Survival and prognostic factors of managing vital cracked teeth with occlusal veneer restoration: A 1-to 2 years prospective clinical study

Abstract

Abstract Background To evaluate the treatment outcomes of the cracked tooth restored using occlusal veneer. Methods Thirty-seven cracked tooth with normal pulp or reversible pulpitis were analyzed, and their demographic and clinical data and medical history were collected. Patients were followed-up to examine the thermal/biting sensitivity and clinical features. Results The maxillary first molar was the most prevalent (N = 17, 46%), and most patients could accurately locate the offending teeth (N = 32, 83.5%). The crack lines (CL) were divided into 5 types depending on tooth preparation. Within 16 months of followed-up, 2 out of 32 teeth developed pulp necrosis, resulting in a rate of 93.75%. A cracked tooth with probing depth > 6mm, number of CL on the finish line > 4, number of CL through preparation on finish line > 2 and widened periodontal ligament (PL) of the apical area were inclined to pulp necrosis after restoring the occlusal veneer. After restoration, 45.71% of the patients felt relief from thermal pain after 1 week, 71.42% after 1 month, 88.57% after 3 months, 94.28% after 6 months, and 100% after 12 months, while biting pain was 54.28%, 77.14%, 94.28%, 97.14%, and 100% cases after 1 week, 1, 3, 6 and 12 months, respectively. Probing depth > 3mm was related to thermal sensitivity, while teeth located in the mandible were correlated with biting sensitivity post-treatment. Widened PL of the apical area was related to thermal and biting sensitivity with 9–19 months followed-up period. Conclusions Occlusal veneer is a feasible and effective therapy for the protection of cracked tooth. Trial registration: The Research Ethics Committee approved this study (PKUSSIRB-202272008). While it was also registered on the webpage of Chinese Clinical Trial Registry and approved by their Institutional Review Board (ChiCTR2200057462, 13/03/2022).