Longitudinal Tooth Fractures Quiz

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Questions and Answers

What is the goal of the newsletter 'Cracking the Cracked Tooth Code'?

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

What are the diagnostic and treatment challenges related to tooth fractures primarily discussed in the newsletter?

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.

Why is the term 'longitudinal fracture' used in the context of tooth fractures?

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.

What are the findings that need to be detected in terms of location and extent according to the text?

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

What is considered pathonomonic for the presence of a vertical root fracture (VRF)?

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. Signup and view all the answers

What is the only predictable treatment for a vertical root fracture?

Removal of the fractured root or extraction of the tooth. Signup and view all the answers

What are the cardinal rules for preventing vertical root fractures?

<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

What is the classic appearance of a vertical root fracture?

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. Signup and view all the answers

What are the exclusive bonus materials available in the ENDODONTICS: Colleagues for Excellence newsletter?

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. Signup and view all the answers

What percentage of cases with crown restoration without root canal treatment required root canal treatment within six months?

20% Signup and view all the answers

What is the recommended treatment for split teeth?

Extraction Signup and view all the answers

What is a split tooth?

A complete fracture initiated from the crown extending subgingivally Signup and view all the answers

What is a true vertical root fracture?

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

What is the prognosis for cracked teeth compared to other longitudinal fractures?

More variable Signup and view all the answers

What is the treatment for extensively cracked teeth?

Cuspal-reinforced restoration or extraction Signup and view all the answers

What are the typical signs and symptoms of patients with vertical root fractures?

Minimal signs and symptoms Signup and view all the answers

What is the recommended treatment for vertical root fractures?

Almost exclusively extraction or removal of the cracked or fractured root Signup and view all the answers

What do virtually all vertical root fractures have a history of?

Root canal treatment Signup and view all the answers

What may vertical root fractures mimic?

Periodontal disease or failed root canal treatment Signup and view all the answers

What is rare in radiographic evidence for vertical root fractures?

Visible separation of segments Signup and view all the answers

Where are cases of vertical root fractures often referred for evaluation?

To a periodontist or endodontist Signup and view all the answers

Describe the diagnostic clues for cracked tooth treatment plan.

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

What is the dependence of root canal treatment in cracked tooth cases?

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

What can help determine the apical extent of the crack and whether the pulp is involved?

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

What is not usually indicated when dealing with the proximal external surface portion of the tooth below the cement-enamel junction?

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

What should patients be informed about regarding the prognosis for cracked teeth?

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

When is the long-term prognosis for a cracked tooth better?

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. Signup and view all the answers

What is the role of cuspal-reinforced restoration in cracked tooth cases?

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

What was the two-year survival rate of root-filled cracked teeth with irreversible pulpitis as determined by a study in 2006?

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. Signup and view all the answers

How many patients were evaluated in the study from 2007 that focused on teeth diagnosed with reversible pulpitis that had a cracked tooth?

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

What is the status of studies outlining successful outcomes for cracked teeth?

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

Explain the potential problem associated with having a crack in a tooth.

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

What are the five types of longitudinal tooth fractures mentioned in the text?

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

What are the steps for crack detection and confirmation mentioned in the text?

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. Signup and view all the answers

What type of longitudinal tooth fracture affects only the enamel?

Craze lines affect only the enamel. Signup and view all the answers

Why is understanding the epidemiology, prognosis, and treatment modalities of each longitudinal fracture classification essential?

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

What are the characteristic signs and symptoms, and early detection mentioned as crucial for saving teeth with cracks?

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

What can happen once fractures in teeth extend to and expose the pulp?

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

What is the definition of a fractured cusp?

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. Signup and view all the answers

How are craze lines commonly mistaken for cracks but can be differentiated?

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

What is the impact of lack of knowledge about the types of fractures?

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

What is 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?

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. Signup and view all the answers

What is crucial for saving teeth with cracks?

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

Flashcards

'Cracking the Cracked Tooth Code' Goal

A newsletter aiding general practitioners in diagnosing and treatment planning for tooth fractures, promoting better communication within dental teams.

Detecting Cracks

Cracks in teeth are critical to identify in terms of both their precise location within the tooth structure and how far they extend.

Pathognomonic Sign of VRF

A sinus tract with a narrow, isolated periodontal pocket around a root canal treated tooth suggests a vertical root fracture (VRF).