Defense Date


Document Type


Degree Name

Master of Science in Dentistry



First Advisor

Garry L. Myers

Second Advisor

Alvin M. Best

Third Advisor

Clara M. Spatafore


Diagnosis and treatment of teeth with longitudinal fractures is challenging. Cracks are usually not visible radiographically; they require a thorough evaluation to aid in diagnosis. Patients may be asymptomatic, demanding the dentist rely on clinical findings to make a diagnosis. Early diagnosis of the presence and extent of a crack is essential for the successful management of a cracked tooth. There is limited information in the literature regarding the prevalence or predictive factors of cracks extending into the pulp chamber of teeth. The purpose of this study was to determine the prevalence of intrapulpal cracks in maxillary molars and to identify factors that may aid in diagnosing the existence of a crack. All maxillary molar teeth requiring non- surgical root canal therapy or retreatment at the Virginia Commonwealth University graduate endodontic clinic from June 2016 through December 2016 were included in the study after obtaining patient consent. Teeth were examined visually, transilluminated, stained, and examined microscopically for the presence of an intrapulpal crack. Demographic information, subjective data associated with the chief complaint, objective results of diagnostic testing (percussion, palpation, bite stick test, transillumination, probing depths, existing restorations, and diagnosis) were analyzed using chi-square and logistic regression (p<0.05) to identify associations of these findings with the existence of a crack. A total of 18% (15/82 teeth) of maxillary molars that were evaluated and had endodontic treatment initiated were cracked. There was a significant association between cracked teeth and pain on biting (P<.0001) and with probing depths greater than 4 millimeters (mm) (P < 0.003). Those positive on a tooth slooth test were more likely to have an intrapulpal crack (P<.001) and teeth with a positive transillumination test were also found to be associated with the presence of a crack(P < .001).


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