Diagnostic and treatment preferences for cracked posterior teeth

Background

Longitudinal cracks in teeth are common and often present challenges in diagnosis and management. This study investigated the preferred diagnostic process and treatment modalities for these cracked teeth.

Methods

Dentists currently registered with Dental Board of Australia and practising within Australia were invited to complete an online Qualtrics-based survey on their perspectives on the presentations, diagnosis, and treatment preferences for cracked teeth.

Results

Of respondents, 56.8% chose to place an indirect cuspal-coverage restoration on an asymptomatic cracked vital tooth. When the tooth was mildly cold sensitive, direct cuspal-coverage restoration was favoured (64.9%), while 36.8% preferred placing an orthodontic band in a tooth with biting pain. Respondents had higher odds of recommending indirect restoration when CAD–CAM milling was available on-site or magnification was routinely used, regardless of presenting symptoms. Almost half (46.8%) preferred to extract if the tooth undergoing root canal treatment had a crack with a 5 mm probing pocket depth. Most (71.4%) demonstrated a poor understanding of cracked tooth biomechanics.

Conclusion

Australian dentists varied in their diagnostic and treatment preferences for cracked teeth, reflecting a need for more well-controlled clinical studies in the diagnostic process, clinical biomechanics and treatment modalities for these teeth. © 2023 Australian Dental Association.