Title Patients with Cracked Tooth Syndrome, The Bite Test is Not Conclusively More Effective Than Transillumination in Diagnosing Tooth Fractures
Clinical Question In patients suffering from a cracked tooth syndrome, is the bite test a better diagnostic tool than transillumination?
Clinical Bottom Line For patients with cracked tooth syndrome, the bite test is not conclusively more effective than transillumination in diagnosing tooth fractures. This is based on a study involving 378 patients with CTS-like conditions. All teeth with CTS-like conditions tested positive response to the bite test. Of the 33 teeth with CTS, all transilluminated. Based on these results a positive bite test is diagnostic of CTS and transillumination is beneficial aid in these situations.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
19249590Udoye/2009375 pt, 18-77 yo, with CTS like conditionsCohort study
Key resultsCTS was more frequent in males, maxillary arch, and restored second molars or unrestored first molars. The patients with CTS had a positive bite test and transilluminated, responded to electric pulp testing at normal threshold levels, and half had detectable cracks. In most cases, symptoms were relieved immediately after diagnosis was made. For those with symptoms of an unexplained source, symptomatic alleviation was effected. Such cases were followed up for evidence of cracks and to rule out other possible causes.
Evidence Search "cracked tooth syndrome" AND transillumination
Comments on
The Evidence
Validity: There is no high-quality evidence demonstrating the effectiveness of transillumination alone in detecting an early coronal fracture. This sample consisted of only cases of cracked tooth. The authors did not report evaluating negative controls (i.e. non-cracked). This study is, therefore, prevalence data rather than a comparison of the properties of the biting test vs. transillumination.
Applicability This study was done in Nigeria. Differences in oral habits and dietary practices might limit the applicability of these results to other populations.
Specialty (Endodontics) (General Dentistry) (Periodontics) (Restorative Dentistry)
Keywords Cracked tooth syndrome, fracture, bite test, transillumination
ID# 2548
Date of submission 08/07/2013
E-mail trantc@livemail.uthscsa.edu
Author Tim C. Tran
Co-author(s) Arwa Khayat
Co-author(s) e-mail Khayat@livemail.uthscsa.edu
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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
Comments and Evidence-Based Updates on the CAT
None available