Kanamaru Junsaku, Tsujimoto Masaki, Yamada Shizuka, Hayashi Yoshihiko
Department of Cariology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto 1-7-1, Nagasaki 852-8102, Japan.
Kanamaru Dental Clinic, Setagaya, Tokyo 157-0073, Japan.
J Dent Sci. 2017 Sep;12(3):291-295. doi: 10.1016/j.jds.2017.04.002. Epub 2017 Jun 9.
BACKGROUND/PURPOSE: The aim of this study was to evaluate the associations between the clinical findings and managements in cracked vital molars that were caused by various factors including restoration and occlusion.
The subjects' gender, age, chief complaint, type of tooth, percussion test results, pulp vitality, restoration material and cavity classification, clinical depth of the crack, evaluation of occlusion, depth of periodontal probing, and final management were recorded.
A total of 44 vital cracked teeth (molars) were diagnosed in 40 patients. Regarding the type of tooth, a greater number of mandibular molars were affected than maxillary molars. Nonworking-side interference (NWI) was recognized in 38 cases (86.4%). Eight teeth (18.2%) had not been restored. Thirty-six teeth (81.8%) had been restored; 26 teeth (72.2%) with a metal inlay, 6 (16.7%) with an amalgam, and 4 (11.1%) with a composite resin. Regarding the final treatment in the endodontically-treated group, all 17 teeth were covered with a metal full crown. Regarding the final treatment in the pulp-reserved group, 19 teeth (70.4%) were covered with a metal full crown, and the other managements were as follows: occlusal adjustment (n = 4, 14.8%), composite resin (n = 2, 7.4%), and only follow-up without treatment (n = 2, 7.4%). All of the cases showed a good clinical prognosis.
The NWI group restored with 58% of metal inlay accounted for more than 86% of the cracked teeth. Thus, in order to achieve a good outcome, cracked teeth, particularly those originating due to occlusal interference should be protected with coverage-type restorations.
背景/目的：本研究旨在评估因包括修复和咬合等多种因素导致的活髓隐裂磨牙的临床症状与治疗之间的关联。
记录受试者的性别、年龄、主诉、患牙类型、叩诊试验结果、牙髓活力、修复材料及洞型分类、隐裂临床深度、咬合评估、牙周探诊深度及最终治疗情况。
40例患者共诊断出44颗活髓隐裂牙（磨牙）。就患牙类型而言，下颌磨牙受累数量多于上颌磨牙。38例（86.4%）存在非工作侧干扰（NWI）。8颗牙（18.2%）未进行修复。36颗牙（81.8%）已进行修复；26颗牙（72.2%）采用金属嵌体修复，6颗牙（16.7%）采用银汞合金修复，4颗牙（11.1%）采用复合树脂修复。在根管治疗组的最终治疗中，所有17颗牙均采用金属全冠修复。在保髓组的最终治疗中，19颗牙（70.4%）采用金属全冠修复，其他治疗方式如下：咬合调整（n = 4，14.8%）、复合树脂修复（n = 2，7.4%）以及仅进行随访观察未治疗（n = 2，7.4%）。所有病例临床预后良好。
NWI组中58%采用金属嵌体修复的隐裂牙占隐裂牙总数的86%以上。因此，为获得良好疗效，隐裂牙，尤其是因咬合干扰导致的隐裂牙，应采用覆盖型修复体进行保护。
