ENDODONTICS:ColleaguesforExcellence

Summer2008
BonusMaterialA

CLASSIFICATIONOFLONGITUDINALTOOTHFRACTURES

VERTICALROOT
CRAZELINE FRACTUREDCUSP CRACKEDTOOTH SPLITTOOTH FRACTURE

Location Enamelonly Crownandcervical Crownonlyorcrown Crownandroot; Rootonly

marginofroot torootextension extensionto
Commononmarginal (depthvaries) proximalsurfaces
ridges

Direction Occlusogingival Mesiodistaland Mesiodistal Mesiodistal Faciolingual

faciolingual

Origination Occlusalsurface Occlusalsurface Occlusalsurface Occlusalsurface Root(anylevel)

Etiologies Occlusalforces, Underminedcusp, Damaginghabits, Damaginghabits, Wedgingposts,

thermocycling damaginghabits weakenedtooth weakenedtooth obturationforces,
structure structure excessiveroot
dentinremoval

Symptoms Asymptomatic Sharppainwith Highlyvariable Painwithmastication Nonetoslight

masticationand
withcold

Signs None Noneofsignificance Variable Separablesegments, Variable

periodontalabscess

Identification Directvisualization, Visualize,remove Biting,remove Removerestoration Reflectflapand

transillumination restoration restoration transilluminate

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 CLASSIFICATIONOFLONGITUDINALTOOTHFRACTURES

VERTICALROOT
CRAZELINE FRACTUREDCUSP CRACKEDTOOTH SPLITTOOTH FRACTURE

DiagnosticTests None Visiblefracturesof Transillumination, Wedgesegments Reflectflapand

cusps,bitingtest, staining,wedge (separable) transilluminate
transillumination segments
(unseparable),
isolated/narrow
perioprobing,
bitingtest,
magnification

Treatment Notreatmentneeded, Removecuspand/or Rootcanaltreatment Variable,must Removetoothor

esthetic restore dependsonpulpal removeone fracturedroot;
andperiapical segment,restoreor considerfixed
diagnosis;restore extract and/orremovable
withfullcuspal bridge,orimplant
coverage

Prognosis Verygood Verygood Alwaysquestionable Hopeless(ifmaintain Hopelessfor

topoor intact) fracturedroot

Variable(ifremove
segment)

Prevention Noneneeded Placeconservative Eliminatedamaging Eliminatedamaging Minimizerootdentin

classIIrestorations; habits(icechewing, habits;coronal removal;avoid
coronalprotection etc.);coronal protection(onlay wedgingposts;
(onlayundermined protection(onlay cusps) reduce
cusps) underminedcusps) condensation
forces;useof
carbonfiberposts

Reprintedwithpermissionfrom:
Principlesandpracticeofendodontics,4thed.MTorabinejadandREWaltoneditors.Philadelphia,Pennsylvania:W.B.SaundersCompany,pp.108128.