Department of Neurology, Medical School, University of Minnesota, Minneapolis, Minnesota; HealthPartners Institute for Education and Research, Bloomington, Minnesota
| | - Djaudat S Idiyatullin
- The Center for Magnetic Resonance Research and Department of Radiology, University of Minnesota, Minneapolis, Minnesota
| | - Alan S Law
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota; Private Practice, The Dental Specialists, Lake Elmo, Minnesota
| | - Brian D Barsness
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota; Private Practice, HealthPartners, St Paul, Minnesota
| | - Samantha H Roach
- Division of Endodontics, School of Dentistry, University of Minnesota, Minneapolis, Minnesota; Private Practice, The Dental Specialists, Eagan, Minnesota
| | - Laurence Gaalaas
- Division of Oral Medicine and Diagnosis, School of Dentistry, University of Minnesota, Minneapolis, Minnesota
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Cracked tooth syndrome in irradiated patients with head and neck cancer. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:335-341.e2. [DOI: 10.1016/j.oooo.2018.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 05/24/2018] [Accepted: 06/10/2018] [Indexed: 12/14/2022]
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Ferracane JL, Funkhouser E, Hilton TJ, Gordan VV, Graves CL, Giese KA, Shea W, Pihlstrom D, Gilbert GH. Observable characteristics coincident with internal cracks in teeth: Findings from The National Dental Practice-Based Research Network. J Am Dent Assoc 2018; 149:885-892.e6. [PMID: 30121122 DOI: 10.1016/j.adaj.2018.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 05/29/2018] [Accepted: 06/03/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND This study determined if there are observable patient-, tooth- and crack-level characteristics markedly associated with whether a tooth with an external crack also has an internal crack. METHODS Two hundred nine dentists in The National Dental Practice-Based Research Network enrolled 2,858 adults with a vital permanent posterior tooth having at least 1 observed external crack. Presence and characteristics of internal cracks were recorded for 435 cracked teeth that were treated. Generalized estimating equations were used to identify significant (P < .05) independent odds ratios associated with the tooth having internal cracks. RESULTS Overall, 389 teeth (89%) had at least 1 internal crack, with 46% of these teeth having 2 or more internal cracks. Sixty-nine percent of treated cracked teeth were associated with 1 or more types of pain assessed before treatment; 53% were associated with cold testing, 37% with bite testing, and 26% with spontaneous pain. In the final model, biting pain, having an external crack that connected with a restoration, or an external crack that extended onto the root was each associated with more than a 2-fold increased odds of having an internal crack. CONCLUSIONS Essentially 9 of 10 teeth that had at least 1 external crack also had at least 1 internal crack. PRACTICAL IMPLICATIONS The external cracks that a dental practitioner should be most concerned about, because they are most likely to be associated with internal cracks in the tooth, are those in which the patient experiences biting pain, is connected with a restoration of some type, or extends onto the root.
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Krell KV, Caplan DJ. 12-month Success of Cracked Teeth Treated with Orthograde Root Canal Treatment. J Endod 2018; 44:543-548. [DOI: 10.1016/j.joen.2017.12.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 12/28/2017] [Accepted: 12/28/2017] [Indexed: 02/06/2023]
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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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Alkhalifah S, Alkandari H, Sharma PN, Moule AJ. Treatment of Cracked Teeth. J Endod 2017; 43:1579-1586. [DOI: 10.1016/j.joen.2017.03.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2016] [Revised: 11/25/2016] [Accepted: 03/16/2017] [Indexed: 11/29/2022]
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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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Banerji S, Mehta SB, Millar BJ. The management of cracked tooth syndrome in dental practice. Br Dent J 2017; 222:659-666. [DOI: 10.1038/sj.bdj.2017.398] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2017] [Indexed: 11/09/2022]
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Sheets CG, Wu JC, Rashad S, Phelan M, Earthman JC. In vivo study of the effectiveness of quantitative percussion diagnostics as an indicator of the level of the structural pathology of teeth. J Prosthet Dent 2016; 116:191-199.e1. [DOI: 10.1016/j.prosdent.2016.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 01/08/2016] [Accepted: 01/08/2016] [Indexed: 10/22/2022]
