lecture 5 cont Flashcards
common types of longitudinal (vertical) fractures list in increasing order of importance and damage:
- craze lines (confined to enamel)
- fractured cusp (oblique shearing fracture)
- crack tooth (incomplete “greenstick”)
- split tooth (crack extends to a surface in all areas)
- vertical root fracture (VRF begins internally at root apex or from crown)
horizontal fractures also important but as easily seen and occur from trauma)
-confined to enamel
-common and generally unimportant
-dont stop light
craze lines
-oblique shearing fracture
-facial-lingual
-often involves undermined cusp, may be restorable
fractured cusp
-incomplete “greenstick”
-M-D fracture involving 1 or both marginal ridges
-may or may not involve the pulp
-may be confined to crown or extend to root
cracked tooth
-cracks extends to a surface in all areas
-involves crown, root, and generally pulp
-must remove fracture and determine restorability
split tooth
-begins internally at root apex or from crown
-primarily in axial plane may be F-L or M-D
-often occur in RCT teeth
vertical root fracture VRF
important but are generally easily seen and are usually associated with known traumatic events
horizontal fractures
vertical lines in enamel of teeth
-best observed by trans-illuminating using fiberoptic light from palatal aspect
-common and generally asymptomatic and not a concern for endotontics
-when stain, esthetic issue may develop and can be treated by several restorative techniques
craze lines
step 1 with this fracture is always so necessary Dx testing, determine condition of pulp
-if vital and restorable, remove fracture portion and restore if possible
fractured cusp
cracks may be stained or made more obvious via trans-illumination
-if pulp tests WNL, normal procedure is to remove this and see if remaining tooth structure will support a restoration(intra-coronal or extra-coronal)
fractured cusp
in some cases, removal of the fractured cusp will reveal:
1
2
- fracture too far below the attached gingiva to maintain periodontally (crown lengthening may be helpful)
- so little tooth structure remains that RCT + post, build up, and crown will be necessary to properly restore
most common site of cracked tooth is
-mand 2nd or 1st molar
followed by max premolars
-often seen in teeth without caries or restorations
-may follow bruxism or clenching habit or other trauma
a cracked tooth is most often discovered following pt complaint of:
acute, sharp, momentary pain upon biting or release of biting pressure
pulp with cracked tooth?
what happens if crack extends?
usually vital in early stages and may remain for some time.
crack extends: pulp can become necrotic and previous pain stops because pulp is now necrotic and can no long respond. later SAP will develop as infection invades the peri-radicular tissues
if crack extends to pulpal floor or canal, RCT…
will not be successful
