IADR Abstract Archives
Pulp Survival of Crowned Vital Cracked Teeth after Orthodontic Banding
Objectives: Orthodontic bands can be used in the interim to manage cracked teeth with reversible pulpitis before definitive restorations. The aim of this prospective study was to investigate the 1-year pulp survival of cracked teeth with reversible pulpitis managed with initial stabilization using orthodontic bands, followed by coronal coverage restorations.
Methods: One-hundred-and-twenty-five patients with a cracked tooth with reversible pulpitis each were recruited. Pre-operative patient and tooth data were collected. After definitive pulp diagnoses were determined following an interim period of 1 to 5 months of orthodontic banding, coronal coverage restorations were placed. Patients were reviewed 1 year after recruitment. Clinical and radiographic findings were recorded to determine pulp survival. Logistic regression was used to assess for possible prognostic factors and to correlate initial time to pulp stabilization while in orthodontic bands with eventual outcome.
Results: One-hundred-and-six cracked teeth were followed up at 1 year. Pulp survival was found in 82 teeth (77.4%.) There was no prognostic factor for pulp survival. Out of 24 failures, 11 (45.8%) required root canal treatment (RCT) at the molar band stage, 10 (41.7%) required RCT during the provision of coronal coverage restorations and 3 (12.5%) presented with asymptomatic apical periodontitis detected at the 1-year review. Teeth that eventually required RCT were found to have required a longer period in orthodontic bands prior to a definitive pulp diagnosis (p<0.05).
Conclusions: A step-by-step approach using orthodontic banding prior to coronal coverage may reduce the incidence of root canal treatment through definitive coronal coverage restorations for cracked teeth.
Methods: One-hundred-and-twenty-five patients with a cracked tooth with reversible pulpitis each were recruited. Pre-operative patient and tooth data were collected. After definitive pulp diagnoses were determined following an interim period of 1 to 5 months of orthodontic banding, coronal coverage restorations were placed. Patients were reviewed 1 year after recruitment. Clinical and radiographic findings were recorded to determine pulp survival. Logistic regression was used to assess for possible prognostic factors and to correlate initial time to pulp stabilization while in orthodontic bands with eventual outcome.
Results: One-hundred-and-six cracked teeth were followed up at 1 year. Pulp survival was found in 82 teeth (77.4%.) There was no prognostic factor for pulp survival. Out of 24 failures, 11 (45.8%) required root canal treatment (RCT) at the molar band stage, 10 (41.7%) required RCT during the provision of coronal coverage restorations and 3 (12.5%) presented with asymptomatic apical periodontitis detected at the 1-year review. Teeth that eventually required RCT were found to have required a longer period in orthodontic bands prior to a definitive pulp diagnosis (p<0.05).
Conclusions: A step-by-step approach using orthodontic banding prior to coronal coverage may reduce the incidence of root canal treatment through definitive coronal coverage restorations for cracked teeth.