Impact of Intraorifice Barrier Materials on the Prognosis of Cracked Teeth: A Systematic Review
Mohd Nazrin Mohd Isa, Abdul Rauf Badrul Hisham, Afzan Adilah Ayoub, Rostam Iffendi Idris, Angeline Hui Cheng LeeAbstract
Objective:
The aim of this study was to evaluate the available clinical evidence on outcomes, tooth survival, and prognostic indicators following intraorifice barrier-based management of cracked teeth with radicular extension.
Methods:
This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Web of Science and Scopus were searched for studies published between 2018 and 2026 using terms related to intraorifice barriers and cracked teeth. Primary clinical studies involving endodontically treated teeth with radicular crack extension managed using an intraorifice barrier were eligible. Two reviewers independently screened records; assessed methodological quality; and extracted data on clinical outcomes, survival, success, and prognostic factors. Owing to substantial clinical and methodological heterogeneity and the limited number of included studies, meta-analysis was not performed.
Results:
Three studies met the eligibility criteria. Reported survival rates ranged from 89.7% to 100% over follow-up periods of up to 5 years. Reported success rates ranged from 82.9% to more than 90%. Favorable outcomes were reported when intraorifice barriers were incorporated within comprehensive endodontic-restorative protocols, including meticulous crack assessment and definitive cuspal coverage. Prognostic factors associated with poorer outcomes included deep periodontal probing depths, extensive radicular crack extension, multiple crack lines, preoperative periapical lesions, and restoration type.
Conclusion:
Favorable clinical outcomes may be achieved following intraorifice barrier-based management of cracked teeth with radicular extension. However, as no included study directly compared treatment protocols with and without an intraorifice barrier, the independent effect of barrier placement on tooth survival and treatment success remains uncertain. Further well-designed comparative studies with standardized outcome measures and long-term follow-up are required.