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- Readers' Forum Predictable management of the cracked tooth
- Sin-Young Kim
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Restorative Dentistry & Endodontics 2016;41(1):79-79.
DOI: https://doi.org/10.5395/rde.2016.41.1.79
Published online: December 23, 2015
Seoul St. Mary's Dental Hospital, the Catholic University, Korea.
©Copyrights 2016. The Korean Academy of Conservative Dentistry.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Q
How can I treat cracked teeth more efficiently?
A
The diagnosis of cracked tooth is difficult in the early stage because the symptoms are not consistent, and often a crack line is not visible. Early detection and proper treatment of cracked tooth are important because all cracks have the potential to become a split tooth.
1. Be reminded that cracked tooth occurs usually on mandibular and maxillary first molars in patients in their 40s and 50s. If the tooth has a large restoration such as gold inlay or amalgam filling, then cracks occur easily.1,2,3
2. If pulp status is reversible pulpitis, remove the old restoration and crack line carefully because cracks are always colonized by bacterial biofilms. Fill the cavity with bonded direct or indirect restoration.2,4,5,6 If biting pain persists, then make a provisional crown and reevaluate the necessity of root canal treatment.
3. If pulp status is irreversible pulpitis or necrotic, perform root canal treatment initially and make a provisional crown.2,4,7 If symptom disappears, then make a final crown.
4. If a crack extends subgingivally and deep periodontal pocket is associated with the crack, explain the poor prognosis to the patient and decide whether to treat or extract the cracked tooth.8
Acknowledgement
Readers' forum is edited by Professor Kyung-Mo Cho (Gangneung-Wonju National University).
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