Longitudinal Tooth Fractures Quiz

The goal is to help general practitioners with diagnosis and treatment planning, and to foster clearer communication between members of the dental team.

The newsletter investigates diagnostic and treatment challenges related to tooth fractures primarily in the long axis of the crown and/or root. This includes determining the extent of longitudinal fractures, when a coronal restoration should be placed, when root canal treatment is needed, and when a tooth or root should be extracted based on the location and extent of the fracture.

The term 'longitudinal fracture' is used because it typically represents vertical extensions of fractures over distance and time. These linear fractures tend to grow and change as opposed to those resulting from impact trauma, leading to problems with diagnosis and treatment.

<p>Cracks in teeth are findings that are to be detected in terms of location and extent.</p> Signup and view all the answers

<p>Having a sinus tract and a narrow, isolated periodontal probing defect in association with a tooth that has had root canal treatment, with or without a post placement.</p> Signup and view all the answers

<p>Removal of the fractured root or extraction of the tooth.</p> Signup and view all the answers

<ol> <li>Avoid excessive removal of intraradicular dentin; and 2. Minimize internal wedging forces. Compaction/condensation of root canal filling materials should be carefully controlled. Posts weaken roots and should not be used unless they are necessary to retain a foundation.</li> </ol> Signup and view all the answers

<p>Rarely visualized so evidently on the radiograph, showing a tooth that has been root-filled with post placement, separation of the distal root into segments, and a large radiolucency involving the apex, mid-root and furcation of the distal root.</p> Signup and view all the answers

<p>A. Classification of Longitudinal Tooth Fractures Table B. Clinical Determination of Cracks and Fractures Based on Location and Separable Segments (Including Treatment) Chart C. The Obvious and the Obscure: Steps for Crack Detection and Confirmation D. Transillumination: The “Light Detector” E. More Information on Post Placement in Endodontically Treated Teeth With Longitudinal Tooth Fractures F. Reference List G. A detailed, unabridged version of this newsletter H. “Ask the Authors” Discussion Board for all of your questions and comments.</p> Signup and view all the answers

<p>20%</p> Signup and view all the answers

<p>Extraction</p> Signup and view all the answers

<p>A complete fracture initiated from the crown extending subgingivally</p> Signup and view all the answers

<p>A complete or incomplete fracture initiated from the root at any level</p> Signup and view all the answers

<p>More variable</p> Signup and view all the answers

<p>Cuspal-reinforced restoration or extraction</p> Signup and view all the answers

<p>Minimal signs and symptoms</p> Signup and view all the answers

<p>Almost exclusively extraction or removal of the cracked or fractured root</p> Signup and view all the answers

<p>Root canal treatment</p> Signup and view all the answers

<p>Periodontal disease or failed root canal treatment</p> Signup and view all the answers

<p>Visible separation of segments</p> Signup and view all the answers

<p>To a periodontist or endodontist</p> Signup and view all the answers

<p>The diagnostic clues for cracked tooth treatment plan include the location and extent of the crack, which can be difficult to determine.</p> Signup and view all the answers

<p>Root canal treatment is dependent on pulpal and periapical diagnosis, not just crack detection.</p> Signup and view all the answers

<p>Removal of the fracture line on the cavity floor can help determine the apical extent of the crack and whether the pulp is involved.</p> Signup and view all the answers

<p>Removal of the fracture line on the proximal external surface portion of the tooth below the cement-enamel junction is not usually indicated.</p> Signup and view all the answers

<p>Patients should be fully informed that the prognosis for cracked teeth is questionable and may evolve into split teeth and require extraction.</p> Signup and view all the answers

<p>The long-term prognosis for a cracked tooth is better when no crack is visible or the crack does not extend to the chamber floor and the tooth is pain-free.</p> Signup and view all the answers

<p>Placement of a cuspal-reinforced restoration does not guarantee success, but is beneficial in most cases.</p> Signup and view all the answers

<p>A study in 2006 evaluated a small number of root-filled cracked teeth with irreversible pulpitis and determined a two-year survival rate of 85.5 percent.</p> Signup and view all the answers

<p>Another study in 2007 evaluated 127 patients with teeth diagnosed with reversible pulpitis that had a cracked tooth.</p> Signup and view all the answers

<p>Studies outlining successful outcomes for cracked teeth have been limited and only for specific conditions.</p> Signup and view all the answers

<p>The potential problem with having a crack in a tooth is the potential for bacterial penetration, leading to inflammation and disease.</p> Signup and view all the answers

<p>The five types of longitudinal tooth fractures are: Craze Lines, Split Tooth, Fractured Cusp, Vertical Root Fracture, and Cracked Tooth.</p> Signup and view all the answers

<p>Steps for crack detection and confirmation include dental history, periodontal probing, radiographic examination, restoration removal, tactile examination, staining, periapical tests, transillumination, bite tests, wedging forces, vitality testing, and surgical assessment.</p> Signup and view all the answers

<p>Craze lines affect only the enamel.</p> Signup and view all the answers

<p>Understanding the epidemiology, prognosis, and treatment modalities of each longitudinal fracture classification is essential to save teeth with cracks.</p> Signup and view all the answers

<p>Identifying and classifying cracks, characteristic signs and symptoms, and early detection are crucial for saving teeth with cracks.</p> Signup and view all the answers

<p>Fractures in teeth, once extended to and exposed the pulp, can lead to severe pulp and/or periapical pathosis.</p> Signup and view all the answers

<p>Fractured cusp is defined as a complete or incomplete fracture initiated from the crown of the tooth and extending subgingivally, usually involving at least two aspects of the cusp and extending to the cervical third of the crown or root.</p> Signup and view all the answers

<p>Craze lines are commonly mistaken for cracks but can be differentiated by transillumination.</p> Signup and view all the answers

<p>Lack of knowledge about the types of fractures may lead to incorrect diagnosis and inappropriate treatment.</p> Signup and view all the answers

<p>Other diagnostic tests are necessary for a diagnosis when the presence of a crack in a tooth does not provide information on the status of the pulp or periapical tissues.</p> Signup and view all the answers

<p>Identifying and classifying cracks, characteristic signs and symptoms, and early detection are crucial for saving teeth with cracks.</p> Signup and view all the answers