06 March 2023

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Lessons learned from the Cracked Tooth Registry

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Background

This article reviews the most salient lessons learned from a large, multisite, three-year observational study of posterior teeth with cracks conducted by The National Dental Practice–Based Research Network.

Types of studies reviewed

Researchers reviewed and discussed eight articles published over a six-year period (2017-2022) describing clinical characteristics of posterior teeth with cracks and their treatment and outcomes. The team aimed to answer three common questions faced by oral health care clinicians: Which cracked teeth will get worse? When should practitioners intervene? What is the best treatment?

Results

Although cracks in teeth are prevalent, few will fracture (3%) or show crack progression in three years (12%). Characteristics that guide the clinician to treatment include active caries, biting pain and to a lesser degree, having a crack detectable with an explorer, connecting with a restoration, or blocking transilluminated light. The main treatment chosen is a complete crown. Of those teeth treated (36%), few (14%) will need retreatment but will still survive, despite having an internal crack as well.

Conclusions, practical Implications

Although cracked teeth often pose a dilemma to clinicians, clinicians are generally good at deciding which teeth to treat and when and which to monitor.

Jack L. Ferracane, Thomas J. Hilton and Ellen Funkhouser. "Lessons learned from the Cracked Tooth Registry: A 3-year clinical study in the Nation’s Network." JADA. 21 January 2023. DOI: https://doi.org/10.1016/j.adaj.2022.11.020