Crack tooth

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presentation "crack tooth"

By WTU DENT01 Group 6 ^^
2013

Crack tooth

  1. 1. Crack Tooth Present By Group 6
  2. 2. Content • Definite • Classification • Incidence • Etiology • The symptoms of cracked tooth syndrome • Objective test • Diagnosis therapy • Prevention
  3. 3. History of cracked • 1954 Gibb : cuspal fracture odontalgia • 1956 Melion : a fractured cusp • 1962 Sutton : greenstick fracture of tooth crown • 1964 Cameron : cracked tooth syndrome • 2001 Ellis : incomplete tooth fracture
  4. 4. Classification of crack tooth syndrome • Craze Lines • Cracked Tooth • Fractured Cusp • Split Tooth • Vertical Root Fracture Simon DE,AAE 1997 Walton and torabinejad,2012
  5. 5. Craze Lines • Most adult teeth • tiny cracks that only affect the outer enamel of the tooth • no treatment
  6. 6. Cracked tooth Definite - An incomplete fracture of a vital posterior tooth that involves the dentine and possibly the dental pulp (Cameron 1964)
  7. 7. Cracked Tooth • hairline crack invole dentin and dental pulp • Common anterior teeht>posterior teeth • ÁมÑั¡กàเ¡กÔิ´ดãใ¹นáแ¹นÇว mesiodistally Tx • ‘hold’ the crack together with a tooth coloured filling or crown • to carry out a root canal filling.
  8. 8. Fractured Cusp - Weakened due to an existing filling - New decay - Sharp pain with mastication and with cold - Treatment RCT with full Crown
  9. 9. Split Tooth - result of an untreated cracked tooth. - cracked tooth with distinct segments which may be mobile. - Treatment extraction
  10. 10. Vertical Root Fracture • not a very common type of fracture • usually occur in teeth that have had root canal therapy • fracture is very short in length => Tx  ฀apicoectomy • involves gaining access to the root tip within the bone => Tx extraction
  11. 11. Reprinted with permission from:
 th ed. M Torabinejad and RE Walton editors. Philadelphia, Pennsylvania: W.B. Saunders Company, pp. 108-128. Principles and practice of endodontics, 4
  12. 12. Incidence - age between 30 to 50 yrs - Male = Females - Most commonly associated with heavily restored mandibular molar tooth. - Mandibular teeth > Maxillary teeth – - Mandibular Second Molar > Mandibular First Molar > Maxillary Premolars > Maxillary First Molar - Mandibular Premolars – least affected
  13. 13. The Etiology of Cracked Tooth Syndrome Classifications Factors Masticatory accident Occlusal Damaging horizontal forces Functional forces Parafunction Examples Sudden and excessive biting force on a piece of bone Eccentric contacts and interferences (especially mandibular second molars) Large untreated carious lesions Cyclic forces Bruxism, clenching The cracked Tooth Syndrome. Lynch CD & McConnell RJ. J Can Dent Assoc 2002; 68 (8); 470
  14. 14. Classifications Factors Examples Over preparation of cavity. Inadequate Insufficient cuspal protection in design features inlay/onlay design. Deep cusp-fossa relationship. Restorative procedures   Stress concentration Pin placement Hydraulic pressure during seating of tightly fitting cast restorations. Physical forces during placement of restoration, e.g., amalgam or soft gold inlays. Non-incremental placement of composite restorations. Torque on abutments of long-span bridges. The cracked Tooth Syndrome. Lynch CD & McConnell RJ. J Can Dent Assoc 2002; 68 (8); 470
  15. 15. Classifications Developmental Factors Examples Incomplete of fusion areas of calcification Occurrence of cracked tooth syndrome in unrestored teeth Thermal cycling (50oC) Enamel cracks Miscellaneous   Dental instruments Cracking and crazing associated with highspeed handpieces The cracked Tooth Syndrome. Lynch CD & McConnell RJ. J Can Dent Assoc 2002; 68 (8); 470
  16. 16. Cracked tooth syndrome – Incidence, clinical findings and treatment, C. I. (Kip) Homewood, BDSc, DDS, LDS, FRACDS*, Australian Dental Journal 1998;43:(4):000-000
