The symptoms of a cracked tooth can be very similar to those of a cavity, but the absence of the tooth decay of cavities is itself one of those symptoms. Along with a painful sensation while chewing and a newly acquired sensitivity, changes in the feeling of the teeth are one of the biggest indicators that there is something wrong. Individuals who experience these symptoms, especially while eating hot, cold, or sticky foods, should visit their dentist.
Cracks in the teeth sometimes can't be seen by the naked eye. Some hairline cracks are not even visible on x-rays, so relying on symptoms for a diagnosis can be one of the only ways to determine if a tooth has been cracked. Often, the symptoms of a cracked tooth are not present all the time, as symptoms of gum disease or impacted teeth are. Abscesses or cavities often bring with them an ache that is constant, while a cracked tooth is typically only painful in certain situations. This includes eating extremely cold or hot foods, chewing in a certain area of the mouth, or chewing sticky foods.
Although craze lines are technically cracks in your teeth, it’s not what we mean when we describe a “cracked tooth.” Instead, a cracked tooth penetrates through the enamel into the dentin or even into the tooth nerve. These can be dangerous, because they allow bacteria to penetrate into the tooth, causing decay or infection. They also structurally weaken the tooth, which can cause it to break in half. Craze Lines: Vertical Lines in Our Teeth. These vertical lines in her front teeth are actually known as craze lines. Over years of use, our teeth tend to develop tiny cracks in the hard outer layer known as enamel. These cracks normally don’t cause any pain, but can easily stain, causing embarrassing discolored lines on your front teeth.
Cracked Tooth. Cracks on teeth are usually quite small. There are two types of cracks. One where the tooth actually is cracked which usually will be very painful, and the other which is an enamel line fracture, which might look like a crack but it doesn't hurt and is only on.
Cracked tooth syndrome (CTS)[2] is where a tooth has incompletely cracked but no part of the tooth has yet broken off. Sometimes it is described as a greenstick fracture.[1] The symptoms are very variable, making it a notoriously difficult condition to diagnose.
Classification and definition[edit]
Cracked tooth syndrome could be considered a type of dental trauma and also one of the possible causes of dental pain. One definition of cracked tooth syndrome is 'a fracture plane of unknown depth and direction passing through tooth structure that, if not already involving, may progress to communicate with the pulp and/or periodontal ligament.'[1]
Signs and symptoms[edit]
Tooth crack in the upper first molar tooth in a patient who suffers from bruxism.
The reported symptoms are very variable,[2] and frequently have been present for many months before the condition is diagnosed.[1] Reported symptoms may include some of the following:
If the crack propagates into the pulp, irreversible pulpitis, pulpal necrosis and periapical periodontitis may develop, with the respective associated symptoms.[1]
Pathophysiology[edit]Hairline Crack In Tooth Causing Pain
CTS is typically characterized by pain when releasing biting pressure on an object. This is because when biting down the segments are usually moving apart and thereby reducing the pressure in the nerves in the dentin of the tooth. When the bite is released the 'segments' snap back together sharply increasing the pressure in the intradentin nerves causing pain. The pain is often inconsistent, and frequently hard to reproduce. If untreated, CTS can lead to severe pain, possible pulpal death, abscess, and even the loss of the tooth.
If the fracture propagates into the pulp, this is termed a complete fracture, and pulpitis and pulp death may occur.If the crack propagates further into the root, a periodontal defect may develop, or even a vertical root fracture.[1]
According to one theory, the pain on biting is caused by the 2 fractured sections of the tooth moving independently of each other, triggering sudden movement of fluid within the dentinal tubules.[1] This activates A-type nociceptors in the dentin-pulp complex, reported by the pulp-dentin complex as pain. Another theory is that the pain upon cold stimuli results from leak of noxious substances via the crack, irritating the pulp.[1]
Diagnosis[edit]
Cracked tooth syndrome (CTS) was defined as 'an incomplete fracture of a vital posterior tooth that involves the dentine and occasionally extends to the pulp' by Cameron in 1964 and more recently has included 'a fracture plane of unknown depth and direction passing through tooth structure that, if not already involving, may progress to communicate with the pulp and/or periodontal ligament'.[3] The diagnosis of cracked tooth syndrome is notoriously difficult even for experienced clinicians.[2] The features are highly variable and may mimic sinusitis, temporomandibular disorders, headaches, ear pain, or atypical facial pain/atypical odontalgia (persistent idiopathic facial pain).[2] When diagnosing cracked tooth syndrome, a dentist takes many factors into consideration. Effective management and good prognosis of cracked teeth is linked to prompt diagnosis. A detailed history may reveal pain on release of pressure when eating or sharp pain when consuming cold food and drink. There are a variety of habits which predispose patients to CTS including chewing ice, pens and hard sweets etc. Recurrent occlusal adjustment of restorations due to discomfort may also be indicative of CTS, alongside a history of extensive dental treatment. Below different techniques used for diagnosing CTS are discussed.
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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 wear faceting indicating excessive forces perhaps from clenching or grinding or the presence of an isolated deep periodontal pocket which may symbolise a split tooth. Removing restorations may help to visualise fracture lines but should only be carried out after gaining informed consent from the patient, as removing a restoration may prove to be of little diagnostic benefit. Tactile examination with a sharp probe may also aid diagnosis.
Gentian Violet or Methylene Blue Stains
Dyes may be used to aid visualisation of fractures. The technique requires 2–5 days to be effective and a temporary restoration may be required. The structural integrity can be weakened by this method, leading to crack propagation.
Transillumination
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. However, transillumination may cause cracks to appear enlarged as well as causing colour changes to become invisible.
Radiographs
Radiographs offer little benefit in visualising cracks. This is due to the fact that cracks propagate in a direction which is parallel to the plane of the film (Mesiodistal) however radiographs can be useful when examining the periodontal and pulpal status.
Bite Test
Different tools can be used when carrying out a bite test which produce symptoms associated with cracked tooth syndrome. Patients bite down followed by sudden release of pressure. CTS diagnosis is confirmed by pain on release of pressure. The involved cusp can be determined by biting on individual cusps separately. Tooth Slooth II (Professional Results Inc., Laguna Niguel, CA, USA) and Fractfinder (Denbur, Oak Brook, IL, USA) are commercially available tools.
Epidemiology[edit]
[4] Aetiology of CTS is multifactorial, the causative factors include:
Most commonly involved teeth are mandibular molars followed by maxillary premolars, maxillary molars and maxillary premolars. in a recent audit, mandibular first molar thought to be most affected by CTS possibly due to the wedging effect of opposing pointy, protruding maxillary mesio-palatal cusp onto the mandibular molar central fissure. Studies have also found signs of cracked teeth following the cementation of porcelain inlays; it is suggested that the debonding of intracoronal restorations may be caused by unrecognized cracks in the tooth.[5]
Treatments[edit]
There is no universally accepted treatment strategy, but, generally, treatments aim to prevent movement of the segments of the involved tooth so they do not move or flex independently during biting and grinding and so the crack is not propagated.[6]
History[edit]
The term 'cuspal fracture odontalgia' was suggested in 1954 by Gibbs.[1] Subsequently, the term 'cracked tooth syndrome' was coined in 1964 by Cameron,[2] who defined the condition as 'an incomplete fracture of a vital posterior tooth that involves the dentin and occasionally extends into the pulp.'[1] Descargar router keygen.
References[edit]
External links[edit]
Retrieved from 'https://en.wikipedia.org/w/index.php?title=Cracked_tooth_syndrome&oldid=918339360'
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