Symptomatic cracked teeth: Associations with patient-level and tooth-level factors-A case-control study

To investigate patient-level and tooth-level risk factors associated with symptomatic cracked teeth through a case-control study.

The case-control study included 100 symptomatic cracked tooth patients and matched controls. Patient-level (demographics and oral behaviors) and tooth-level parameters (type, location, crack location and cuspal inclination) were respectively assessed through questionnaires and clinical examinations. Univariate logistic regression analysis assessed the relationships between patient-level/tooth-level parameters and the occurrence of cracked teeth. Significant parameters (p ≤ 0.1) underwent multivariate analysis. Cuspal angles were compared using an independent samples t-test.

The highest prevalence of cracked teeth occurred in individuals aged 30-39 years, predominantly affecting the maxillary first molar. Significant behavioral risk factors were hard food consumption and unilateral chewing. The tooth-related risk factors included dental caries, deep overbite, Angle's Class II malocclusion and Class I occlusal wear. Cracked teeth in maxillary first and second molars with four cusps were significantly associated with the inclination of the mesiobuccal, mesiolingual and distolingual cusps (p < 0.05). This was also observed in the distobuccal cusp of maxillary second molars with three cusps (p < 0.05). In mandibular first molars, cusp tilting was significantly associated with cracked teeth for all cusps except the distolingual cusp (p < 0.05).

Eating hard food, unilateral chewing, dental caries, deep overbite, Class II malocclusion, wear and a steep cuspal inclination angle were all identified as potential risk factors for cracked teeth.

The findings may facilitate the development of an effective and results-oriented prevention strategy for cracked teeth.