A 2-year Review of Endodontically-treated Teeth With Incomplete Tooth Fracture

Incomplete tooth fracture present as fracture lines visible or invisible to inspection and may progress to cuspal fractures or partial or complete root fractures (Ailor, 2000). When cracks extend near or into the dental pulp chamber, pulpal pathosis may be present and root canal treatment is necessary. However, the prognosis for such teeth is questionable as they are weakened and the crack lines may cause endodontic and periodontal infection in future. There is a lack of literature on the survival of endodontically-treated cracked teeth and the predictors for their survival. Objectives: The aim of this study is to assess the survival of root canal-treated cracked teeth at 2-year review. Methods: Patients who had root canal treatment completed on posterior teeth diagnosed with incomplete tooth fracture at National Dental Centre from January 2000 to June 2001 were recalled for a 2-year review. Clinical data like whether the tooth is a terminal abutment, the extent, location and number of cracks and the periodontal status were collected. During review, the soft tissue and periodontium of the root canal-treated teeth were evaluated. Any extraction was also recorded. Results: 50 teeth of 49 patients were included in this study. The 2-year survival rates were 85.47%. Using logistic regression analysis, teeth with multiple cracks were 1.4 times more likely to be extracted, terminal abutments were 6.5 times more likely to be extracted and teeth with pre-RCT mesio-buccal pocketings were 7.3 times more likely to be extracted. Conclusion: The 2-year survival rates were 85%. Within the limitation of the study, the number of cracks, function of tooth as terminal abutment and pre-RCT mesio-buccal pocketings are significant predictors for survival of endodontically-treated teeth with incomplete tooth fracture.