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“Rebound pain” - pain on the release of pressure upon intake of fibrous foods is a consistent feature. History of the discomfort of several months and sharp pain when biting or when consuming cold food/beverages may be elicited. Ĭracked tooth syndrome presents with varied clinical signs and symptoms, according to the position and extent of the incomplete fracture. The crack may involve either the entire root or only a portion of the root. The crack is generally complete though may be incomplete and involve only one surface. Vertical root fractures commence in the root generally in a bucco-lingual direction. The crack is generally located at the center of the tooth and this entity occurs due to crack propagation. Ī split tooth is indicative of a crack extending through both marginal ridges usually in a mesiodistal direction splitting the tooth completely into two individual fragments. The crack is generally located at the center of the tooth in a mesiodistal direction and may involve one or both marginal ridges.
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#BUT CRACK SPLITTING CRACKED#
Ī cracked tooth is indicative of a crack extending from the occlusal surface of the tooth apically without separation of the two fragments. They are usually seen in heavily restored teeth, causing unsupported cuspal enamel. (a) Depicting visible fracture lines within the enamel suggestive of Craze lines (b) Fractured cusp terminating in the cervical part of the tooth (c) Cracked tooth extending from the occlusal tooth surface without separation of tooth fragments (d) Separated tooth fragments suggestive of a split tooth (e) Vertical root fractureįractured cusps begin at the crown of the tooth, extend into dentin, and the fracture ends in the cervical part of the tooth. According to Luebke, fractures are either complete or incomplete, although, other terms such as split-root syndrome, hairline fracture, hairline tooth fracture, enamel infraction, crown craze, craze lines, and tooth structure cracks are also known. In the late 1970s, Maxwell and Braly advocated the use of the term incomplete tooth fracture. Cameron in 1964 coined the term “cracked tooth syndrome.” Here, the signs and symptoms were not apparent, and the teeth showed painful response to cold or pressure applications and became necrotic, however, the pulp and periodontium were apparently healthy.Įllis defined, incomplete tooth fracture as a “fracture plane of unknown depth and direction passing through tooth structure, and may advance to connect with the pulp and/or periodontal ligament.” Gibbs in 1954, was the first to describe the clinical symptoms of incomplete fracture of posterior teeth involving the cusp and termed it as “cuspal fracture odontalgia.” Cases of incomplete fracture with subsequent pulpitis were reported by Ritchey et al. This article provides a detailed literature on the causes, classification, signs and symptoms, diagnosis, and treatment planning of cracked tooth syndrome.Ĭracked tooth syndrome may be defined as a fracture plane of unknown depth, which originate from the crown, passes through the tooth structure and extends subgingivally, and may progress to connect with the pulp space and/or periodontal ligament. Early diagnosis has been linked with successful restorative management and good prognosis. Accurate diagnosis and appropriate treatment are complicated due to lack of awareness of this condition and its bizarre clinical features. Therefore, evaluation by both dentists and physicians are sometimes necessary to diagnose medical illnesses causing “toothache.” Cracked tooth syndrome is a major diagnostic challenge in clinical practice. The toothache may sometimes be the result of radiating pain from structures in the vicinity of tooth and jaws (cardiac pain, ear, nose, throat pain, and sinusitis). Mostly, toothaches are caused by a carious cavity, a broken tooth, an exposed tooth root or gum disease. Pain is defined as an “unpleasant sensory and emotional feeling which is associated with actual or potential injury of tissue or expressed in terms of such injury.” Tooth pain usually refers to pain around the teeth or jaws mainly as a result of a dental condition.