Diagnostic and treatment preferences for cracked posterior teeth

Abstract

Background: Longitudinal cracks in teeth are common and often present challenges in diagnosis and management. This study investigated the preferred diagnostic process and treatment modalities for these cracked teeth. Methods: Dentists currently registered with Dental Board of Australia and practising within Australia were invited to complete an online Qualtrics-based survey on their perspectives on the presentations, diagnosis, and treatment preferences for cracked teeth. Results: Of respondents, 56.8% chose to place an indirect cuspal-coverage restoration on an asymptomatic cracked vital tooth. When the tooth was mildly cold sensitive, direct cuspal-coverage restoration was favoured (64.9%), while 36.8% preferred placing an orthodontic band in a tooth with biting pain. Respondents had higher odds of recommending indirect restoration when CAD–CAM milling was available on-site or magnification was routinely used, regardless of presenting symptoms. Almost half (46.8%) preferred to extract if the tooth undergoing root canal treatment had a crack with a 5 mm probing pocket depth. Most (71.4%) demonstrated a poor understanding of cracked tooth biomechanics. Conclusion: Australian dentists varied in their diagnostic and treatment preferences for cracked teeth, reflecting a need for more well-controlled clinical studies in the diagnostic process, clinical biomechanics and treatment modalities for these teeth. © 2023 Australian Dental Association.