LAUSR

INTRODUCTION Cracked teeth (CT) frequently require protective adhesive restorations. This long-term, longitudinal retrospective clinical study aimed to evaluate the factors influencing the success and survival rates of CT with crack lines (CLs) in different directions, when restored early with onlays or full-coverage crowns. METHODS The dental records of 71 patients with a total of 86 CT, with different pulpal and periapical diagnoses, and with follow-ups spanning over 1-11 years were included. Data regarding the demographics; clinical symptoms and signs; bruxism; occlusal interferences; eating habits; pulpal and periapical diagnoses; number, direction, location, and extent of crack lines; probing depth; and coronary condition before and after the placement of definitive restorations were collected. Univariate associations between tooth survival and explanatory variables were assessed. The long-term survival rate was estimated using the Kaplan-Meier analysis and the log-rank test. A multivariate analysis was performed using Cox regression analysis. RESULTS The overall success rate was 93.0%, and the overall survival estimates of CT restored early were 98.6%, 94.9% and 55.9% at the 1-, 5-, and 11-year follow-ups, respectively. The direction of the CLs did not influence the survival of the tooth. No significant association was observed between the type of tooth, probing depth, root canal treatment (RCT), and tooth loss (P>0.05). The multivariate analysis showed that previously treated CT (P<0.05), provision of onlay restorations (P<0.05), and placement of posts (P<0.05) had higher correlations with tooth loss. Additionally, placement of full-coverage crowns resulted in lower tooth loss compared with the placement of onlays (P<0.05). CONCLUSION Previous endodontic treatment in teeth that subsequently develop CLs has a negative impact on the survival rate of the teeth. Moreover, early placement of full-coverage crowns should be implemented for CT, regardless of the direction or number of CLs, since it is associated with a higher cracked tooth survival rate.