Description

Finding a cracked tooth can be difficult since the tooth may be grossly intact. Diagnosis requires a high level of suspicion and persistence.


Patient Presentation

Pain Duration

Usual Association

aching provoked by many stimuli, including percussion

may be prolonged

pulpal damage

sensitive to selective pressure, biting or thermal stimuli

usually short duration

pulp not involved

 

If the tooth is not immediately obvious, then it must be searched for. Selective pressure or biting on an individual cusp may trigger the pain and indicate the affected tooth.

 

Means of demonstrating the crack:

(1) radiograph (many negative)

(2) staining

(3) transillumination, preferrably using a highly collimated light source

(4) if a filling is present, removal of restoration and examination of base

 

Type of Damage

Definitive Treatment

Prognosis

not involving pulp

cast restoration with circumferential reinforcement

excellent

involving pulp but not extending to the root surface or pulpal floor

root canal with cast restoration with circumferential reinforcement

good

involving pulp and extending to the root surface or pulpal floor

extract with prosthesis

good

 


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