Jack L Ferracane1,1, Thomas J Hilton2, Ellen Funkhouser3, Valeria V Gordan4, Gregg H Gilbert5, Rahma Mungia6, Vanessa Burton7, Cyril Meyerowitz8, Dorota T Kopycka-Kedzierawski9, National Dental Pbrn Collaborative Group. 1. Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, 2730 S. Moody Ave, Portland, OR, 97201-5042, USA. ferracan@ohsu.edu. 2. Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, 2730 S. Moody Ave, Portland, OR, 97201-5042, USA. 3. School of Medicine, University of Alabama, Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294-0007, USA. 4. Department of Restorative Dental Sciences, University of Florida, 1600 SW Archer Rd, Gainesville, FL, 32610, USA. 5. Department of Clinical and Community Sciences, School of Dentistry, University of Alabama at Birmingham, 1919 7th Ave. S., Birmingham, AL, 35233, USA. 6. Department of Periodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA. 7. HealthPartners, 5901 John Martin Dr, Brooklyn Center, MN, 55430, USA. 8. Eastman Institute for Oral Health, University of Rochester, 601 Elmwood Avenue, Box 686, Rochester, NY, 14642, USA. 9. Eastman Institute for Oral Health, 625 Elmwood Ave, Box 683, Rochester, NY, 14620, USA.
Abstract
OBJECTIVES: To describe treatment and monitoring outcomes of posterior teeth with cracks at baseline followed in the National Dental Practice-Based Research Network for up to three years. MATERIALS AND METHODS: Two hundred and nine dentists enrolled a convenience sample of 2,858 patients, each with a posterior tooth with at least one visible crack and followed them for three years. Characteristics at the patient, tooth, and crack level were recorded at baseline and at annual recall visits. Data on all teeth referred for extraction were reviewed. Data on all other teeth, treated or monitored, seen at one or more recall visits were reviewed for evidence of failure (subsequent extraction, endodontics, or recommendation for a re-treatment). RESULTS: The survival rate for teeth with cracks at baseline exceeded 98% (only 37 extractions), and the failure rate for teeth that were treated restoratively was only 14%. Also, only about 14% of teeth recommended at baseline for monitoring were later recommended to be treated, and about 6.5% of teeth recommended for monitoring at baseline were later treated without a specific recommendation. Thus, about 80% of teeth recommended at baseline for monitoring continued with a monitoring recommendation throughout the entire three years of the study. Treatment failures were associated with intracoronal restorations (vs. full or partial coverage) and male patients. CONCLUSIONS: In this large 3-year practice-based study conducted across the USA, the survival rate of posterior teeth with a visible crack exceeded 85%. Clinical relevance Dentists can effectively evaluate patient-, tooth-, and crack-level characteristics to determine which teeth with cracks warrant treatment and which only warrant monitoring.
OBJECTIVES: To describe treatment and monitoring outcomes of posterior teeth with cracks at baseline followed in the National Dental Practice-Based Research Network for up to three years. MATERIALS AND METHODS: Two hundred and nine dentists enrolled a convenience sample of 2,858 patients, each with a posterior tooth with at least one visible crack and followed them for three years. Characteristics at the patient, tooth, and crack level were recorded at baseline and at annual recall visits. Data on all teeth referred for extraction were reviewed. Data on all other teeth, treated or monitored, seen at one or more recall visits were reviewed for evidence of failure (subsequent extraction, endodontics, or recommendation for a re-treatment). RESULTS: The survival rate for teeth with cracks at baseline exceeded 98% (only 37 extractions), and the failure rate for teeth that were treated restoratively was only 14%. Also, only about 14% of teeth recommended at baseline for monitoring were later recommended to be treated, and about 6.5% of teeth recommended for monitoring at baseline were later treated without a specific recommendation. Thus, about 80% of teeth recommended at baseline for monitoring continued with a monitoring recommendation throughout the entire three years of the study. Treatment failures were associated with intracoronal restorations (vs. full or partial coverage) and male patients. CONCLUSIONS: In this large 3-year practice-based study conducted across the USA, the survival rate of posterior teeth with a visible crack exceeded 85%. Clinical relevance Dentists can effectively evaluate patient-, tooth-, and crack-level characteristics to determine which teeth with cracks warrant treatment and which only warrant monitoring.
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