Outcomes of endodontically treated cracked teeth: a systematic review and meta-analysis

Objective Systematic review analyzing the treatment outcomes of cracked teeth that received endodontic treatment is unavailable. The purpose of this study was to examine the treatment outcome of cracked teeth that received root canal treatment and to determine factors that influenced outcome. Materials and methods The specific PIO questions were as follows: Population: patients who were healthy individuals ≥ 18 years old and required root canal treatment due to cracked tooth; Intervention: root canal treatment with at least 1 year in occlusal function; Outcomes: survival rate and pre-operative factors. Ovid, PubMed, and Cochrane databases were searched in conjunction with hand searching. Pooled survival rates were determined from a meta-analysis of the data retrieved from the articles. All statistics were performed by the Comprehensive Meta-Analysis software. Results Four articles met the inclusion criteria. The overall tooth survival at 60 months was 84.1% (95%CI, 72.3–91.5%). Although no pre-operative factors had statistical significance, 4 factors had possible clinical significance. Teeth with single crack and teeth with cracks contained within crowns exhibited lower extraction risk, while teeth with pre-treatment periodontal probing > 3 mm and teeth that were terminal abutments showed a greater risk of extraction. Conclusion This systematic review determined the survival rate of endodontically treated cracked teeth to be moderately high. More studies in this area are, however, warranted before definitive conclusions can be derived. Clinical relevance In view of the relatively high survival rate, endodontic treatment rather than extraction should be considered for cracked teeth.