Cracked Tooth Syndrome

Cracks can arise from functional and developmental factors, as well as dental causes. Inappropriate root canal treatment and improper restorative procedures are among the dental causes discussed for cracked tooth syndrome.

A crack may be incomplete or complete. It can take the form of a cusp fracture, extend into a tooth furcation, or become a root fracture; the fracture plane may continue to propagate.

Biomechanical factors can facilitate cracks in teeth. Functional status, developmental factors, prior root canal treatment and restorative procedures are all relevant causes considered in this condition.

Tiny crack lines and enamel craze lines can be inspected with magnification of six to eight times or more, or with a surgical operating microscope and focused illumination. The crack’s direction and whether it is complete are part of the diagnosis.

Management can include immediate care and direct or indirect restoration. A full-coverage crown may be considered when it can prevent further propagation of a fracture plane.

A crack can need immediate management, a direct restoration, an indirect restoration or a full-coverage crown. The crack’s location, direction and propagation therefore determine the level of treatment required.

As a fracture progresses, bacteria can enter dentin and reach the pulp, and symptoms can become irreversibly severe. This is the reason a crack is assessed rather than judged only by its surface line.

Prevention for cracked tooth syndrome addresses the factors that induce cracks and aims to stop a fracture plane from propagating. Where a crown is indicated, its role may be to prevent that progression.