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Decision Making for Retention of Endodontically Treated Posterior Cracked Teeth: A 5-year Follow-up Study. J Endod 2016; 42:225-9. [DOI: 10.1016/j.joen.2015.11.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 10/30/2015] [Accepted: 11/11/2015] [Indexed: 02/07/2023]
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Jun MK, Ku HM, Kim E, Kim HE, Kwon HK, Kim BI. Detection and Analysis of Enamel Cracks by Quantitative Light-induced Fluorescence Technology. J Endod 2016; 42:500-4. [PMID: 26794344 DOI: 10.1016/j.joen.2015.12.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 11/24/2015] [Accepted: 12/06/2015] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The ability to accurately detect tooth cracks and quantify their depth would allow the prediction of crack progression and treatment success. The aim of this in vitro study was to determine the capabilities of quantitative light-induced fluorescence (QLF) technology in the detection of enamel cracks. METHODS Ninety-six extracted human teeth were selected for examining naturally existing or suspected cracked teeth surfaces using a photocuring unit. QLF performed with a digital camera (QLF-D) images were used to assess the ability to detect enamel cracks based on the maximum fluorescence loss value (ΔFmax, %), which was then analyzed using the QLF-D software. A histologic evaluation was then performed in which the samples were sectioned and observed with the aid of a polarized light microscope. The relationship between ΔFmax and the histology findings was assessed based on the Spearman rank correlation. The sensitivity and specificity were calculated to evaluate the validity of using QLF-D to analyze enamel inner-half cracks and cracks extending to the dentin-enamel junction. RESULTS There was a strong correlation between the results of histologic evaluations of enamel cracks and the ΔFmax value, with a correlation coefficient of 0.84. The diagnostic accuracy of QLF-D had a sensitivity of 0.87 and a specificity of 0.98 for enamel inner-half cracks and a sensitivity of 0.90 and a specificity of 1.0 for cracks extending to the dentin-enamel junction. CONCLUSIONS These results indicate that QLF technology would be a useful clinical tool for diagnosing enamel cracks, especially given that this is a nondestructive method.
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Affiliation(s)
- Mi-Kyoung Jun
- Department of Preventive Dentistry and Public Oral Health, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Hye-Min Ku
- Department of Preventive Dentistry and Public Oral Health, College of Dentistry, Yonsei University, Seoul, South Korea; BK 21 PLUS Project, Yonsei University, College of Dentistry, Seoul, South Korea
| | - Euiseong Kim
- Microscope Center, Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Hee-Eun Kim
- Department of Dental Hygiene, Gachon University College of Health Science, Incheon, South Korea
| | - Ho-Keun Kwon
- Department of Preventive Dentistry and Public Oral Health, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Baek-Il Kim
- Department of Preventive Dentistry and Public Oral Health, College of Dentistry, Yonsei University, Seoul, South Korea; BK 21 PLUS Project, Yonsei University, College of Dentistry, Seoul, South Korea; Oral Science Research Institute, Yonsei University, College of Dentistry, Seoul, South Korea.
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Rivera EM, Walton RE. Longitudinal tooth cracks and fractures: an update and review. ACTA ACUST UNITED AC 2015. [DOI: 10.1111/etp.12085] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Abstract
Pain is defined as an “unpleasant sensory and emotional feeling which is associated with actual or potential injury of tissue or expressed in terms of such injury.” Tooth pain usually refers to pain around the teeth or jaws mainly as a result of a dental condition. Mostly, toothaches are caused by a carious cavity, a broken tooth, an exposed tooth root or gum disease. The toothache may sometimes be the result of radiating pain from structures in the vicinity of tooth and jaws (cardiac pain, ear, nose, throat pain, and sinusitis). Therefore, evaluation by both dentists and physicians are sometimes necessary to diagnose medical illnesses causing “toothache.” Cracked tooth syndrome is a major diagnostic challenge in clinical practice. Accurate diagnosis and appropriate treatment are complicated due to lack of awareness of this condition and its bizarre clinical features. Early diagnosis has been linked with successful restorative management and good prognosis. This article provides a detailed literature on the causes, classification, signs and symptoms, diagnosis, and treatment planning of cracked tooth syndrome.
