Dataset Information

Onset and resolution of pain among treated and untreated posterior teeth with a visible crack: Three-year findings from the national dental practice-based research network.

ABSTRACT:

Objective

Cracked teeth may be associated with pain, especially biting pain, and to a lesser degree cold and spontaneous pain. Described are how commonly these pains remain constant, develop, or resolve over time, none of which have been well-described, especially among untreated cracked teeth.

Methods

Cracked teeth from the Cracked Tooth Registry (CTR) study were followed for 3 years. Assessments of cold, biting, and spontaneous pain and treatments performed were completed at enrollment (Y0) and at each annual recall visit.

Results

209 practitioners enrolled 2,858 patients, each with a visible crack on a posterior tooth; 2601 (91%) patients attended at least one recall visit. Overall, 960 (37%) were treated, primarily with crowns. Among both treated and untreated cracked teeth with biting pain or spontaneous pain at Y0, the vast majority (92-99%) had their pain resolved by the time of a recall visit and 85-93% remained pain-free after initial resolution. The observations for cold pain were similar: 68% (untreated) and 78% (treated) became free of cold pain at some point during follow-up, and 84% of these stayed free of cold pain after initial resolution. Few teeth developed biting or spontaneous pain (4-8%) and 44-67% of these had pain resolution during the follow-up period.

Conclusion

In this study, treatment resolved a preponderance of pain associated with a cracked tooth. Pain was also resolved for most untreated cracked teeth, especially biting pain, and to a lesser degree spontaneous and cold pain, although not to the same degree as with the treated cracked teeth.

SUBMITTER: Funkhouser E

PROVIDER: S-EPMC8988449 | biostudies-literature | 2022 Apr

REPOSITORIES: biostudies-literature

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Publications

Onset and resolution of pain among treated and untreated posterior teeth with a visible crack: Three-year findings from the national dental practice-based research network.

Funkhouser Ellen E Ferracane Jack L JL Hilton Thomas J TJ Gordan Valeria V VV Gilbert Gregg H GH Mungia Rahma R Burton Vanessa V Meyerowitz Cyril C Kopycka-Kedzierawski Dorota T DT

Journal of dentistry 20220225

<h4>Objective</h4>Cracked teeth may be associated with pain, especially biting pain, and to a lesser degree cold and spontaneous pain. Described are how commonly these pains remain constant, develop, or resolve over time, none of which have been well-described, especially among untreated cracked teeth.<h4>Methods</h4>Cracked teeth from the Cracked Tooth Registry (CTR) study were followed for 3 years. Assessments of cold, biting, and spontaneous pain and treatments performed were completed at e ...[more]

PMID: 35227834

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Project description:OBJECTIVES:The objective of this study was to determine which patient traits, behaviors, external tooth and/or crack characteristics correlate with the types of symptoms that teeth with visible cracks exhibit, namely pain on biting, pain due to cold stimuli, or spontaneous pain. METHODS:Dentists in the National Dental Practice-Based Research Network enrolled a convenience sample of subjects each of whom had a single, vital posterior tooth with at least one observable external crack (cracked teeth); 2858 cracked teeth from 209 practitioners were enrolled. Data were collected at the patient-, tooth-, and crack-level. Generalized estimating equations were used to obtain significant (p < .05) independent odds ratios (OR) associated with teeth that were painful for 10 outcomes based on types of pain and combinations thereof. RESULTS:Overall, 45% of cracked teeth had one or more symptoms. Pain to cold was the most common symptom, which occurred in 37% of cracked teeth. Pain on biting (16%) and spontaneous pain (11%) were less common. Sixty-five percent of symptomatic cracked teeth had only one type of symptom, of these 78% were painful only to cold. No patient-, tooth- or crack-level characteristic was significantly associated with pain to cold alone. Positive associations for various combinations of pain symptoms were present with cracks that: (1) were on molars; (2) were in occlusion; (3) had a wear facet through enamel; (4) had caries; (5) were evident on a radiograph; (6) ran in more than one direction; (7) blocked transilluminated light; (8) connected with another crack; (9) extended onto the root; (10) extended in more than one direction; or (11) were on the distal surface. Persons who were <65 yo or who clench, grind, or press their teeth together also were more likely to have pain symptoms. Pain was less likely in teeth with stained cracks or exposed roots, or in non-Hispanic whites. CONCLUSIONS:Although pain to cold was the most commonly noted pain associated with symptomatic cracked teeth, no patient-, tooth- or crack-level characteristic was significantly associated with pain to cold alone. Characteristics were only associated with pain on biting and/or spontaneous pain with or without pain to cold. CLINICAL SIGNIFICANCE:Although often considered the most reliable diagnosis for a cracked tooth, pain on biting is not the most common symptom of a tooth with a visible crack, but rather pain to cold.

