Description

A condition known as Cracked Tooth Syndrome (CTS) occurs when a tooth has cracked but not broken completely. It is sometimes referred to as a greenstick fracture. Because the symptoms can vary widely, it is notoriously difficult to diagnose. Broken tooth disorder could be viewed as a sort of dental injury and furthermore one of the potential reasons for dental torment. 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," is one definition of cracked tooth syndrome.

Periodontal Ligament

Common symptoms of CTS include pain when releasing pressure from a bite. This is due to the fact that when you bite down, the segments typically move apart, lowering the pressure on the nerves in the tooth's dentin. When the bite is released, the "segments" abruptly snap back together, putting more pressure on the nerves in the intradentin, which causes pain. The pain is frequently inconsistent and difficult to replicate. It has been reported that biting-related pain is more likely to occur than pressure release after biting. CTS can result in severe pain, abscess, possible pulpal death, and even tooth loss if left untreated. A complete fracture, also known as pulpitis and pulp death, occurs when the fracture extends into the pulp. On the off chance that the break spreads further into the root, a periodontal deformity might create, or even an upward root crack. One theory asserts that the two fractured sections of the tooth moving independently triggers the sudden movement of fluid within the dentinal tubules, which in turn activates A-type nociceptors in the dentin-pulp complex and causes pain to be felt by the pulp-dentin complex. Another possibility is that the pulp is irritated by noxious substances that leak through the crack and cause pain when exposed to cold stimuli.

Cracked Tooth Syndrome (CTS) was first defined by Cameron in 1964 as "an incomplete fracture of a vital posterior tooth that involves the dentine and occasionally extends to the pulp." More recently, it has been expanded to include "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." The diagnosis of cracked tooth syndrome is notoriously difficult, even for experienced clinicians. The features are highly the prompt diagnosis of cracked teeth is necessary for effective treatment and a favorable prognosis. A thorough history may reveal sharp pain when consuming cold food and drink or pain when releasing pressure while eating. Patients are more likely to develop CTS if they engage in a number of risky behaviors, such as chewing on hard candy, pens, and ice. Along with a history of extensive dental treatment, recurrent occlusal adjustment of restorations due to discomfort may also be indicative of CTS. The various methods for diagnosing CTS are discussed below.

During a clinical exam, cracks can be hard to see, which may make it harder to make a diagnosis. Wear faceting, which may indicate excessive forces from clenching or grinding, or the presence of an isolated deep periodontal pocket, which may represent a broken tooth, are two other clinical signs that may lead to the diagnosis of CTS. Because removing a restoration may be of little diagnostic benefit, it should only be done after obtaining the patient's informed consent because it may help to visualize fracture lines. Additionally, a sharp probe-based tactile examination may aid in diagnosis.

Lip Wounds and Lacerations

Transillumination works best when a fiber optic light source is placed directly on the tooth, and magnification can help get the best results. Dentine cracks block the transmission of light. Transillumination, on the other hand, has the potential to make color changes and cracks appear larger. Cracks can't be seen very well on radiographs. This is because cracks spread in a direction that is parallel to the film's plane (mesiodistal), but radiographs can be useful for checking the pulpal and periodontal health. When performing a bite test, a variety of instruments can be used to identify signs and symptoms of cracked tooth syndrome. The patients bite down, then suddenly let go of the pressure. When pressure is released, pain confirms a CTS diagnosis. By biting on each cusp individually, you can figure out which cusp is involved. Mandibular molars are the teeth most frequently affected, followed by maxillary premolars, molars and premolars. According to a recent audit, the mandibular first molar is thought to be most affected by CTS because the opposing pointy, protruding maxillary mesio-palatal cusp binds to the central fissure of the mandibular molar. Following the cementation of porcelain inlays, signs of cracking have also been observed, according to studies; unnoticed tooth cracks may be to blame for intracoronal restoration debonding, according to some theories. There is no one-size-fits-all approach to treatment, but in general, the goal is to stop the crack from spreading by preventing the segments of the affected tooth from moving or flexing independently while biting and grinding (stabilization of the crack). Provisionally, a band can be put around the tooth or a direct composite splint can be put in supra-occlusion to minimize flexing. Dental trauma frequently brings about injuries to the soft tissues. The lips, buccal mucosa, gingivae, frenum and tongue are typically affected. The lips and gingivae are the most common injuries. Through careful examination, it is essential to rule out the presence of foreign objects in lip wounds and lacerations. Any potential foreign objects can be identified by taking a radiograph.

Small gingivae wounds typically heal on their own and do not necessitate treatment. However, this might be one of the symptoms of an alveolar fracture in the clinic. Bleeding from the gingivae, particularly around the margins, may indicate that the tooth's periodontal ligament has been damaged. Primary teeth are most frequently injured between the ages of two and three, during the development of motor coordination. When primary teeth are injured, the treatment should avoid damaging the permanent successors because the injured primary tooth's root apex is close to the adult tooth germ.