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Affiliation(s)
- Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Kuldeep Singh
- Department of Prosthodontics, Teerthanker Mahaveer Dental College and Research Center, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - Naseer Salati
- Department of Oral Pathology, Z. A Dental College and Hospitals, A.M.U, Aligarh, Uttar Pradesh, India
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A temporary filling material during endodontic treatment may cause tooth fractures in two-surface class II cavities in vitro. Clin Oral Investig 2015; 20:615-20. [PMID: 26243457 DOI: 10.1007/s00784-015-1543-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 07/20/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To investigate the effect of a zinc oxide/zinc sulphate-based cement as a temporary filling material during root canal treatment on the occurrence of cracks within the filling material or the tooth. MATERIALS AND METHODS Root canals of 122 extracted human molars were prepared using ProTaper instruments. Standardized occlusal-distal cavities were prepared. After placing calcium hydroxide into the root canals, the teeth were divided randomly into four groups containing 33 specimens each. In the Coltosol group, the cavity was completely filled with Coltosol® F. In the Coltosol-Clearfil group, a 2-mm layer of Coltosol® F was placed into the apical part of the pulp chamber, and in the Clearfil group, a foam pellet was placed into the coronal pulp chamber. The remaining cavities were filled with Clearfil™. In the control group, the cavities were not restored. The teeth were stored at 37 °C for 14 days and examined every 24 h under a stereomicroscope. RESULTS Fractures of the filling and/or the tooth were only observed in the Coltosol group. All Coltosol® F restorations had cracks after 24 h. Tooth fractures were found in 25 (76 %) teeth. Among these teeth, 21 (84 %) had crown fractures, four (16 %) had root-crown fractures. All root-crown fractures were vertical. CONCLUSION Coltosol® F when used alone led to tooth fractures in two-surface class II cavities in teeth undergoing root canal treatment. CLINICAL RELEVANCE Coltosol® F solely used as restorative material may lead to tooth fractures in two-surface class II cavities.
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Abstract
This article reviews the diagnosis and treatment of cracked teeth, and explores common clinical examples of cracked teeth, such as cusp fractures, fractures into tooth furcations, and root fractures. This article provides alternative definitions of terms such as cracked teeth, complete and incomplete fractures and crack lines, and explores the scientific rationale for dental terminology commonly used to describe cracked teeth, such as cracked tooth syndrome, structural versus nonstructural cracks, and vertical, horizontal, and oblique fractures. The article explains the advantages of high magnification loupes (×6-8 or greater), or the surgical operating microscope, combined with co-axial or head-mounted illumination, when observing teeth for microscopic crack lines or enamel craze lines. The article explores what biomechanical factors help to facilitate the development of cracks in teeth, and under what circumstances a full coverage crown may be indicated for preventing further propagation of a fracture plane. Articles on cracked tooth phenomena were located via a PubMed search using a variety of keywords, and via selective hand-searching of citations contained within located articles.
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Li Y, Carrera C, Chen R, Li J, Chen Y, Lenton P, Rudney JD, Jones RS, Aparicio C, Fok A. Fatigue failure of dentin-composite disks subjected to cyclic diametral compression. Dent Mater 2015; 31:778-88. [PMID: 25958269 DOI: 10.1016/j.dental.2015.03.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 12/30/2014] [Accepted: 03/30/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Our aim was to establish the relationship between cyclic loading and fatigue life of the dentin-composite interface using the newly developed disk in diametral compression tests. The results were then used to estimate the fatigue life of restored teeth under occlusal loading. METHODS Disk specimens (5mm dia.×2mm thick) were prepared using bovine incisors and restored with either a methacrylate-based composite Z100™ with Adper Single Bond Plus (Z100) or silorane-based composite Filtek™ LS with LS System adhesive (LS). The dentin-composite disks were tested under cyclic diametral compression to determine the number of cycles to failure (Nf) at three load levels (n=3 per group). Finite element analysis (FEA) was used to calculate the interfacial stresses (σ) within the specimen, to establish the σ vs. Nf curves, and those within a restored tooth under normal chewing forces (15N maximum). These were then used to estimate the lifetime of the restored tooth for the two restorative systems. RESULTS The disks restored with LS had a higher fatigue resistance than those restored with Z100. The maximum interfacial stress in the restored tooth determined by FEA was ∼0.5MPa. Based on the estimate of 300,000 cycles of chewing per year, the predicted lifetime under occlusal loading for teeth restored with LS and Z100 was 33 and 10 years, respectively. SIGNIFICANCE The disk in cyclic diametral compression has been used successfully to provide fatigue data which allows the lifetime of composite-restored teeth under occlusal loading to be predicted using numerical simulation.
