Survival of Endodontically Treated Cracked Teeth: A 10- to 15-Year Retrospective Study

To investigate long-term (10- to 15-year) survival and success rates of endodontically treated cracked teeth and to identify possible prognostic factors related to their survival and success.

Patients who had endodontically treated cracked teeth were seen for a 10- to 15-year review. Preoperative and intraoperative treatment records were retrieved. Clinical and radiographic evaluations were performed. Two outcomes were investigated: survival (tooth present) and success (asymptomatic with complete radiographic healing). The 10- and 15-year tooth survival and success rate were estimated. Cox proportional hazards regression assessed the impact of various factors on the time to tooth extraction and time to complete healing.

Data from 196 patients with 204 endodontically treated cracked teeth were analyzed. The 10- and 15-year survival rates were 66% (95% confidence interval [CI]: 60%-73%) and 55% (95% CI: 48%-63%), respectively. Success rates declined from 64% at 10 years to 37% at 15 years. Preoperative probing depth (PD) was the primary statistically significant factor for survival. Teeth with no preoperative PD (<4 mm) had higher survival rates of 76% at 10 years and 64% at 15 years. Multivariable analysis revealed significantly increased risk for teeth with PD of 4-5 mm (adjusted hazard ratio [aHR] = 2.48, 95% CI: 1.41-4.38, P = .002) and ≥6 mm (aHR = 3.19, 95% CI: 1.56-6.54, P = .002) for survival analysis. Older age was a modest independent risk factor (aHR = 1.03 per year, 95% CI: 1.00-1.05, P = .026) for survival.

Endodontic treatment of cracked teeth with favorable preoperative PDs demonstrates long-term survival comparable to noncracked teeth and is a viable long-term treatment option which should be recommended.