IADR Abstract Archives

Observational 16-year Study of Posterior Tooth Fracture in Dental Practice

Objectives: An observational study of an approach to manage posterior tooth fracture up to 16 years in primary dental care.

Methods: Posterior Tooth Fractures (PTF) were observed up to 16 years in all patients attending a dental practice in London, using a previously established recording system; Class I enamel only fracture, Class II enamel and dentine fracture, Class III enamel and dentine fracture coronal to the amelo-gingival margin, Class IV enamel and dentine fracture below the amelo-gingival margin. Teeth were in occlusion with natural tooth antagonists. Whether a fracture occurred in a Functional (F) or Non-Functional (NF) cusp was recorded. The material/s used to restore fractures were also recorded. All teeth were followed up annually up to 16 years. One skilled operator undertook all procedures.
Results: At 16 years, 5273 patients of average age 74 years were observed. Most patients were caucasian (99.5%) female (68%). The total PTF recorded was 7% (n=4,473) in 63,900 posterior teeth. The proportions of PTF in these teeth were Class I 3%, Class II 37%, Class III 55%, Class IV 5%. Restorations placed following fracture included Glass Ionomer Cement (GIC) 70% (placed out of occlusion in exposed dentine fractures), Composite 15%, Amalgam 11% and full Crowns 4%. Restorations survived up to 16 years. Significantly more fractures occurred in NF cusps compared with F cusps in mandibular second premolars, and mandibular first and second molars (p=0.04). There were no significant differences in fracture between maxillary NF and F cusps.
Conclusions: Limited posterior tooth fractures and low restoration maintenance are possible long-term in an ageing dentition with good annual recall. GIC was commonly used for restoration of PTFs in dentine and survived out of occlusion. Non-functional posterior cusps in the mandible had significantly more fractures and thus occlusion should be planned carefully to reduce fracture risk.

Continental European and Scandinavian Divisions Meeting
2019 Continental European and Scandinavian Divisions Meeting (Madrid, Spain)
Madrid, Spain
  • Frost, Peter  ( King's College London , London , United Kingdom )
  • Olley, Ryan  ( King's College London , London , United Kingdom )
  • No disclosures
    Oral Session
    Educational Research, Geriatric Oral Research & Orofacial Pain
    Thursday, 09/19/2019 , 04:00PM - 06:00PM