Endodontic Management of Tooth Fractures Tooth fractures are a common dental issue that range from minor cracks to severe breaks. Proper management is crucial to preserve the tooth's function and prevent complications. Endodontic treatment addresses deep fractures that affect the pulp or root of the tooth.Types of Tooth FracturesTooth fractures can be classified into several categories based on their location and severity: Craze LinesThese are superficial cracks in the enamel that do not pose a threat to the tooth's health and typically require no treatment. Fractured CuspA portion of the chewing surface breaks off, and often spares the pulp. This is typically managed with restorative procedures. Cracked ToothThe crack extends from the crown toward the root, and may expose the pulp. Fast intervention is necessary to save the tooth. Split ToothA split tooth involves a severe fracture that divides the tooth into two segments. Treatment requires extraction or advanced restorative techniques. Vertical Root FractureA vertical root fracture is where there is a crack starting in the root of the tooth and progressing upward that may require extraction. When Is Endodontic Treatment Needed?Endodontic treatment is commonly known as root canal therapy, and it is required when a fracture compromises the pulp of the tooth. Pulp is the soft tissue beneath the enamel and dentin that contains nerves and blood vessels. Symptoms such as persistent pain, sensitivity to hot or cold, or swelling may indicate pulp exposure. When left untreated, bacterial infiltration can lead to infection, abscess formation, or tooth loss. Steps in Endodontic ManagementThere are two steps to endodontic management for tooth fractures. Afterward, a restoration is placed: Diagnosis and AssessmentAccurate diagnosis is critical to manage a fracture effectively. We use clinical examinations, radiographs, and advanced imaging such as cone beam computed tomography (CBCT) to evaluate the extent of the fracture, and identify whether the pulp is inflamed or infected. This information guides treatment decisions. Root Canal TherapyIf the pulp is damaged, root canal therapy is performed to remove the infected tissue, clean and shape the root canals, and seal them to prevent reinfection. This procedure eliminates infection, alleviates pain, and preserves the natural tooth structure. Restorative MeasuresAfter endodontic treatment, restorative procedures are essential to reinforce the weakened tooth. Options include: Bonding or SealingFor minor fractures, adhesive resins can seal the crack and prevent further propagation. Crown PlacementA full coverage crown protects the treated tooth from bite forces, and further damage. BandingIn some cases, banding around the tooth provides additional stability during healing. Challenges in Managing Cracked TeethFractures can be difficult to detect and may worsen over time when not diagnosed and treated quickly. In addition, cracks that extend below the gumline or into the root pose significant challenges for long term oral health. In such cases, surgical interventions or extraction may be necessary. Preventing Tooth FracturesPreventive measures include wearing custom mouthguards during sports, treatment of teeth grinding, avoiding chewing hard objects such as ice, and maintaining regular dental checkups. Early detection of fractures allows us to intervene and get the best outcomes for our patients. |
