Defense Date

2015

Document Type

Thesis

Degree Name

Master of Science

Department

Dentistry

First Advisor

Dr. Karan Replogle

Abstract

Cracked teeth have long presented a diagnostic challenge. Previous investigators have considered possible predictive factors, many of which revolve around the tooth’s restorative characteristics. Few have investigated the restorative status of teeth with cracks extending into the pulp chamber. The purpose of this investigation was to determine the prevalence of the different types of restorations present in intrapulpally cracked teeth and determine any other restorative factors that may aid in predicting the presence or extent of an intrapulpal crack. Intrapulpally cracked molars requiring endodontic therapy at the VCU Graduate Endodontic Practice were included in this study. For each tooth, the type of restorative material present and surfaces involved were recorded. The Restoration Volume Proportion (RVP) was calculated to accurately quantify the size of the restoration present. Pulpal and periapical diagnoses, and intrapulpal crack classification were also recorded. Chi squared analysis and logistic regression were used to determine any significant associations. This study included 43 teeth. The study population was 65% female and the average age was 56. Of the various restoration types evaluated, 73% of teeth presented with amalgams, 12% with composites. Class I restorations were 61% of the sample. The most frequently occurring restoration size by volume was a “small” restoration. The most commonly involved teeth were the maxillary 1st molar and mandibular 2nd molar. A significant association was found between restoration size and crack classification suggesting that teeth with larger restorations had a higher incidence of coronal cracks while those with smaller restorations had a higher incidence of radicular cracks. Restoration classification and pulpal walls involved were also significantly associated suggesting that Class II restorations were most frequently associated with cracks involving a single pulpal wall while Class I restorations were evenly associated with one and two wall cracks. Other significant associations were found between tooth type and pulpal walls involved and between restoration surfaces and pulpal wall classification. This study found several significant associations between restoration characteristics and intrapulpal cracks. Further research may continue to reveal how a tooth’s restorative status may influence its risk for the presence of an intrapulpal crack.

Rights

© The Author

Is Part Of

VCU University Archives

Is Part Of

VCU Theses and Dissertations

Date of Submission

4-30-2015

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