A six year evaluation of cracked teeth diagnosed with reversible pulpitis: treatment and prognosis

Study Overview: A Six-Year Evaluation of Cracked Teeth Diagnosed with Reversible Pulpitis

Author: Dr. K. Krell et al

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Key Study Details

  • Objective: To assess long-term outcomes of cracked teeth diagnosed with reversible pulpitis (RP).
  • Duration: Six years
  • Sample Size: 8,175 patients evaluated; 796 (9.7%) diagnosed with cracked teeth

Methodology

Diagnostic Procedures

  • Medical and dental history review
  • Radiographic examinations
  • Pulpal and periapical diagnosis
  • Periodontal probing
  • Crack detection using transillumination
  • Bite testing on individual cusps

Treatment Protocol

  • All RP-diagnosed teeth were planned for full-coverage crowns without initial root canal treatment, regardless of periapical findings.

Follow-Up

  • Patients were reviewed at one year, unless RCT was needed sooner.

Results

Progression of Reversible Pulpitis

  • Of 127 patients with RP:
    • 21 (16.5%) developed irreversible pulpitis within an average of 58 days
    • 6 (4.7%) developed pulp necrosis within an average of 149 days
    • 27 (21.3%) required root canal treatment (RCT) within 6 months

Pulp Vitality Maintenance

  • 100 patients (78.7%) maintained pulp vitality without needing RCT during the 6-year period

Conclusions

  • Early detection and full crown coverage of cracked teeth with RP can maintain pulp vitality in nearly 80% of cases over six months
  • This approach may reduce the immediate need for RCT in appropriately diagnosed cases

These findings highlight the value of timely diagnosis and restorative intervention in managing cracked teeth conservatively and preserving pulp health.

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