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Precision Endodontics

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Cracked Teeth

Cracked Teeth demonstrate symptoms, including pain on chewing and temperature sensitivities. It is common for the pain to come and go, making it difficult to diagnose and identify the cause of the discomfort. Biting down on the tooth can cause the shifting of the crack, irritating the pulp within the tooth. At the same time, releasing the bite can cause the crack to close, resulting in additional pulpal irritation and sharp pain. Eventually, the pulp will become irreversibly damaged and the tooth will hurt continuously without provocation. Eventually cracks to lead to the infection of the pulp tissue, which can result in bone loss and swelling.

Types of Cracks

Craze Lines


These are small cracks that are superficially found in the enamel layer of the tooth. These cracks are common in adults. They typically do not require treatment.

Fractured Cusp

When a cusp is undermined it may result in a portion of the tooth breaking off. The broken segment may be be removed by your general dentist. A fractured cusp can damage the pulp in which case root canal therapy may be necessary.  After treatment you general dentist will usually restore the tooth with a full coverage restoration.

Cracked Tooth

This type of crack extends from the chewing surface of the tooth and vertically migrates towards the root. In some cases, the crack may extend below the gum line. It is possible for the crack to extend further into the root. Damage to the pulp is common and usually necessitates root canal treatment. A cracked tooth that is not treated will worsen, resulting in the loss of the tooth, therefore, early detection is essential.

Split Tooth

A split tooth is usually the result of an untreated cracked tooth. It can be identified by a crack with distinct segments. This type of tooth can never be saved intact, however, the position and extent of the problem will dictate whether any portion of the tooth can be saved. Sometimes, endodontic retreatment and then restoration by your dentist can save a portion of the tooth.

Vertical Root Fracture

This type of crack usually extends from the chewing surface of the tooth towards the root/roots. In some cases, the crack may extend below the gingiva and possibly onto the root. Damage to the pulp is common and usually necessitates root canal therapy. A cracked tooth that is not treated in time may result in the loss of the tooth, therefore, early detection is essential.

Traumatic injuries

Intrusion


Trauma to the mouth can cause teeth to be pushed back into their sockets. The doctor may reposition and stabilize your tooth. Root canal therapy is usually initiated after the tooth has had a chance to heal.

Lateral luxation

Sometimes a tooth may be pushed partially out of the socket. Again, the doctor or your general dentist may reposition and stabilize your tooth. If the pulp remains healthy, then no other treatment is necessary. If the pulp tissue does not heal and becomes irreversibly damaged or infected, root canal therapy will be required.

Avulsed Teeth


If an injury causes a tooth to be completely knocked out of your mouth, it is critical that you are treated immediately. Until professional care can be obtained care must be taken to avoid drying out the avulsed tooth.  To avoid the desiccation of the tooth it may be placed in milk or a glass of water (add a pinch of salt).  If possible, the tooth can also be put it back into the socket. After examination the doctor may recommend the initiation of root canal therapy based upon the stage of root development, the length of time the tooth was out of your mouth and the way the tooth was stored.

Pulpal Injuries In Children

An injured immature tooth may need one of the following procedures to improve the chances of saving the tooth:

Apexogenesis


This procedure encourages the tooth to continue development as we allow for root growth by maintaining healthy pulp tissue.  After the removal of the injured pulp tissue the remaining healthy tissue is covered with a biocompatible filling to   encourage growth. It is anticipated that the root (apex) will continue to grow and eventually mature as the child gets older.  If the pulp remains healthy, no additional treatment will be necessary.

Apexification


In this procedure, infected and unhealthy pulp is first removed. After the initial cleaning a medication is placed into the root to help a hard tissue formation at the end of the root. This hardened tissue provides a barrier to fill against for the root canal filling.