A cracked tooth is a tooth damaged by a partial crown fracture which, if neglected, can extend to the deepest part of the tooth.
The diagnosis of the crack is not always simple, sometimes previous restorations, due to conservative therapies, can hide the severity of a cracked tooth.
What factors can promote tooth cracking
There are some factors that can increase the possibility of developing a tooth crack. Of all amalgam restorations that cover a large part of the tooth surface, mandibular molar restorations in particular are often associated with crown cracks.
To date, there is no standard procedure for the treatment of cracked teeth. Dentists choose the best therapy based on the individual patient and their clinical experience.
Treatment for the cracked tooth
In a recent study published in the Journal of Endodontics in February 2021, the results obtained on endodontically treated fractured teeth were evaluated.
3,680 patients undergoing endodontic therapy were included in the observation sample.
A follow-up of at least one year was foreseen for all patients included in the sample. In the patients included in the final analysis, fractures were evaluated and observed through the surgical microscope.
Tooth extraction was recommended in clinical cases in which the fracture extended to the pulp chamber. Visible cracks were found in 64 teeth at high magnification using an operating microscope.
The variables included in the cracked teeth analysis were:
- symptoms;
- clinical signs;
- imaging diagnostics;
- type of restoration.
The results of endodontic therapy on the cracked tooth
The data analysis showed that fractured teeth treated endodontically with definitive full-coverage restorations had a 2-year success rate of 93.6%.
However, the evaluation of the individual clinical case by the dentist remains fundamental. The dentist, using highly advanced tools, such as the operating microscope, can verify the severity of the fracture. A cracked tooth may undergo a conservative restoration, while a deep fracture may be irreparable and the dentist may opt for alternative therapies or ultimately for tooth extraction.
