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Síndrome do dente fissurado: etiologia, novas prospectivas de diagnóstico, tratamento e prevenção: revisão integrativa
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A Síndrome do Dente Fissurado (Cracked Tooth Syndrome – CTS) é uma condição clínica caracterizada por fraturas incompletas de dentes vitais, frequentemente de difícil diagnóstico devido a sintomas vagos e variáveis. Esta revisão integrativa tem como objetivo analisar a literatura atual sobre a etiologia, diagnóstico, tratamento e prevenção da CTS, destacando novas perspetivas de diagnóstico e estratégias de manejo. Foi realizada uma pesquisa estruturada nas bases de dados PubMed e Google Scholar, complementada com publicações científicas de associações e instituições profissionais. Seguindo as diretrizes PRISMA, foram inicialmente identificados 312 artigos, dos quais 10 estudos preencheram os critérios de inclusão para análise detalhada. As evidências indicam que a CTS tem uma etiologia multifatorial, envolvendo envelhecimento, sobrecarga oclusal, hábitos parafuncionais e fatores iatrogénicos. Avanços em ferramentas de diagnóstico, como a tomografia computadorizada de feixe cónico (CBCT) e a tomografia de coerência ótica de varrimento (SS-OCT), permitem uma deteção mais precoce e precisa das fissuras em comparação com métodos clínicos e radiográficos convencionais. As estratégias de tratamento dependem da extensão e da localização da fratura, variando desde restaurações adesivas conservadoras até terapias endodônticas ou extração em casos graves. As medidas preventivas, incluindo o controlo de hábitos parafuncionais e abordagens restauradoras minimamente invasivas, são essenciais para reduzir o risco de progressão. Apesar dos avanços tecnológicos, a CTS continua a ser subdiagnosticada, sendo necessários mais estudos clínicos de longo prazo para estabelecer protocolos de tratamento padronizados.
Cracked Tooth Syndrome (CTS) is a clinical condition characterized by incomplete fractures of vital teeth, often difficult to diagnose due to vague and variable symptoms. This integrative review aims to analyze the current literature on the etiology, diagnosis, treatment, and prevention of CTS, highlighting new diagnostic perspectives and management strategies. A structured search was conducted in PubMed and Google Scholar, supplemented with scientific publications from professional associations and institutions. Following PRISMA guidelines, 312 articles were initially identified, with 10 studies meeting the inclusion criteria for detailed review. The evidence indicates that CTS has a multifactorial etiology, involving aging, occlusal overload, parafunctional habits, and iatrogenic factors. Advances in diagnostic tools such as cone-beam computed tomography (CBCT) and swept-source optical coherence tomography (SS-OCT) allow for earlier and more accurate detection of cracks compared with conventional clinical and radiographic methods. Treatment strategies depend on the extent and location of the fracture, ranging from conservative adhesive restorations to endodontic therapy or extraction in severe cases. Preventive measures, including management of parafunctional habits and minimally invasive restorative approaches, are essential to reduce the risk of progression. Despite technological progress, CTS remains underdiagnosed, and further long-term clinical studies are required to establish standardized treatment protocols.
Cracked Tooth Syndrome (CTS) is a clinical condition characterized by incomplete fractures of vital teeth, often difficult to diagnose due to vague and variable symptoms. This integrative review aims to analyze the current literature on the etiology, diagnosis, treatment, and prevention of CTS, highlighting new diagnostic perspectives and management strategies. A structured search was conducted in PubMed and Google Scholar, supplemented with scientific publications from professional associations and institutions. Following PRISMA guidelines, 312 articles were initially identified, with 10 studies meeting the inclusion criteria for detailed review. The evidence indicates that CTS has a multifactorial etiology, involving aging, occlusal overload, parafunctional habits, and iatrogenic factors. Advances in diagnostic tools such as cone-beam computed tomography (CBCT) and swept-source optical coherence tomography (SS-OCT) allow for earlier and more accurate detection of cracks compared with conventional clinical and radiographic methods. Treatment strategies depend on the extent and location of the fracture, ranging from conservative adhesive restorations to endodontic therapy or extraction in severe cases. Preventive measures, including management of parafunctional habits and minimally invasive restorative approaches, are essential to reduce the risk of progression. Despite technological progress, CTS remains underdiagnosed, and further long-term clinical studies are required to establish standardized treatment protocols.