Classification, Definition, and Pathophysiology
- Cracked tooth syndrome is a type of dental trauma characterised by a fracture plane passing through tooth structure.
- If left untreated, it can lead to irreversible pulpitis, pulpal necrosis, and periapical periodontitis.
- The pain is caused by the fractured sections of the tooth moving independently and activating A-type nociceptors in the dentin-pulp complex.
- Cold stimuli may also cause pain due to the leakage of noxious substances via the crack, irritating the pulp.
- If the fracture propagates further into the root, a periodontal defect or vertical root fracture may develop.
Signs and Symptoms
- Symptoms of cracked tooth syndrome include sharp pain when biting on a certain tooth, worsened by increased biting force or certain types of food.
- Rebound pain, pain when grinding the teeth, sensitivity to cold beverages or foods, and pain with sugary substances may also be present.
- Symptoms can be present for months before diagnosis.
Diagnosis and Epidemiology
- Diagnosing cracked tooth syndrome can be challenging, as symptoms can mimic other conditions.
- Diagnostic techniques include clinical examination, stains to visualize fractures, transillumination, radiographs, and bite tests.
- Cracked tooth syndrome has a multifactorial etiology and can be caused by previous restorative procedures, occlusal factors, trauma, and other factors.
- Mandibular molars are the most commonly affected teeth, followed by maxillary premolars and molars.
History and Definitions
- The term "cuspal fracture odontalgia" was suggested by Gibbs in 1954, and the term "cracked tooth syndrome" was coined by Cameron in 1964.
- Cracked tooth syndrome is defined as an incomplete fracture of a vital posterior tooth involving dentin and occasionally extending into the pulp.
- Accurate diagnosis is important for appropriate treatment and differentiation from other dental conditions.
Management and Treatment, Research and Publications
- Management options for cracked tooth syndrome include conservative approaches, restorative options, endodontic treatment, and extraction as a last resort.
- Individualised treatment plans should be based on the patient's condition and preferences.
- Prominent studies and articles on cracked tooth syndrome have been conducted by researchers like Banerji, Mehta, Millar, Mathew, Thangavel, and Das.
- Evidence-based dentistry plays a crucial role in understanding and managing cracked tooth syndrome.
- Dental journals contribute to disseminating knowledge on cracked tooth syndrome and advancements in diagnosis and treatment.
Cracked tooth syndrome (CTS) 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. The symptoms are very variable, making it a notoriously difficult condition to diagnose.
| Cracked tooth syndrome | |
|---|---|
| Other names | Cracked cusp syndrome, split tooth syndrome, incomplete fracture of posterior teeth |
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| Cross-section of a posterior tooth. | |
| Specialty | Dentistry |
