Cracked Tooth Syndrome
Diseases Of Pulp And Periradicular Tissues
CRACKED TOOTH SYNDROME
Contributed By: Dr. Himani
DEFINITION:- Cracked tooth syndrome denotes an incomplete fracture of tooth with a vital pulp. The fracture involves enamel and dentin, often involving the pulp.
- Molars of older individuals are most frequently present with cracked tooth syndrome.
- It is commonly seen to be associated in teeth with large and complex restorations.
- Mandibular molars are most commonly affected, followed by maxillary molars and maxillary premolars.
- The patient usually complains of mild to excruciating pain at the initiation or release of biting pressure.
- Eventually this pain becomes severe when the fracture involves the pulp chamber also. The pulp in these teeth may become necrotic
Close examination of crown of tooth may disclose an enamel crack, which may better be visualized by following methods:
- Fibre optic light:- Used to trans-illuminate fracture line.
- Dye:- Staining the fracture with a dye , such as methylene blue, is a valuable aid to detect a fracture.
- Tooth slooth:- Patient is asked to bite on tooth slooth. The pain during biting or chewing especially upon the release of pressure is a classic sign of cracked tooth syndrome.
- Percussion of teeth.
- Careful probing with an explorer.
- Biting on tooth slooth, cotton applicator or rubber wheel.
- Urgent care:- It involves immediate reduction of its occlusal contacts by antagonist.
- Definitive treatment:-
- Definitive treatment aims to preserve the pulpal vitality by providing full occlusal coverage for cusp protection.
- Full coverage crown if fracture involves crown portion only.
- If fracture involves root canal system, and it is superficial to alveolar crest, endodontic treatment and restoration of tooth is done.
- If fracture of tooth extends below alveolar crest extract the tooth.
- Textbook of endodontics- Nisha garg, 3rd edition, pg no 337.
- Grossman’s Endodontic practice , 13th edition,pg no 147- 149