Abulhamael Ayman M, Tandon Radhika, Alzamzami Ziyad T, Alsofi Loai, Roges Rafael A, Rotstein Ilan
Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia, Phone: +966 598977241; e-mail:
Private practice San Francisco and the Bay Area.
J Contemp Dent Pract. 2019 May 1;20(5):543-547.
The aim of this study is to survey the opinion of endodontists in the United States regarding their approach to treatment of cracked teeth.
A survey assessing the opinions of 3,500 endodontists in the United States was administered over a 4-week period. It consisted of a hypothetical clinical case and eight different treatment scenarios. Participants were asked to select one of the two treatment options: (A) informing the patient of the presence of a crack, reinforcing the tooth, and continuing with endodontic treatment; and (B) extraction of the tooth followed by replacement with an implant supported crown or fixed partial denture.
When the crack extended across the distal marginal ridge with no associated probing depths, 92.65% endodontists preferred to continue with endodontic treatment and reenforcing the tooth. When the crack extended across the distal marginal ridge and was associated with a probing depth of 6 mm, 80% preferred extraction of the tooth. When the crack extended across the mesial marginal ridge up to the orifice of the mesiolingual canal with no associated probing depth, 82.78% preferred to continue with the treatment. When the crack was associated with a 6-mm probing depth, 83.79% preferred tooth extraction. When the crack extended across the mesial marginal ridge and down into the mesiolingual canal with/without associated probing depth, 91.13% and 63.54% preferred tooth extraction, respectively. When the crack involved both mesial and distal marginal ridges and extended across the pulp chamber, 79.74% preferred tooth extraction. When a split tooth was presented, 98.48% preferred tooth extraction.
It appears that the presence of a 6-mm periodontal pocket is considered an important factor by most American endodontists when deciding whether to preserve the cracked tooth or extract it.
There is no consensus among dentists regarding the best approach to treat cracked teeth. Conclusive studies evaluating clinical approaches of endodontists regarding treatment of cracked teeth are lacking. Therefore, surveyed opinion of endodontists in the United States regarding their approach to treatment of cracked teeth was done to try to reach the best clinical decision regarding this dilemma.
本研究旨在调查美国牙髓病医生对隐裂牙治疗方法的看法。
在4周内对美国3500名牙髓病医生的意见进行了一项调查。调查包括一个假设的临床病例和八种不同的治疗方案。参与者被要求从两种治疗方案中选择一种：（A）告知患者牙齿存在隐裂，加固牙齿，并继续进行牙髓治疗；（B）拔除牙齿，然后用种植体支持的冠或固定局部义齿进行修复。
当隐裂延伸至远中边缘嵴且无相关探诊深度时，92.65%的牙髓病医生倾向于继续进行牙髓治疗并加固牙齿。当隐裂延伸至远中边缘嵴且伴有6mm的探诊深度时，80%的医生倾向于拔除牙齿。当隐裂延伸至近中边缘嵴直至近中舌侧根管口且无相关探诊深度时，82.78%的医生倾向于继续治疗。当隐裂伴有6mm的探诊深度时，83.79%的医生倾向于拔牙。当隐裂延伸至近中边缘嵴并向下进入近中舌侧根管，无论有无相关探诊深度，分别有91.13%和63.54%的医生倾向于拔牙。当隐裂累及近远中边缘嵴并延伸穿过髓腔时，79.74%的医生倾向于拔牙。当出现牙裂时，98.48%的医生倾向于拔牙。
对于大多数美国牙髓病医生而言，在决定保留还是拔除隐裂牙时，6mm牙周袋的存在似乎是一个重要因素。
在治疗隐裂牙的最佳方法上，牙医之间尚未达成共识。缺乏评估牙髓病医生治疗隐裂牙临床方法的结论性研究。因此，对美国牙髓病医生关于隐裂牙治疗方法的意见进行了调查，试图就这一困境达成最佳临床决策。
