The clinical findings and managements in 44 cases of cracked vital molars

Abstract

Background/purpose: The aim of this study was to evaluate the associations between the clinical findings and managements in cracked vital molars that were caused by various factors including restoration and occlusion.

Materials and methods: The subjects' gender, age, chief complaint, type of tooth, percussion test results, pulp vitality, restoration material and cavity classification, clinical depth of the crack, evaluation of occlusion, depth of periodontal probing, and final management were recorded.

Results: A total of 44 vital cracked teeth (molars) were diagnosed in 40 patients. Regarding the type of tooth, a greater number of mandibular molars were affected than maxillary molars. Nonworking-side interference (NWI) was recognized in 38 cases (86.4%). Eight teeth (18.2%) had not been restored. Thirty-six teeth (81.8%) had been restored; 26 teeth (72.2%) with a metal inlay, 6 (16.7%) with an amalgam, and 4 (11.1%) with a composite resin. Regarding the final treatment in the endodontically-treated group, all 17 teeth were covered with a metal full crown. Regarding the final treatment in the pulp-reserved group, 19 teeth (70.4%) were covered with a metal full crown, and the other managements were as follows: occlusal adjustment (n = 4, 14.8%), composite resin (n = 2, 7.4%), and only follow-up without treatment (n = 2, 7.4%). All of the cases showed a good clinical prognosis.

Conclusion: The NWI group restored with 58% of metal inlay accounted for more than 86% of the cracked teeth. Thus, in order to achieve a good outcome, cracked teeth, particularly those originating due to occlusal interference should be protected with coverage-type restorations.

Keywords: cracked tooth; final treatment; occlusion; restoration; vital molar.