EVALUATION OF TREATMENT OUTCOMES OF CRACKED POSTERIOR TEETH.

Ogundare T.O,^1* Ajayi D.M,² Idon P.I,³ Bamise C.T,⁴Oginni A.O,⁴ Esan T.A^4
1Department of Restorative Dentistry, Obafemi Awolowo University Teaching Hospitals Complex, Osun State, Nigeria.
²Department of Restorative Dentistry, Faculty of Dentistry, University of Ibadan, Oyo State, Nigeria.
³ Department of Dental Surgery, University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria.
⁴ Department of Restorative Dentistry, Faculty of Dentistry, Obafemi Awolowo University, Osun State, Nigeria.

Corresponding author: Dr. Temiloluwa Olawale Ogundare Email: likkysmart@yahoo.com
Conflict of interest: None
Sources of funding: None

ABSTRACT

Aim: To document the clinical features associated with cracked posterior teeth and determine the outcome of their treatment among adult patients.

Materials and methods: A prospective clinical study among consecutive patients that assessed the signs and symptoms associated with cracked teeth, which were grouped based on diagnosis into: Class A (asymptomatic), Class B (reversible pulpitis), Class C (irreversible pulpitis, pulpal necrosis, apical periodontitis and apical abscess) and Class D (features of class C with extension of cracks into the pulpal floor, roots, with periodontal complication and or swelling). In order to determine the class of cracks the teeth fell into, the teeth were examined for presence of mobility, periodontal pocket and tenderness to percussion; and chewing pain was verified with bite tests. Treatment protocols applied included counseling, composite restoration and occlusal adjustment, root canal treatment and crowning and extractions. Baseline and post-treatment assessments of chewing pain were performed with visual analog scale (VAS). The data generated were analysed using the IBM SPSS version 23 and the variables compared with chi square, student t test (paired and independent) and analysis of variance (ANOVA) tests. The level of statistical significance was set at p<0.05.

Results: Of the 264 cracked teeth, 129(48.9%) were asymptomatic (Class A). Twenty-five (9.5%) were in Class B, 71 (26.9%) in Class C and 39 (14.8%) in Class D. From the 135 teeth in symptomatic classes (B, C and D), chewing pain was seen in 117 (86.7%) and thermal sensitivity in 92 (68.1%). One hundred and four teeth (39.4%) were tender to percussion. Frequency of chewing pain was higher in classes C (93%) and D (82.1%), while class B had a higher frequency (76%) of thermal sensitivity. One hundred and nine (84.5%) of the asymptomatic cracks (class A) available for review at 3 months remained asymptomatic. Also, 22 (88%) of class B and 65 (91.5%) of class C were asymptomatic at 3 months. There were no complaints following extractions for class D cracks. There was a great reduction in mean VAS scores for chewing pain between baseline and review periods for classes B and C and this was statistically significant (p < 0.05).

Conclusion: Almost half of the patients with cracked teeth were asymptomatic. Chewing pain was the commonest complaint while the most prevalent sign was tenderness to percussion. The treatment protocols gave positive outcomes, and can be recommended for treatment of cracked teeth.

Key words: cracked posterior teeth, signs, symptoms, treatment outcome.