Abstract: Objective: To explore the impact of cusp inclinations on dental fractures in cracked tooth syndrome model and formulate corresponding risk scale. Methods: Forty maxillary premolars were randomized into four groups. For cracked tooth models, buccal and palatal cusp inclinations were different, with Group IV as blank control. All groups underwent compression loading test and fracture levels were recorded for statistical analysis. Results: The fracture modes included a majority of crown root fractures and a minority of crown fractures in Groups I and II, exclusive crown root fractures in Group III, and exclusive crown fractures in Group IV. Overall, palatal fractures were predominant versus buccal fractures, with exclusive palatal fractures in Group IV, and oblique fractures were overwhelming versus the scanty vertical fractures. Fracture risk classification: grade III was prevalent in Groups I and II, grade IV in Group III, and grades I and II in Group IV only. The fracture risk scores in Groups III and IV had significant statistical differences versus Groups I and II (P<0.05), with insignificant differences between Groups I and II. Conclusion: Cracked teeth are more vulnerable to complex fractures, with increment of cusp inclinations contributable to complex fracture modes, involving deep fracture and high risk scores.

Key words: Cracked tooth syndrome, Cusp inclination, Fracture mode, Fracture risk score