DENTINAL CRACKS The Thin Line Between Strength and Failure

The American Association of Endodontists has classified five specific variations of cracked teeth; craze line, fractured cusp, cracked tooth, split tooth, and vertical root fracture. Furthermore, the character, duration of pain have important implications for both diagnosis and treatment. Diagnostically, it is important to differentiate the differences between dentin, pulpal and periodontal pain before treatment is commenced. Therefore, developing a diagnosis, prognosis assessment and treatment plan for teeth with suspected cracks and fractures is essential, with an emphasis on early detection. Because of the wide variety of different types of cracks and fractures in teeth, there may be a myriad of symptoms and presentations that may appear at different stages of the crack or fracture development, making their diagnosis often difficult. The term "cracked tooth syndrome" is misleading as range of symptoms that do not form a distinct and reliable pattern. Symptoms will vary with teeth that have healthy pulps, inflamed or necrotic pulps, and have been root filled. Early diagnosis is most important in the treatment of cracked teeth to limit the propogation of the crack.