Risk factors for the appearance of cracks and fractures of teeth according to a survey of dentists

BACKGROUND: Preventive treatment is essential in modern dentistry, resulting in increased attention to the causes and potential predictability of dental pathologies, including tooth cracks and fractures. Currently, there is a lack of comprehensive, detailed studies on this subject. AIM: To assess the detectability of risk factors for tooth cracks and fractures (based on a survey of dentists). MATERIALS AND METHODS: A survey of 52 dentists of various specialties was performed using a special questionnaire on the incidence and causes of tooth cracks and fractures. RESULTS: According to the survey of dentists, the incidence of confirmed tooth cracks and fractures was 6.7% and 4.4% for extracted and treated teeth, respectively. Maxillary premolar roots were the most common site (59.1%), with longitudinal cracks/fractures predominating (68.2%). Of all reported cracks and fractures, 15.6% were only detected during an X-ray or CT examination. Overall, 87.7% of cracks and fractures were detected in devitalized teeth, 79.3% in patients with unreplaced missing teeth, dental cavities, or restoration of more than 50% of the occlusal surface (76.3% and 49.3%, respectively), and 30.6% in patients with root wall thinning. At least 65.0% of tooth destruction cases occurred within 5 years of devitalization, filling, or replacement. CONCLUSION: The study found that the main risk factors for tooth cracks and fractures (more than 10% of extracted and treated teeth) are devitalization and excessive load caused by incomplete dental restoration, as well as significant destruction of the crown, root wall thinning, and a long period following devitalization, filling, or replacement. More than half of all tooth cracks are longitudinal. Maxillary premolars are more prone to cracks and fractures. These factors can be used to predict long-term complications such as tooth cracks and fractures after dental tissue treatment.