Cracked Tooth Syndrom
Cracked Tooth Syndrom
Cracked Tooth Syndrom
Sharp pain when biting on a certain tooth, which may get worse if the
applied biting force is increased. Sometimes the pain on biting occurs
when the food being chewed is soft with harder elements, e.g.
seeded bread.
"Rebound pain" i.e. sharp, fleeting pain occurring when the biting
force is released from the tooth,
Sharp pain when drinking cold beverages or eating cold foods, lack
of pain with heat stimuli.
Signs and symptoms
Clinical examination:
Cracks are difficult to see during a clinical exam which may limit diagnosis.
However other , clinical signs which may lead to the diagnosis of CTS includes:
1. Wear faceting indicating excessive forces perhaps from clenching or grinding .
2. Presence of an isolated deep periodontal pocket which may symbolize a split
tooth.
3. Removing restorations may help to visualize fracture lines but should only be
carried out after gaining informed consent from the patient.
4. Tactile examination with a sharp probe may also aid diagnosis.
Techniques used for diagnosing CTS
Transillumination
Transillumination of tooth , showing vertical fracture
(blue arrows) and inflammation in marginal gingiva at
fracture site (green arrow)
Transillumination is best performed by placing a fibre
optic light source directly onto the tooth and optimal
results can be achieved with the aid of magnification.
Cracks involving dentine interrupt the light
transmission.
Techniques used for diagnosing CTS
Radiographs
Radiographs offer little benefit in visualizing
cracks( This is due to the fact that cracks
propagate in a direction which is parallel to the
plane of the film) (Mesio-distal)
Techniques used for diagnosing CTS
Bite Test
o Patients bite down followed by sudden
release of pressure.
o CTS diagnosis is confirmed by pain on
release of pressure.
o The involved cusp can be determined
by biting on individual cusps separately.
Tooth Slooth II
Techniques used for diagnosing CTS
Microscopic Detection
Experienced clinicians using a clinical
microscope have reached a general
consensus that ×16 provides an ideal
magnification level for the evaluation
of enamel cracks, with a range from .
Epidemiology