Thomas J Hilton1, Ellen Funkhouser2, Jack L Ferracane3, Gregg H Gilbert4, Valeria V Gordan5, Sandra Bennett6, Jennifer Bone7, Peggy A Richardson8, Hans Malmstrom9. 1. School of Dentistry, Oregon Health &, Science University, 2730 S.W. Moody Ave, Portland, OR 97201-5042, United States. Electronic address: hiltont@ohsu.edu. 2. School of Medicine, University of Alabama, Birmingham, 1720 2nd Avenue South, Birmingham, AL 35294-0007, United States. 3. Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, 2730 S.W. Moody Ave, Portland, OR 97201-5042, United States. 4. Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, United States. 5. Department of Restorative Dental Sciences, University of Florida, 1600 SW Archer Rd, Gainesville, FL 32610, United States. 6. Private Practice, 22400 SE Stark Street, Gresham, OR 97030, United States. 7. Private Practice, 710 Hill Country Drive, Suite 1, Kerrville, TX 78028, United States. 8. Private Practice, 7060 Centennial Drive, Suite 103, Tinley Park, IL 60477, United States. 9. Division of General Dentistry, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Avenue, Rochester, NY 14620, United States.
Abstract
OBJECTIVES: The study objective was to: (1) quantify symptom (pain) and crack changes during one year of follow-up, among teeth that had at least one visible crack at baseline but which did not receive treatment for those cracks; (2) identify any patient traits/behaviors and external tooth/crack characteristics correlated with these changes. METHODS: In this observational study, 209 National Dental Practice-Based Research Network dentists enrolled a convenience sample of 2858 subjects, each with a single, vital posterior tooth with at least one observed external crack; 1850 teeth remained untreated after one year of follow-up and were the cohort for analyses. Data were collected at the patient-, tooth-, and crack-level at baseline, one-year follow up (Y1), and interim visits. Associations between changes in symptoms and cracks were identified, as were changes in symptoms associated with baseline treatment recommendations. RESULTS: Changes in pain symptoms were observed in 32% of patients; decreases were twice as common as increases (23% vs. 10%). More changes were observed in cold pain than in biting pain and spontaneous pain combined; 2% had increases in biting pain and 2% in spontaneous pain. Only 6% had an increase in the number of cracks. Changes in pain symptoms were not associated with an increase in the number of cracks, but were associated with baseline treatment recommendations. Specifically, pain symptom changes (especially decreases) were more common when the tooth was recommended for treatment at baseline. CONCLUSIONS: Cracked teeth that have not received treatment one year after baseline do not show meaningful progression as measured by increased symptoms or number of cracks during follow-up. CLINICAL SIGNIFICANCE: Untreated cracked teeth, most of which were recommended for monitoring at baseline and some of which were recommended for treatment but did not receive treatment, remained relatively stable for one year with little progression of cracks or symptoms.
OBJECTIVES: The study objective was to: (1) quantify symptom (pain) and crack changes during one year of follow-up, among teeth that had at least one visible crack at baseline but which did not receive treatment for those cracks; (2) identify any patient traits/behaviors and external tooth/crack characteristics correlated with these changes. METHODS: In this observational study, 209 National Dental Practice-Based Research Network dentists enrolled a convenience sample of 2858 subjects, each with a single, vital posterior tooth with at least one observed external crack; 1850 teeth remained untreated after one year of follow-up and were the cohort for analyses. Data were collected at the patient-, tooth-, and crack-level at baseline, one-year follow up (Y1), and interim visits. Associations between changes in symptoms and cracks were identified, as were changes in symptoms associated with baseline treatment recommendations. RESULTS: Changes in pain symptoms were observed in 32% of patients; decreases were twice as common as increases (23% vs. 10%). More changes were observed in cold pain than in biting pain and spontaneous pain combined; 2% had increases in biting pain and 2% in spontaneous pain. Only 6% had an increase in the number of cracks. Changes in pain symptoms were not associated with an increase in the number of cracks, but were associated with baseline treatment recommendations. Specifically, pain symptom changes (especially decreases) were more common when the tooth was recommended for treatment at baseline. CONCLUSIONS: Cracked teeth that have not received treatment one year after baseline do not show meaningful progression as measured by increased symptoms or number of cracks during follow-up. CLINICAL SIGNIFICANCE: Untreated cracked teeth, most of which were recommended for monitoring at baseline and some of which were recommended for treatment but did not receive treatment, remained relatively stable for one year with little progression of cracks or symptoms.
Authors: Thomas J Hilton; Ellen Funkhouser; Jack L Ferracane; Valeria V Gordan; Kevin D Huff; Julie Barna; Rahma Mungia; Timothy Marker; Gregg H Gilbert Journal: J Dent Date: 2017-12-28 Impact factor: 4.379
Authors: Ellen Funkhouser; Jack L Ferracane; Thomas J Hilton; Valeria V Gordan; Gregg H Gilbert; Rahma Mungia; Vanessa Burton; Cyril Meyerowitz; Dorota T Kopycka-Kedzierawski Journal: J Dent Date: 2022-02-25 Impact factor: 4.379
Authors: Thomas J Hilton; Ellen Funkhouser; Jack L Ferracane; Gregg H Gilbert; Valeria V Gordan; Dorota T Kopycka-Kedzierawski; Cyril Meyerowitz; Rahma Mungia; Vanessa Burton Journal: J Am Dent Assoc Date: 2020-12-24 Impact factor: 3.634