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.
Highlights
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 were referred for endodontic treatment of 285 teeth during the time of data collection, of which 80 teeth of 72 patients complied with the inclusion criteria
These results differ from the results published by Kang et al.[5] reporting that half of the teeth presented with M-D cracks, and only a few (19%) presented with B-L cracks. They have reported that a single crack was diagnosed in only 14% of the teeth. These differences may be explained by the fact that, unlike Kang et al.[5], this study evaluated only non-endodontically treated teeth, while teeth with vertical root fracture (VRF) were excluded
Summary
The objective of this study was to evaluate potential risk factors, including the placement of dental implants, for the development of tooth cracks. A systematic review of the literature published in 20163 confirmed that this potential complication had not been reported prior to that review Another recent study[12] presented a series of 18 cases of non-endodontically treated teeth that were diagnosed with cracks after the reconstruction of an implant-supported rehabilitation, and proposed that “the most common patient profile would be a woman over 50 years old, having a cracked mandibular premolar tooth, which was diagnosed more than 1 year after reconstruction based on multiple implants”[12]. The objective of this study was to evaluate potential risk factors for the development of cracked teeth, including the placement of dental implants, based on a retrospective evaluation of patients that were referred for endodontic treatment
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