Table 2.
Clinical studies and systematic reviews focusing on cracked teeth that received endodontic treatment
| Study | No of cracked teeth | Management of crack lines | Interim treatment (intra‐ or post‐endodontic) | Definitive post‐endodontic restoration | Follow‐up | Outcomes |
|---|---|---|---|---|---|---|
| Systematic reviews (n = 2) | ||||||
| Leong et al. (2020) | See below data from included studies (Kang et al., 2016; Krell & Caplan, 2018; Sim et al., 2016; Tan et al., 2006) | 5 years (estimated) | 84% survival rate | |||
| Olivieri et al. (2020) | See below data from included studies (Dow, 2016; Kang et al., 2016; Kim et al., 2013; Krell & Caplan, 2018; Krell & Rivera, 2007; Sim et al., 2016; Tan et al., 2006) | 1 year (estimated) | 88% survival rate, 82% success | |||
| Interventional study (n = 1) | ||||||
| Lu et al. (2021) | 87 | N/S+ | Temporary filling | Crowns (45 teeth), direct composite (42 teeth) | 6 months | Crowns exhibited significantly better therapeutic effect, bite force, chewing efficiency, quality of life as well as reduced periodontal index compared to direct composite restorations |
| Observational studies (n = 17) | ||||||
| Chen et al. (2021) | 62 | N/S | N/S | Crowns (15 teeth remained with temporary filling) | 23.3 months | 75.8% overall success rate; 93.6% with crowns; 20% for unrestored teeth |
| Davis and Shariff (2019) | 65 | N/S | Occlusal adjustment (post‐endodontic) | Resin composite core (with intra‐orifice barriers) and crowns | 2–4 years (mean 2.8) | 96.6% survival rate; 90.6% success |
| de Toubes et al. (2022)± | 63 | N/S | Direct composite or temporary filling; occlusal adjustment was performed for some cases | Crowns or onlays | 3.3 years | 90.5% survival rate |
| Dow (2016) | 15 | N/S | N/S | Not specified | 16.2 months | 67% survival rate; 46.6% success rate |
| Kanamaru et al. (2017)± | 17 | N/S | N/S | Crowns | 1–3 years | 100% survival rate |
| Kang et al. (2016)± | 88 | N/S | Provisional crowns or orthodontic bands (post‐endodontic) | Crowns | 2 years | 90% survival rate |
| Kim et al. (2013)± | 60 | N/S | Provisional crowns (post‐endodontic) | Crowns | 2 years | 98.3% survival rate |
| Krell and Caplan (2018) | 363 | N/S | N/S | Crowns | 1 year | 82% success rate |
| Krell and Rivera (2007)±,§ | 14 | N/S | N/S | Crowns | 1 year | 93% survival and success rate |
| Lee et al. (2021a)± | 8 | See Table 2 | Provisional crowns (post‐endodontic) | Crowns | 2.6 years | 100% survival rate |
| Liu et al. (2021) | 10 | N/S | N/S | N/S | 19 months | 40% success rate |
| Malentacca et al. (2021) | 87 | Flowable resin was applied with a size 6 K file under microscope magnification to seal crack lines extending beyond the canal orifices | Occlusal adjustment and pre‐endodontic reconstruction (for heavily compromised teeth) | Direct cuspal coverage composite or crowns | 5.6 years | 68% 5‐year survival and 53% success rate |
| Ng et al. (2011a) | 127 | N/S | N/S | N/S | 2–4 years | Survival rate of 95.3% for primary endodontic treatment and 96.8% for endodontic retreatment |
| Ng et al. (2011b) | 199 (counted as the number of roots) | N/S | N/S | N/S | 2–4 years | Success rate of 77% for primary endodontic treatment and 76.8% for endodontic retreatment |
| Nguyen Thi and Jansson (2021) | 200 | N/S | N/S | Composite restorations (75%), full crowns (24%) | 4.5 years | 68% 5‐year survival rate (97% with full crowns) |
| Sim et al. (2016) | 84 | N/S | N/S | Crowns or amalgam cores + orthodontic bands | 5 years | 95% survival rate |
| Tan et al. (2006) | 50 | Crack lines were left in situ | N/S | Crowns or amalgam cores + orthodontic bands | 2 years | 85.5% survival rate |
| Case reports/series (n = 11) | ||||||
| de Toubes et al. (2020)± | 2 | See Table 2 | Direct composite in infra‐occlusion | Crowns | 5‐years | Both teeth survived |
| Dutner et al. (2020) | 1 | N/S | N/S | Crown | 30 months | The tooth was extracted after exacerbation of symptoms |
| Fawzy et al. (2020) | 1 | N/S | Temporary filling and occlusal adjustment | Glass‐ionomer restoration of the access cavity | 1 year | The tooth survived and there was radiographic healing of the apical lesion |
| Gutmann and Rakusin (1994) | 2 | N/S | Orthodontic bands and occlusal adjustment | Glass‐ionomer core build‐up with intra‐orifice barriers and crowns | 8–16 months | Both teeth survived without symptoms |
| Ito et al. (1998)± | 1 | See Table 2 | N/S | Crown | 2 years | Tooth survived |
| Jun et al. (2019) | 1 | N/S | N/S | Crown | 3 years | Tooth survived |
| Liu and Sidhu (1995) | 6 | Cracks removed to determine their extent | Orthodontic bands (occlusal splint was also provided for one of the cases) | Intra‐radicular amalgam cores and crowns (two of the cases had not received a definitive restoration at review) | 1–3.5 years | All cases survived |
| Mahgoli et al. (2019) | 4 | Crack lines were disinfected with chlorhexidine and sealed with a self‐cure resin cement | Occlusal adjustment | Post‐and‐core build‐ups and crowns | 1.5–10 years | All cases survived |
| Michaelson (2015) | 3 | Complete removal of crack lines with a surgical bur or an ultrasonic tip and repair of the iatrogenic perforation with mineral trioxide aggregate | N/S | Crack excision and perforation repair were performed through existing crowns | 1–2 years | All cases survived and remained asymptomatic |
| Michaelson (2017) | 3 – same cases with Michaelson (2015) | Same as Michaelson (2015) | N/S | Same as Michaelson (2015) | 3.5–5.5 years | All cases survived and remained asymptomatic |
| Ritchey et al. (1957)± | 1 | N/S | Temporary crown | Crown | 20 months | Tooth survived |
Note: Olivieri et al., mention regarding the treatment of cracked teeth with normal pulp or reversible pulpitis.
● §: Based on data obtained through personal communication by Olivieri et al. (2020).