Department of Restorative Dentistry, School of Dentistry, Oregon Health & Science University, 2730 S. Moody Ave, Portland, OR, 97201-5042, USA.
School of Medicine, University of Alabama, Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294-0007, USA.
Clin Oral Investig. 2022 Mar;26(3):2453-2463. doi: 10.1007/s00784-021-04211-0. Epub 2021 Oct 9.
To describe treatment and monitoring outcomes of posterior teeth with cracks at baseline followed in the National Dental Practice-Based Research Network for up to three years.
Two hundred and nine dentists enrolled a convenience sample of 2,858 patients, each with a posterior tooth with at least one visible crack and followed them for three years. Characteristics at the patient, tooth, and crack level were recorded at baseline and at annual recall visits. Data on all teeth referred for extraction were reviewed. Data on all other teeth, treated or monitored, seen at one or more recall visits were reviewed for evidence of failure (subsequent extraction, endodontics, or recommendation for a re-treatment).
The survival rate for teeth with cracks at baseline exceeded 98% (only 37 extractions), and the failure rate for teeth that were treated restoratively was only 14%. Also, only about 14% of teeth recommended at baseline for monitoring were later recommended to be treated, and about 6.5% of teeth recommended for monitoring at baseline were later treated without a specific recommendation. Thus, about 80% of teeth recommended at baseline for monitoring continued with a monitoring recommendation throughout the entire three years of the study. Treatment failures were associated with intracoronal restorations (vs. full or partial coverage) and male patients.
In this large 3-year practice-based study conducted across the USA, the survival rate of posterior teeth with a visible crack exceeded 85%. Clinical relevance Dentists can effectively evaluate patient-, tooth-, and crack-level characteristics to determine which teeth with cracks warrant treatment and which only warrant monitoring.
描述在全国牙科实践为基础的研究网络中，对基线时有裂缝的后牙进行治疗和监测的结果，随访时间最长可达三年。
209 名牙医纳入了一个方便样本，共 2858 名患者，每位患者都有一颗或多颗可见裂缝的后牙，随访时间为三年。在基线和每年的随访就诊时，记录患者、牙齿和裂缝水平的特征。所有转诊拔牙的牙齿数据均进行了回顾。对所有其他经过治疗或监测、在一次或多次随访就诊时可见的牙齿，评估其失败（后续拔牙、牙髓治疗或重新治疗建议）的证据。
基线时有裂缝的牙齿的存活率超过 98%（仅有 37 颗拔牙），经修复治疗的牙齿的失败率仅为 14%。此外，在基线时建议监测的牙齿中，只有约 14%后来被建议治疗，而在基线时建议监测的牙齿中，约有 6.5%后来未经特定建议就被治疗。因此，在基线时建议监测的牙齿中，约 80%在整个三年研究期间继续建议监测。治疗失败与牙内修复体（与全冠或部分冠相比）和男性患者有关。
在这项在美国进行的大规模、为期三年的实践为基础的研究中，可见裂缝的后牙的存活率超过 85%。临床意义牙医可以有效地评估患者、牙齿和裂缝水平的特征，以确定哪些有裂缝的牙齿需要治疗，哪些只需要监测。
