Cracked Teeth

Question 1

Fractured Cusp

Extends from 2

Present

Symptoms during

Answer 1

• Complete/incomplete fracture intiated from crown and extending subgingivally
• Mesio-distally and facio-lingually
• Extensive caries or large restorations
• Brief sharp pain on mastication and with cold, pain on masticatory release

Question 2

Tx for fractured cusp

4

Answer 2

• Remove affected cusp
• adhesive resin restoration
• Full crown or onlay
• RCT/ Vital pulp therapy if indicated
  
  • Pulp exposure, vitality tests, symptoms

Question 3

Split tooth

Extends 2

Symptoms during

Visually

Answer 3

• Complete fracture initiated from the crown and extending subgingivally
• Mesio-distally
• Marked pain on mastication, periodontal abcess
• Visual seperation of segments, wedging of segments

Question 4

Split tooth Tx

3

Answer 4

• If fracture is deep apically, extraction
• If fracture is not too far apically, remove fractured segment, crown legthening or orthodontic extrusion
• Consider crown/root ratio and furcation involvement

Question 5

Vertical root fracture

Extends 2

Often

forces

Answer 5

• Complete or incomplete fracture INTIATED from the root at any level
  
  • Fracture involves only one surface of the root
  • Fracture extends completely through the root to involve both surfaces of the root
• Facio-lingually (bucco-lingual)
• More often in endodontically tx teeth
• Wedging forces within canal that exceed binding strength of root canal dentin

Question 6

Potential etiologic factors for Vertical root fractures

5

Answer 6

• Root shape, canal shape, dentin thickness
• Biomechanical instrumentation
• Obturation technique
• Irrigation /ICM
• Restoration-Type, post, ferrule

Question 7

Dx of Vertical root fracture

chief complaint2

clinical signs5

Answer 7

• Chief complaint- pain, abcess
• Clinical signs- pocket, percusion, mobility, swelling sinus tract

Question 8

Clinical Examination of vertical root fractures 4

Answer 8

• Periodontal probing with local
• Swelling and palpation
• Prescence of sinus tract
• Bite test an percussion

Question 9

Periodontal probing on vertical fractured teeth

3

Answer 9

• Deep narrow, isolated perio pockets
• Pocket adjacent fracture site
• Deep probing in 2 positions on opposite sides of infection- indicative of vertical root fracture

Question 10

Radiographic signs

Answer 10

• Space beside root filling (guta percha)
• Cement trail
• Dislodged root end filling
• Widening of PDL
• Halo like RL
• J shaped RL

Question 11

Cracked tooth

Answer 11

• Incomplete fracture initiated from the crown and extending subgingivally
• Mesio-distally
• Parafunctional habits, trauma, restorative procedures,
• Localized pain on mastication (pressure or release) sharp brief pain to cold
• Bite test and transillumination for dx