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Coping with cracked tooth syndrome.

Cracked tooth syndrome typically poses a diagnostic challenge for the dentist. Symptoms include tenderness to biting on certain foods, often poorly localized, and occasional thermal sensitivity. Knowing where to look for this entity, especially in the mandibular molar region, can be especially helpful. Treatment of the tooth depends on the degree of pulpal involvement and the extent of the crack. Cuspal coverage is required of all cracked posterior teeth that are retainable. Root canal therapy is included if symptoms persist or if pulpal pathosis exists at the outset. Cracks extending beyond the osseous crest indicate a poor prognosis. Armed with this knowledge, the dentist can overcome many cracked tooth dilemmas, resulting in satisfaction for both patient and practitioner alike.

Cracked Tooth Syndrome↗

Cracked tooth syndrome--incidence, clinical findings and treatment.

Cracked tooth syndrome (CTS) is a common occurrence in modern general practice. This article reviews the forces placed on the human dentition and the effect restorative dentistry has on the strength of tooth structure. The study reports on the incidence of CTS in a general practice, finding a far higher incidence in teeth which have had the marginal ridge restored than those which have not. The various types of treatment modalities advocated and their relative merits are discussed.

Cracked Tooth Syndrome↗

Cracked tooth syndrome: diagnosis, treatment and correlation between symptoms and post-extraction findings.

Although the cracked tooth syndrome has been known for over twenty years, it frequently remains undiagnosed because the condition is not sufficiently well recognized. Cracked tooth syndrome has been defined as an incomplete fracture of the dentine in a vital posterior tooth, and must be distinguished from a split tooth. A diagnosis can often be made by means of the history, and must be confirmed by reproducing the patient's symptoms. The ideal treatment consists of applying a stainless steel band to the tooth, with cessation of symptoms confirming the diagnosis, followed by a full coverage restoration. Case histories illustrating the syndrome are presented, and a further case is reported where a diagnosis of cracked tooth syndrome was made, and the tooth extracted, sectioned and stained to show the nature of the cracks and their relationship to the pulp.

Adult↗

Bonded restorations for the prevention and treatment of the cracked-tooth syndrome.

Several reports revealed that the cracked-tooth syndrome is a common problem in dental practice, which often results in extraction of the affected incompletely fractured teeth. Predominantly restored teeth suffer from these incomplete fractures. Therefore, it is of outstanding importance to stabilize teeth weakened due to cavity preparation. Besides full cuspal coverage by partial or full crowns, bonded restorations have been proposed for internal splinting of restored teeth. Although contradictory data have been published, there is evidence that bonded amalgam or resin-based composite restorations (RBC) do not increase fracture resistance of teeth with wide occlusal-proximal cavities to values similar to sound, unrestored controls. Indirectly fabricated RBC inlays and various ceramic inlays, however, increased fracture strength to levels as high as those of sound caries-free teeth. Therefore, it is recommended that weakened teeth with wide cavities be strengthened by full cuspal coverage with cast or ceramic restorations, by bonded ceramic inlays, or by indirectly-fabricated bonded RBC composite inlays.

Composite Resins↗

The cracked tooth syndrome: an elusive diagnosis.

The authors review the literature and present a case of cracked tooth syndrome. Special emphasis is placed on diagnostic problems associated with this syndrome. The case report demonstrates classic and atypical features of cracked tooth syndrome.

Bruxism↗

The cracked-tooth syndrome and fractured posterior cusp.

1. Even from such a small sample as that reported in this study, it is evident that the fractured cusp and cracked-tooth syndrome are common problems. The large number of fractured cusps compared to the cracked-tooth syndrome suggests that some of the cases of fractured cusp could have been diagnosed earlier. 2. It is most important that dentists be aware of the cracked-tooth syndrome in order to relieve the patient's discomfort, prevent the possible eventual loss of the pulp or tooth, and avoid unnecessary and possibly damaging treatment for misdiagnosed facial pain. 3. Conservation of tooth structure in restorative procedures is most necessary in order to prevent the cracked-tooth syndrome or fractured posterior cusp.

Cracked Tooth Syndrome↗

The diagnosis and treatment of the cracked tooth syndrome.

Teeth restored with intracoronal restorations that provide no protection of the cusps from occlusal loading may fracture completely or partially. An incomplete dentinal fracture of a vital posterior tooth may cause pain. This condition is commonly known as the "cracked tooth syndrome". Location of the dentinal crack is difficult and must be guided by a precise history, thermal pulp testing and inspection of the dentinal walls within the suspect tooth. The number, extent and direction of the fracture lines may be ascertained readily by using transillumination and magnification. This allows the clinician to distinguish between oblique and vertical cracks. Treatment of oblique incomplete fracture relies on desensitisation of the hypersensitive dentine followed by splinting of the tooth fragments. Treatment of vertical incomplete fracture requires pulpectomy and immediate splinting of the crown. Two case reports are presented.

Cracked Tooth Syndrome↗