Analysis of Factors Associated with Cracked Teeth
Deog-Gyu Seo, DDS, MS, PhD,* Young-Ah Yi, DDS, MS, PhD,† Su-Jung Shin, DDS, MS, PhD,‡
and Jeong-Won Park, DDS, MS, PhD‡
Abstract
Introduction: The purpose of this study was to analyze
the characteristics, distribution, and associated factors
of longitudinal fractured teeth according to the well-
defined criteria of the American Association of Endodon-
tists (AAE). Methods: One hundred seven teeth with
longitudinal fracture from 103 patients were diagnosed
and analyzed. The patients’ signs, symptoms, age, and
sex were noted as well as the tooth number, dental
arch, filling materials, size/classification of restoration,
crack direction, pulp vitality, whether the patient had
undergone endodontic treatment, bite test results,
percussion test results, wear facet, and periodontal
pocket depth. Results: Eighty-seven teeth were diag-
nosed with a cracked tooth (81.3%), 14 were diagnosed
with vertical root fracture (VRF, 13.1%), 4 had a split
tooth (3.7%), and 2 had a fractured cusp (1.9%);
82.2% showed a sensitive reaction on the bite test.
Longitudinal tooth fractures were observed most
frequently in patient in their 40s. The upper first molar
(28.0%) was most frequently cracked, followed by the
lower first molar (25.2%), the lower second molar
(20.6%), and the upper second molar (16.8%). Most
longitudinal tooth fractures (72.0%) occurred mainly in
restored teeth, whereas only 28.0% were found in intact
teeth. Compared with resin (4.7%) or porcelain (0.9%),
the use of nonbonded inlay restoration materials such as
gold (20.5%) or amalgam (18.7%) increased the occur-
rence of longitudinal tooth fractures. Out of 107 of
longitudinal fractured teeth, 33 (30.8%) were treated
endodontically and 74 (69.2%) were not. VRF was asso-
ciated with endodontic treatment. Conclusions: The
bite test is most reliable for reproducing symptoms.
The combined use of various examination methods
is recommended for detecting cracks and minutely
inspecting all directions of a tooth. (J Endod
2012;38:288–292)
Key Words
Associated factors, bite test, cracked tooth, longitudinal
tooth fracture, restoration materials
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