demeclocycline and Cracked-Tooth-Syndrome

The aims of this study were to assess symptoms and signs caused by cracks in teeth and to assess a conservative management protocol.. The symptoms and signs of 100 consecutive teeth that had reversible pulpitis associated with cracks were compared to findings from other reports. Teeth were managed with a conservative protocol which involved removal of cracks, caries and restorations, followed by placement of a sedative lining and interim restoration unless there were pulp exposures or insufficient tooth structure remaining. Teeth were monitored for pulp healing after three months and for up to five years.. Eighty teeth did not require endodontic treatment. One tooth had an uncertain pulp status at review appointments. Fifteen teeth required endodontic treatment at the initial appointment because of carious pulp exposures (4 teeth), cracks extending into the pulp (2), and posts required (9). Four other teeth required endodontic treatment later following conservative pulp treatment due to continued pulpitis under the temporary restoration (1), pulpitis after core restoration (2), and pulp necrosis diagnosed at the review (1).. Provided there is an accurate diagnosis of the pulp status and its cause, teeth with reversible pulpitis due to cracks can be treated conservatively without endodontic treatment in about 80 per cent of cases.

Topics: Adolescent; Adult; Aged; Clinical Protocols; Cracked Tooth Syndrome; Demeclocycline; Dental Restoration, Permanent; Drug Combinations; Female; Humans; Male; Middle Aged; Prospective Studies; Pulpitis; Root Canal Therapy; Toothache; Triamcinolone Acetonide; Young Adult; Zinc Oxide-Eugenol Cement

Teeth restored with intracoronal restorations that provide no protection of the cusps from occlusal loading may fracture completely or partially. An incomplete dentinal fracture of a vital posterior tooth may cause pain. This condition is commonly known as the "cracked tooth syndrome". Location of the dentinal crack is difficult and must be guided by a precise history, thermal pulp testing and inspection of the dentinal walls within the suspect tooth. The number, extent and direction of the fracture lines may be ascertained readily by using transillumination and magnification. This allows the clinician to distinguish between oblique and vertical cracks. Treatment of oblique incomplete fracture relies on desensitisation of the hypersensitive dentine followed by splinting of the tooth fragments. Treatment of vertical incomplete fracture requires pulpectomy and immediate splinting of the crown. Two case reports are presented.

Topics: Cracked Tooth Syndrome; Demeclocycline; Dental Cements; Dentin; Dentin Sensitivity; Drug Combinations; Female; Humans; Male; Middle Aged; Molar; Tooth Fractures; Triamcinolone Acetonide