Title For Healthy Patients with an Asymptomatic Tooth Fracture Limited to the Enamel, There Is a Lack of Evidence to Suggest That Placing a Full-Coverage Restoration Upon First Observation Is More Effective at Increasing the 10-year Prognosis of the Tooth Than Waiting Until Symptoms Develop
Clinical Question In a healthy patient with an asymptomatic tooth fracture limited to the enamel, does placing a full-coverage restoration upon first observation increase the 10-year prognosis of the tooth, compared to waiting until symptoms develop?
Clinical Bottom Line For healthy patients with an asymptomatic tooth fracture limited to the enamel, there is a lack of evidence to suggest that placing a full-coverage restoration upon first observation is more effective at increasing the 10-year prognosis of the tooth than waiting until symptoms develop. This is supported by narrative reviews of the literature which show that knowledge regarding treatment is currently extremely limited, and researchers recommend further clinical trials to determine when and how to treat asymptomatic fractured teeth.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
23032237Wright/2012n/aNarrative review of randomized trials
Key resultsThis is a narrative review that did not provide details regarding the literature that was reviewed. It found that knowledge regarding treatment is currently extremely limited.
20590967Lubisich/2010n/aNarrative review of randomized trials
Key resultsThis is a narrative review that did not apply any particular restrictions to the search of prior research; rather, it aimed to be as comprehensive and inclusive as possible. This review found that there is a lack of a consensus and evidence indicating the best treatment, if any.
Evidence Search ("cracked tooth syndrome"[MeSH Terms] OR ("cracked"[All Fields] AND "tooth"[All Fields] AND "syndrome"[All Fields]) OR "cracked tooth syndrome"[All Fields] OR ("cracked"[All Fields] AND "tooth"[All Fields]) OR "cracked tooth"[All Fields]) AND ("therapy"[Subheading] OR "therapy"[All Fields] OR "treatment"[All Fields] OR "therapeutics"[MeSH Terms] OR "therapeutics"[All Fields])
Comments on
The Evidence
Validity: These were both narrative reviews that methodically went through the literature to gather as much information as possible. They both indicate that the evidence base regarding the question is extremely limited.
Applicability This is a question that comes up in general dentistry practices on a regular basis; it is a very important topic for any restorative practice. Further research and more conclusive evidence will prove to be very helpful in the field of restorative dentistry.
Specialty (Endodontics) (General Dentistry) (Prosthodontics) (Restorative Dentistry)
Keywords Asymptomatic fractured tooth, full coverage restorations, cracked tooth syndrome
ID# 2698
Date of submission 03/27/2014
E-mail dekochs@livemail.uthscsa.edu
Author Susie DeKoch
Co-author(s)
Co-author(s) e-mail
Faculty mentor Richard B. Magness, DDS
Faculty mentor e-mail magnessr@uthscsa.edu
   
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)
None available