Therapeutic strategy for cracked teeth. 2022

William Pacquet, and Constance Delebarre, and Stephane Browet, and David Gerdolle

The management of cracked teeth represents a difficulty because their diagnosis is complex and there is no consensus concerning their treatment. The present article explains this pathology within enamel and dentin and also focuses on the clinical consequences of crack development in dental tissue. As cracks have both biologic and mechanical implications, a complete review of the literature on the subject has enabled the development of a comprehensive diagnostic approach to identify cracked teeth and optimize their management. The elements of diagnosis are the bite test, transillumination, the pulp sensitivity test, the periodontal test, radiologic examinations, removal of existing restorations, and the use of quantitative light-induced fluorescence. Finally, the management of biologic and mechanical imperatives relating to the treatment of cracked teeth has allowed the proposal of a reliable and reproducible therapeutic strategy based on two pillars: the arrest of bacterial infiltration using immediate dentin sealing, and the limitation of crack propagation using relative cuspal coverage. In this article, the proposed clinical protocol is explained through the use of a decision map and is illustrated by a clinical case example.

UI MeSH Term Description Entries
D003387 Cracked Tooth Syndrome Incomplete fracture of any part of a tooth, characterized by pain during mastication and sensitivity to heat, cold, sweet or sour tastes, and alcohol; it is often undiagnosed because the tooth is usually X-ray negative and normal to pulp vitality tests. Cracked Tooth Syndromes,Syndrome, Cracked Tooth,Syndromes, Cracked Tooth
D003743 Dental Enamel A hard thin translucent layer of calcified substance which envelops and protects the dentin of the crown of the tooth. It is the hardest substance in the body and is almost entirely composed of calcium salts. Under the microscope, it is composed of thin rods (enamel prisms) held together by cementing substance, and surrounded by an enamel sheath. (From Jablonski, Dictionary of Dentistry, 1992, p286) Enamel,Enamel Cuticle,Dental Enamels,Enamel, Dental,Enamels, Dental,Cuticle, Enamel,Cuticles, Enamel,Enamel Cuticles,Enamels
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001688 Biological Products Complex pharmaceutical substances, preparations, or matter derived from organisms usually obtained by biological methods or assay. Biologic,Biologic Drug,Biologic Product,Biological,Biological Drug,Biological Medicine,Biological Product,Biologics,Biopharmaceutical,Natural Product,Natural Products,Biologic Drugs,Biologic Medicines,Biologic Pharmaceuticals,Biologic Products,Biological Drugs,Biological Medicines,Biologicals,Biopharmaceuticals,Products, Biological,Drug, Biologic,Drug, Biological,Drugs, Biologic,Drugs, Biological,Medicine, Biological,Medicines, Biologic,Medicines, Biological,Pharmaceuticals, Biologic,Product, Biologic,Product, Biological,Product, Natural
D014070 Tooth One of a set of bone-like structures in the mouth used for biting and chewing. Teeth

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