Cracked tooth Diagnosis and management - WordPress.com
46 years old doctor, intermittent pain in lower right quadrant when chewing. No caries or periodontal pathology, yet the lower first molar responded negative to vitality testing. Lower second molar root
canal treated since 6 months. Shows favorable healing and satisfactory obturation. At the 6 years recall, deep
distal pocket and vertical bone loss (arrows). CRACKED TOOTH
Diagnosis AND Management What are teeth crack?
Etiology of cracks. Types of teeth cracks. How to diagnose such cracks. Management of teeth cracks.
A fracture plane of unknown depth and direction passing through tooth structure that, if not already involving, may progress to communicate with the pulp and/or periodontal ligament.
In patients aged between 30 years and 60 years. Men = women. Mandibular second molars > mandibular first molars > maxillary premolars.
Usually mesio-distal orientation but may run buccolingually in mandibular molars. 10% of the population, 15% resulting in pulpal involvement or extraction. 35% of fractures occurred in caries and
restoration free teeth. Etiology of cracks Naturally occurring causes such as bruxism, clenching and severe attrition.
Iatrogenic causes such as excessive tooth structure removal. Types of tooth cracks
Craze lines Visible fractures that only involve enamel Fractured cusps Usually originate in the crown, extend into
dentin, and end in the cervical region. Fractured distolingual cusp
Fractured palatal cusp Cracked tooth
A crack extending from the occlusal surface of the tooth apically without separation of the two segments (incomplete fracture). Split tooth
A crack that extends through both marginal ridges usually in a mesiodistal direction, splitting the tooth completely into two separate segments.
Vertical root fracture A complete or incomplete crack initiated from the root at any level, usually directed buccolingually.
Diagnosis of cracks Often presents a diagnostic dilemma to the dentist and a painful, frustrating event to the patient, 20% of patients presenting with diagnostic uncertainties to
endodontists were eventually diagnosed with teeth cracks. Patient complaints
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