TY - JOUR
T1 - Baseline characteristics as 3-year predictors of tooth fracture and crack progression
T2 - Findings from The National Dental Practice-Based Research Network
AU - The National Dental Practice-Based Research Network Collaborative Group
AU - Hilton, Thomas J.
AU - Funkhouser, Ellen
AU - Ferracane, Jack L.
AU - Gilbert, Gregg H.
AU - Gordan, Valeria V.
AU - Kopycka-Kedzierawski, Dorota T.
AU - Meyerowitz, Cyril
AU - Mungia, Rahma
AU - Burton, Vanessa
N1 - Publisher Copyright:
© 2021 American Dental Association
PY - 2021/2
Y1 - 2021/2
N2 - Background: The authors of this practice-based study estimated the risk of experiencing tooth fractures and crack progression over 3 years and correlated baseline patient-, tooth-, and crack-level characteristics with these outcomes. Methods: Two-hundred-and-nine National Dental Practice-Based Research Network dentists enrolled a convenience sample of 2,601 participants with a cracked vital posterior tooth that had been examined for at least 1 recall visit over 3 years. Data were collected at the patient, tooth, and crack levels at baseline, annual follow-up visits, and any interim visits. Associations between these characteristics and the subsequent same-tooth fractures and crack progression were quantified. Results: Of the 2,601 teeth with a crack or cracks at baseline, 78 (3.0%; 95% confidence interval, 2.4% to 3.7%) subsequently developed a fracture. Of the 1,889 patients untreated before year 1, 232 (12.3%; 95% confidence interval, 10.9% to 13.8%) had some type of crack progression. Baseline tooth-level characteristics associated with tooth fracture were the tooth was maxillary and had a wear facet through enamel and a crack was detectable with an explorer, on the facial surface, and in a horizontal direction. Crack progression was associated with males and teeth with multiple cracks at baseline; teeth with a baseline facial crack were less likely to show crack progression. There was no commonality between characteristics associated with tooth fracture and those associated with crack progression. Conclusions: Development of tooth fractures and crack progression over 3 years were rare occurrences. Specific characteristics were associated with the development of tooth fracture and crack progression, although none were common to both. Practical Implications: This information can aid dentists in assessing factors that place posterior cracked teeth at risk of experiencing adverse outcomes.
AB - Background: The authors of this practice-based study estimated the risk of experiencing tooth fractures and crack progression over 3 years and correlated baseline patient-, tooth-, and crack-level characteristics with these outcomes. Methods: Two-hundred-and-nine National Dental Practice-Based Research Network dentists enrolled a convenience sample of 2,601 participants with a cracked vital posterior tooth that had been examined for at least 1 recall visit over 3 years. Data were collected at the patient, tooth, and crack levels at baseline, annual follow-up visits, and any interim visits. Associations between these characteristics and the subsequent same-tooth fractures and crack progression were quantified. Results: Of the 2,601 teeth with a crack or cracks at baseline, 78 (3.0%; 95% confidence interval, 2.4% to 3.7%) subsequently developed a fracture. Of the 1,889 patients untreated before year 1, 232 (12.3%; 95% confidence interval, 10.9% to 13.8%) had some type of crack progression. Baseline tooth-level characteristics associated with tooth fracture were the tooth was maxillary and had a wear facet through enamel and a crack was detectable with an explorer, on the facial surface, and in a horizontal direction. Crack progression was associated with males and teeth with multiple cracks at baseline; teeth with a baseline facial crack were less likely to show crack progression. There was no commonality between characteristics associated with tooth fracture and those associated with crack progression. Conclusions: Development of tooth fractures and crack progression over 3 years were rare occurrences. Specific characteristics were associated with the development of tooth fracture and crack progression, although none were common to both. Practical Implications: This information can aid dentists in assessing factors that place posterior cracked teeth at risk of experiencing adverse outcomes.
KW - Cracked teeth
KW - crack progression
KW - tooth fracture
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U2 - 10.1016/j.adaj.2020.09.023
DO - 10.1016/j.adaj.2020.09.023
M3 - Article
C2 - 33358237
AN - SCOPUS:85098178128
SN - 0002-8177
VL - 152
SP - 146
EP - 156
JO - Journal of the American Dental Association
JF - Journal of the American Dental Association
IS - 2
ER -