Treatment Decision-making of Cracked Teeth: Survey of American Endodontists

JOURNAL TITLE: The Journal of Contemporary Dental Practice

Author
1. Rafael A Roges
2. Ayman M Abulhamael
3. Loai Alsofi
4. Radhika Tandon
5. Ziyad T Alzamzami
6. Ilan Rotstein
ISSN
DOI
10.5005/jp-journals-10024-2554
Volume
20
Issue
5
Publishing Year
2019
Pages
5
Author Affiliations
    1. Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
    1. All India Institute of Medical Sciences New Delhi, India
    2. AIIMS, New Delhi, India
    3. All India Institute of Medical Sciences, New Delhi, India
    4. Dr Rajendra Prasad Centre, for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
    5. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
    6. Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi
    7. All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
    8. Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
    9. Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
    10. All India Institute of Medical Sciences (AIIMS), New Delhi, India
    1. Private practice San Francisco and the Bay Area
    1. Department of Endodontics, Faculty of Dentistry, King Abdulaziz University Dental Hospital, Jeddah, Saudi Arabia
    1. Department of Endodontics, Herman Ostrow School of Dentistry of USC, Los Angeles, California, USA
    1. Department of Endodontics at the Herman Ostrow School of Dentistry of the University of Southern California, Los Angeles, California, USA
  • Article keywords
    Cracked tooth, Probing depth, Root canal treatment, Tooth survival

    Abstract

    Aim: The aim of this study is to survey the opinion of endodontists in the United States regarding their approach to treatment of cracked teeth. Materials and methods: A survey assessing the opinions of 3,500 endodontists in the United States was administered over a 4-week period. It consisted of a hypothetical clinical case and eight different treatment scenarios. Participants were asked to select one of the two treatment options: (A) informing the patient of the presence of a crack, reinforcing the tooth, and continuing with endodontic treatment; and (B) extraction of the tooth followed by replacement with an implant supported crown or fixed partial denture. Results: When the crack extended across the distal marginal ridge with no associated probing depths, 92.65% endodontists preferred to continue with endodontic treatment and reenforcing the tooth. When the crack extended across the distal marginal ridge and was associated with a probing depth of 6 mm, 80% preferred extraction of the tooth. When the crack extended across the mesial marginal ridge up to the orifice of the mesiolingual canal with no associated probing depth, 82.78% preferred to continue with the treatment. When the crack was associated with a 6-mm probing depth, 83.79% preferred tooth extraction. When the crack extended across the mesial marginal ridge and down into the mesiolingual canal with/without associated probing depth, 91.13% and 63.54% preferred tooth extraction, respectively. When the crack involved both mesial and distal marginal ridges and extended across the pulp chamber, 79.74% preferred tooth extraction. When a split tooth was presented, 98.48% preferred tooth extraction. Conclusion: It appears that the presence of a 6-mm periodontal pocket is considered an important factor by most American endodontists when deciding whether to preserve the cracked tooth or extract it. Clinical significance: There is no consensus among dentists regarding the best approach to treat cracked teeth. Conclusive studies evaluating clinical approaches of endodontists regarding treatment of cracked teeth are lacking. Therefore, surveyed opinion of endodontists in the United States regarding their approach to treatment of cracked teeth was done to try to reach the best clinical decision regarding this dilemma.

    © 2019 Jaypee Brothers Medical Publishers (P) LTD.   |   All Rights Reserved