PART III: Definitions, Classification, Etiology and Initiation Mechanism of Tooth Structure Cracks
Marwan Abou-Rass, DDS, MDS, Ph.D
Expiration Date: August 31, 2020
Clinical management of cracked teeth in dental practice is an area replete with misunderstanding and misinformation. First, the literature lacks prospective studies and clinically useful universal definitions. Second, although cracked teeth problems vary significantly in diagnosis, treatment and prognosis. The literature terminology does not specifically differentiate between “Fractured teeth”, “Cracked teeth”, “Cracked Tooth Syndrome”, “Green stick fractures” and “Incomplete coronal fractures”.
The author’s 3x3 Tooth Structure Cracks (TSC) classification, grouped the various terminologies which relate to the cracked or fractured teeth problems, under one term “Tooth Cracks”. Then defined and classified the “cracks” according to their anatomic, physical and pathologic characteristics.
Physically, “Tooth Cracks” are classified into:
Anatomically, “Tooth Cracks” are classified into:
Pathologically, “Tooth Cracks “are classified into:
The webinar presentation shows how to differentiate between the harmless “noncontributory crack” and the harmful “contributory crack”.
Contributory cracks cause reversible and irreversible pulpitis, pulp calcification, pulp necrosis, periapical and periradicular lesions. On the other hand, noncontributory cracks could be microscopically visible microcracks or clinically visible line. These cracks remain at the early initiation or development stages for years. They remain still and stationery, cause no pulpal or periodontal pathology as long as they are not pressured, and stressed by new forces or loads. Forces such as root filling condensation or traumatic fitting of a post.
Updated information about the etiology and initiation mechanism of tooth cracks is presented focusing on:
Abusive restorative procedures that cause coronal cracks
Abusive mechanical endodontic procedures that cause radicular cracks
Abusive post placement procedures
Dental occlusion factors