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Crack tooth
This document discusses cracked tooth syndrome, including its classification, incidence, etiology, symptoms, diagnosis, and treatment. It begins with a brief history of cracked tooth classification from the 1950s onwards. Cracked tooth syndrome can be classified into different types including craze lines, cracked teeth, fractured cusps, split teeth, and vertical root fractures. Cracked teeth most commonly occur in those aged 30-50 years old and involve the mandibular molars. Symptoms include pain from cold or pressure. Diagnosis involves dental history, visual examination, tactile examination, bite tests, staining, transillumination, and sometimes radiographs. Treatment aims to stabilize the crack immediately with splints or crowns and may involve
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Crack tooth
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- 2. Content • Definite • Classification •Incidence • Etiology • The symptoms of cracked tooth syndrome • Objective test • Diagnosis therapy • Prevention
- 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. Classification of cracktooth syndrome • Craze Lines • Cracked Tooth • Fractured Cusp • Split Tooth • Vertical Root Fracture Simon DE,AAE 1997 Walton and torabinejad,2012
- 5. Craze Lines • Mostadult teeth • tiny cracks that only affect the outer enamel of the tooth • no treatment
- 6. Cracked tooth Definite - Anincomplete fracture of a vital posterior tooth that involves the dentine and possibly the dental pulp (Cameron 1964)
- 7. Cracked Tooth • hairlinecrack 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. Fractured Cusp - Weakeneddue to an existing filling - New decay - Sharp pain with mastication and with cold - Treatment RCT with full Crown
- 9. Split Tooth - resultof an untreated cracked tooth. - cracked tooth with distinct segments which may be mobile. - Treatment extraction
- 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. Reprinted with permissionfrom: th ed. M Torabinejad and RE Walton editors. Philadelphia, Pennsylvania: W.B. Saunders Company, pp. 108-128. Principles and practice of endodontics, 4
- 12. Incidence - age between30 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. The Etiology ofCracked 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. Classifications Factors Examples Over preparation ofcavity. 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. Classifications Developmental Factors Examples Incomplete of fusion areasof 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. 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. The symptoms ofcracked 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. Objective test ! - Periapicaltests 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.
- 20. Diagnosis • Dental History • Visual examination • Tactile examination • Bite tests • Periodontal probing • Staining • Transillumination • Radiographs • Restoration removal • Surgical assessment
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- 31. Periodontal probing www2.aofoundation.org www.gumsbleeding.com Deep narrow pocket medical.tpub.com
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- 39. Surgical assessment Int PosterJ Dent Oral Med 13 (2011), No. 1, Poster 526 www.nature.com
- 40. 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.
- 41. Therapy Immediate therapy. ! = Theprimary 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
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- 44. การวางแผนการรักษาฟันร้าว, KDJ. Vol.11No.1 January - June, 2008 Page 39
- 45. diagnosis, therapy, andprevention 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.
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