Cracked Tooth Syndrome: Etiology, Classification, Signs and Symptoms, Diagnosis, Management, Treatment | Dentistry. What is Cracked Tooth Sy...
Cracked Tooth Syndrome: Etiology, Classification, Signs and Symptoms, Diagnosis, Management, Treatment | Dentistry.
What is Cracked Tooth Syndrome?
Cracked Tooth Syndrome is the incomplete fracture of the tooth portion involving enamel, dentin, and sometimes to the pulp. If pulp involves it became a complete fracture. The term cracked tooth syndrome was initially called "Cuspal Fracture Odontalgia". Later it was replaced by the "Cracked Tooth Syndrome" or "Cracked Cusp Syndrome".
Epidemiology
Mandibular Molars are the most commonly affected followed by maxillary premolars and maxillary molars. Females are most prone to cracked tooth syndrome. But recent studies show both males and females equally affected. It occurs in the age between 30 to 60 years of age.
Etiology
Many factors cause cracking of tooth, some of them are, Faulty restoration which causes fracture of the tooth. Parafunctional habits such as bruxism can also cause fracture of teeth due to an increase in vertical pressure. Excessive removal of tissues around the tooth during surgeries may cause fracture to the tooth. Masticatory forces and a stressful lifestyles are other possible etiological factors for cracked tooth syndrome.
Classifications
This Classification based on the Pulpal and Periodontal involvement of the fracture. They are,
Class A- Crack involving enamel and dentin but won't extend to the pulp.
Class B- Crack involves pulp but won't extend to the periodontal apparatus
Class C- Crack involves pulp and the periodontal apparatus.
Class D- Complete division of the tooth
Class E- Apically induced fracture
Signs and Symptoms
Pain is mild to severe. Pain occurs during the Mastication while releasing the bit. The tooth is nontender on percussion. If pulpal involvement is present, signs and symptoms are similar to irreversible pulpitis.
Diagnosis
Dyes are used to detecting the fractured line on the tooth. Methylene blue dyes are used for staining. A percussion test is used to find the pain. By probing with the explorer. On biting with cotton applicator fractured segment get separated and pain is produced while releasing the pressure. Fiber-optic transilluminations are also used to detect the fracture line.
Management and Treatment
The involved cusp is reduced with the help of selective grinding and proper occlusal contacts are made. If the crack present across the floor of the chamber, then the tooth is bonded with a temporary crown. Depending upon the prognosis, the involved tooth may undergo extraction, hemisection, and root resection. Full occlusal coverage will be for the protection of the cusp.
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