Clinical Characteristics and Diagnostic Features of Cracked Molar Teeth - An Evaluative Study

The purpose of this study was to analyse the diagnostic features and clinical characteristics of cracked molar teeth.

Patients diagnosed with cracked molar teeth were selected for this study. Clinical signs and symptoms, age, gender, and radiographic findings were recorded. Data collected included tooth number, presence/absence of restoration, direction and location of the crack, pulp vitality testing (cold test/electronic pulp testing), transillumination findings, methylene blue dye staining results, bite test response, percussion and palpation findings, presence of wear facets, presence or absence of periodontal pocket depth, and the final pulpal and periapical diagnoses.

Out of 220 patients, 33 patients with cracked teeth were diagnosed. Cracked teeth were most frequently observed in patients aged between 30 and 40 years. A sensitive response to the bite test was observed in 98% of cases. Transillumination and methylene blue dye were effective in detecting cracks in 99% of cases. Mandibular first molar (55%) was most commonly affected, followed by mandibular second molar (36%) and maxillary first molar (9%). Most cracks (67%) were found in intact teeth, while 33% were associated with restored teeth, which was significant ( P = 0.021). Cracks were not significantly associated with deep periodontal pockets (18%) ( P = 0.026). The presence of wear facets was not significantly higher in cracked teeth. ( P = 0.602). Fifteen per cent of cracked teeth showed reversible pulpitis, 45% irreversible pulpitis, and 39% pulpal necrosis.

A combined approach using history, clinical signs and symptoms, and tests, such as bite test, transillumination, and staining with methylene blue dye, is recommended for detecting cracks in teeth. Most cracked teeth showed pulpal diagnosis of irreversible pulpitis and pulpal necrosis, for which root canal treatment is recommended.