  17. 17. The symptoms of cracked tooth syndrome - Acute pain on mastication (pressure or release) of grainy, though foods - Sharp, brief pain with cold - Slight to very spontaneous pain It can be with irreversible pulpitis, pulp necrosis, or apical periodontitis. Even an acute apical abscess, with or without swelling or draining sinus tract, may be present if the pulp has undergone necrosis. The cracked Tooth Syndrome. Lynch CD & McConnell RJ. J Can Dent Assoc 2002; 68 (8); 470
  18. 18. Objective test ! - Periapical tests are also vary, but usually pain is not elicited with percussion or palpation if the pulp is vital. - Directional percussion is also advocated. - Direct inspection (microscope is useful), staining with methylene blue or iodine and transillumination are usually effective. - Biting test with cotton application/ rubber wheel/ tooth sloth. - Radiographic findings may be not seen.
  19. 19. Diagnosis                   •    Dental  History •    Visual  examination •    Tactile  examination •    Bite  tests •    Periodontal  probing •    Staining •    Transillumination •    Radiographs •    Restoration  removal •    Surgical  assessment
  20. 20. Dental  History
  21. 21. www.sevacall.com www.thenewage.co.za lifeandstyle.ca
  22. 22. www.medindia.net
  23. 23. www.bhbdental.co.nz http://www.oralsurgeryandimplants.com/blog/bruxism-­‐solutions-­‐for-­‐teeth-­‐grinding/
  24. 24. www.stop-grinding-teeth.com www.orthoapnea.com www.assureasmile.com www.castlehilldentalcare.com.au
  25. 25. www.deardoctor.com njrootcanal.com www.docsparks.com 27
  26. 26. Visual  examination http://www.oralsurgeryandimplants.com/blog/bruxism-­‐solutions-­‐for-­‐teeth-­‐grinding/
  27. 27. Tactile  examination commons.wikimedia.org boynedental.ie www.dentalemergencies.com
  28. 28. Bite  tests www.smartpractice.com http://www.endodovgan.com/Endoinfo_Cracked_Fractured.htm
  29. 29. Periodontal  probing www2.aofoundation.org www.gumsbleeding.com Deep  narrow  pocket medical.tpub.com
  30. 30. Methylene Blue http:/ /www.roydent.com Caries  finder https:/ /www.dentalaegis.com
  31. 31. http:/ /www.dentalindia.com/ccr.html
  32. 32. Transillumination www.mahwahsmile.com http://www.endodovgan.com/Endoinfo_Cracked_Fractured.htm
  33. 33. http://www.endodovgan.com/Endoinfo_Cracked_Fractured.htm http://www.endodovgan.com/Endoinfo_Cracked_Fractured.htm
  34. 34. Radiographs www.dentalcare.com www.aadmrt.com “Halo” “J-sharpe” myteethnvd.wordpress.com
  35. 35. agdblogs.blogspot.com
  36. 36. Surgical  assessment Int Poster J Dent Oral Med 13 (2011), No. 1, Poster 526 www.nature.com
  37. 37. Treatment  planning: The cracked  tooth  treatment plan will vary depending on the location  and  extent  of  the  crack.     Even when the crack can be located, the extent is still difficult to determine.
  38. 38. Therapy Immediate therapy. ! = The primary goal must be to splint and stabilize a cracked tooth immediately. Final therapy. = Function & xáà{xà|vá diagnosis, therapy, and prevention of the cracked tooth syndrome,Quintessence International,Volume 34, Number 6, 2003,Page 415-416
  39. 39. www.diytrade.com www.diytrade.com Immediate therapy. www.onlinedentist.org www.vintagemedical.com www.photodental.com www.zammitortho.com
  40. 40. www.markacruzdds.com occlusionconnections.com Immediate therapy. www.deardoctor.com
  41. 41. การวางแผนการรักษาฟันร้าว, KDJ. Vol.11 No.1 January - June, 2008 Page 39
  42. 42. diagnosis, therapy, and prevention of the cracked tooth syndrome,Quintessence International,Volume 34, Number 6, 2003,Page 415-416 PREVENTION 1. Awareness of the existence and etiology of CTS is an essential component . 2. Conservation of tooth structure during cavity preparations. 3. Prevention of stress concentration during restoration. 4. Prophylactic removal of eccentric contacts. 5. Provision of mouth guards in patients with para-functional habits like bruxism and clenching.
  43. 43. 46
  44. 44. Members Miss Jindara Miss Chawanun Miss Benjaporn Jaklang Chaimee Auttagang ! Western University 2013 ! THANK YOU !!! 5209110037 5209110038 5209110039

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