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Affiliation(s)
- Yuping Li
- Minnesota Dental Research Center for Biomaterials and Biomechanics (MDRCBB), School of Dentistry, University of Minnesota, MN, USA
| | - Carola Carrera
- Minnesota Dental Research Center for Biomaterials and Biomechanics (MDRCBB), School of Dentistry, University of Minnesota, MN, USA; Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, MN, USA
| | - Ruoqiong Chen
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, MN, USA
| | - Jianying Li
- Minnesota Dental Research Center for Biomaterials and Biomechanics (MDRCBB), School of Dentistry, University of Minnesota, MN, USA
| | - Yungchung Chen
- Minnesota Dental Research Center for Biomaterials and Biomechanics (MDRCBB), School of Dentistry, University of Minnesota, MN, USA
| | - Patricia Lenton
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, MN, USA
| | - Joel D Rudney
- Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, MN, USA
| | - Robert S Jones
- Department of Developmental and Surgical Sciences, School of Dentistry, University of Minnesota, MN, USA
| | - Conrado Aparicio
- Minnesota Dental Research Center for Biomaterials and Biomechanics (MDRCBB), School of Dentistry, University of Minnesota, MN, USA
| | - Alex Fok
- Minnesota Dental Research Center for Biomaterials and Biomechanics (MDRCBB), School of Dentistry, University of Minnesota, MN, USA.
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An in vitro comparison of quantitative percussion diagnostics with a standard technique for determining the presence of cracks in natural teeth. J Prosthet Dent 2014; 112:267-75. [DOI: 10.1016/j.prosdent.2014.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 02/13/2014] [Accepted: 02/20/2014] [Indexed: 11/18/2022]
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Banerji S, Mehta S, Kamran T, Kalakonda M, Millar B. 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; 42:862-71. [DOI: 10.1016/j.jdent.2014.02.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 02/02/2014] [Accepted: 02/20/2014] [Indexed: 11/28/2022] Open
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Tennert C, Eismann M, Goetz F, Woelber JP, Hellwig E, Polydorou O. A temporary filling material used for coronal sealing during endodontic treatment may cause tooth fractures in large Class II cavities in vitro. Int Endod J 2014; 48:84-8. [PMID: 24646310 DOI: 10.1111/iej.12280] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 03/13/2014] [Indexed: 11/27/2022]
Abstract
AIM To investigate the use of a zinc oxide/zinc sulphate-based cement (Coltosol(®) F, Coltène Whaledent, Cuyahoga Falls, OH, USA) as a temporary filling material during multiple-visit root canal treatments and the occurrence of cracks within the filling material or the tooth. METHODOLOGY Root canals of one hundred and twenty-two extracted human molars were prepared using ProTaper instruments up to size F2. After root canal preparation, standardized mesial-occlusal-distal cavities were prepared. The buccal-lingual/palatal width of the cavities was 4.5 mm), so that the remaining cavity walls had a mean thickness of 3.5 mm. Teeth were checked for cracks and fracture lines using a stereomicroscope with 10× magnification. A calcium hydroxide slurry was used as an intracanal dressing. The teeth were divided into three groups. In the Coltosol group, the cavity was filled with Coltosol(®) F. In the Coltosol-Clearfil group, a 2-mm layer of Coltosol(®) F was placed into the coronal pulp chamber, the remaining cavity was filled with Clearfil(™) . In the Clearfil group, a foam pellet was placed onto the orifices of the root canals, the remaining cavity was filled with Clearfil(™) . In the control group, the cavities were left without any filling material. The teeth were stored in water at 37 °C for 14 days and examined every 24 h under a stereomicroscope for fracture lines occurring on the tooth surface or in the filling material. RESULTS In the Coltosol group, fractures within the filling material were observed in 28 (85%) of 33 teeth. 13 (39%) teeth had tooth fractures. Amongst these teeth, 8 (61%) had root fractures, 1 (8%) had a crown fracture and 4 (31%) had a root-crown fracture. CONCLUSION Coltosol(®) F, when used alone as a restorative material, led to tooth fractures in Class II cavities in teeth undergoing root canal treatment. Tooth fractures may occur 4 days after placement of the filling.