Project description:BackgroundVertical preparation techniques (VPTs), particularly the biologically oriented preparation technique (BOPT), have gained prominence in restorative dentistry due to their conservative approach to tooth structure preservation and improved aesthetic outcomes. This study aims to assess the knowledge and clinical practices of VPTs, including BOPT, among dental professionals in Sanaa, Yemen, and explore the barriers to their widespread use.Materials and methodsAn online cross-sectional survey was conducted among general practitioners and specialists in Sanaa, Yemen using a structured, self-administered questionnaire. The survey explored the participants' knowledge, familiarity, and clinical use of VPTs and their perceptions of its advantages and challenges. Data were analyzed using descriptive statistics and Chi-square tests to evaluate associations between professional roles and VPT knowledge and practice. P values < 0.05 indicated statistical significance.ResultsOut of 285 participants, 76.8% were familiar with VPTs but only 11.6% reported using these approaches in clinical practice. The primary source of knowledge acquisition was informal, with 26.3% of the participants citing social media as their main resource. Specialists demonstrated significantly higher proficiency and confidence in applying VPTs compared with general practitioners (p < 0.05). Key challenges identified in clinical adoption were controlling gingival bleeding (32.28%) and achieving precise margins during tooth preparation (34.74%). The majority (55.8%) of participants acknowledged the potential of VPTs as the future of restorative dentistry. Despite these benefits, 36.1% of the respondents emphasized the need for further training and educational programs to enhance proficiency and overcome the perceived complexity of these techniques.ConclusionThis study highlights significant gaps in the knowledge and practice of VPTs, particularly BOPT, among the participants. While these techniques offer promising clinical and aesthetic benefits, their adoption is hindered by inadequate training and perceived complexity. Targeted educational interventions and further research are needed to support the broad implementation of VPTs in clinical practice.Clinical trial numberNot applicable.

Project description:OBJECTIVES:This study quantified and compared practice patterns of treatment for deep occlusal carious lesions among Japanese dentists, and tested the hypothesis that dentist characteristics are significantly associated with the decision to choose an indirect pulp capping (IPC), a form of selective carious tissue removal that involves leaving a thin layer of demineralized tissue over the pulp, that is then covered with a protective liner. METHODS:This cross-sectional study was conducted using a questionnaire survey of dentists affiliated with the Dental Practice-based Research Network Japan (n?=?297). Dentists were asked to indicate what percentage of time they use three treatment options when treating patients with deep occlusal caries and possible mild pulpitis on a posterior tooth. Response options were "1. Stop before removing all caries and perform an IPC", "2. Remove all caries and proceed with a direct pulp cap", and "3. Remove all caries and proceed with endodontic-related procedures". Percentages of options 1-3 were compared by multiple comparison. Associations between dentist characteristics and a higher percentage of IPC provision (option 1) were analyzed via logistic regression. RESULTS:Responses were obtained from 206 dentists. Median percentages (interquartile ranges) of options 1, 2 and 3 were 30% (10-59%), 10% (0-30%), and 40% (19-80%), respectively. The differences between option 3 and options 1 and 2 were significant (p?<?0.001). In logistic regression analysis, a higher frequency of obtaining evidence from English-language scientific articles was significantly associated with a higher percentage of IPC, with an odds ratio of 2.28 (95%CI: 1.14-4.54). CONCLUSIONS:Endodontic-related procedures remain the most frequent treatment option for deep occlusal caries. Frequent use of evidence-based information in English-language scientific articles was associated with Japanese dentists' preference toward IPC. CLINICAL SIGNIFICANCE:Japanese dentists would most frequently choose endodontic-related procedures, followed by IPC and direct pulp capping for treatment of patients with deep occlusal caries with possible mild pulpitis on posterior teeth. Significant association was identified between use of evidence-based information in the English-language scientific literature and Japanese dentists' preference for IPC.

Dataset Information

Onset and resolution of pain among treated and untreated posterior teeth with a visible crack: Three-year findings from the national dental practice-based research network.

Objective

Methods

Results

Conclusion

Publications

Onset and resolution of pain among treated and untreated posterior teeth with a visible crack: Three-year findings from the national dental practice-based research network.

Similar Datasets

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