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Affiliation(s)
- C Tennert
- Department of Operative Dentistry and Periodontology, University of Freiburg - Medical Center, Freiburg, Germany
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Batalha-Silva S, Gondo R, Stolf SC, Baratieri LN. Cracked tooth syndrome in an unrestored maxillary premolar: a case report. Oper Dent 2014; 39:460-8. [PMID: 24517730 DOI: 10.2341/13-257] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Cracked tooth syndrome is known to occur most frequently in heavily restored teeth. Nevertheless, when the symptoms occur in intact teeth, there is difficulty in obtaining a correct diagnosis because it is difficult for the dentist to find where the crack is located. This clinical report describes the diagnostic procedures and the direct bonded composite restoration used to restore an incompletely fractured unrestored maxillary premolar in a 22-year-old female patient. To achieve a correct diagnosis, the following were performed: periapical and bitewing radiographs, percussion and thermal vitality tests, a bite test, and the placement of a stainless steel band. Once the symptoms ceased with band placement, cone beam computed tomography, transillumination, macro photographs, and isolation with a rubber dam helped to visualize the crack line along the occlusal surface involving distal and mesial marginal ridges. The crack was traced using a high-speed tungsten carbide bur until the fracture line was not visible. The tooth was restored with a direct composite resin, associated with a total-etch adhesive system, and the symptoms were immediately eliminated.
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Brady E, Mannocci F, Brown J, Wilson R, Patel S. A comparison of cone beam computed tomography and periapical radiography for the detection of vertical root fractures in nonendodontically treated teeth. Int Endod J 2013; 47:735-46. [DOI: 10.1111/iej.12209] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 10/29/2013] [Indexed: 11/29/2022]
Affiliation(s)
- E. Brady
- Department of Conservative Dentistry; King's College London Dental Institute; London UK
| | - F. Mannocci
- Department of Conservative Dentistry; King's College London Dental Institute; London UK
| | - J. Brown
- Department of Dento-Maxillofacial Imaging; King's College London Dental Institute; London UK
| | - R. Wilson
- Department of Periodontology; King's College London Dental Institute; London UK
| | - S. Patel
- Department of Conservative Dentistry; King's College London Dental Institute; London UK
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47
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Briso ALF, Lima APB, Gonçalves RS, Gallinari MO, dos Santos PH. Transenamel and transdentinal penetration of hydrogen peroxide applied to cracked or microabrasioned enamel. Oper Dent 2013; 39:166-73. [PMID: 23802644 DOI: 10.2341/13-014-l] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The present study evaluated transenamel and transdentinal penetration of hydrogen peroxide during tooth whitening recognized in altered enamel by the presence of cracks or microabrasion. We used 72 experimental units (n=20) obtained from bovine incisors: GI-sound enamel; GII-teeth showing visible enamel cracks (4 mm to 5.7 mm in length); and GIII-microabrasioned enamel. The 12 remaining specimens were used to analyze the enamel surface morphology using scanning electron microscopy. The specimens were cylindrical and 5.7 mm in diameter and 3.5 mm thick. A product based on 35% hydrogen peroxide was used for bleaching, following the manufacturer's recommendations for use. To quantify the H2O2 penetration, the specimens were placed in artificial pulp chambers containing an acetate buffer solution. After bleaching, the solution was collected and adequately proportioned with leucocrystal violet, peroxidase enzyme, and deionized water. The resulting solution was evaluated using ultraviolet visible reflectance spectrophotometer equipment. The data were analyzed by analysis of variance (ANOVA) and Fisher's PLSD at a significance level of 0.05, and significant differences in the penetration of peroxide in different substrate conditions were observed (p<0.0001). The penetration of hydrogen peroxide was more intense in cracked teeth. The group in which the enamel was microabraded showed intermediate values when compared to the control group. Microabrasion and the presence of cracks in the enamel make this substrate more susceptible to penetration of hydrogen peroxide during in-office whitening.
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48
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Different Treatment Protocols for Different Pulpal and Periapical Diagnoses of 72 Cracked Teeth. J Endod 2013; 39:449-52. [DOI: 10.1016/j.joen.2012.11.052] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Revised: 11/19/2012] [Accepted: 11/26/2012] [Indexed: 11/19/2022]
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49
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Lin CL, Chang YH, Hsieh SK, Chang WJ. Estimation of the Failure Risk of a Maxillary Premolar with Different Crack Depths with Endodontic Treatment by Computer-aided Design/Computer-aided Manufacturing Ceramic Restorations. J Endod 2013; 39:375-9. [DOI: 10.1016/j.joen.2012.11.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 11/16/2012] [Accepted: 11/16/2012] [Indexed: 10/27/2022]
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50
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Seghi RR, Nasrin S, Draney J, Katsube N. Root Fortification. J Endod 2013; 39:S57-62. [DOI: 10.1016/j.joen.2012.10.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 10/23/2012] [Indexed: 10/27/2022]
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