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Crack Assessment - Technique - Courtesy ROOTS

The opinions and photographs within this web page are not ours. Authors have been
credited for the individual posts where they are - www.rxroots.com
From: Terry Pannkuk
To: ROOTS
Sent: Friday, July 29, 2011 1:30 AM
Subject: [roots] Crack Assessment - Technique

I thought I would follow-up on the thread regarding the prognosis of 
cracked teeth with this tooth I explored this morning.  Same patient 
with the failing Thermafilth  (Maxillary 3rd Molar). Interestingly 
the patient asked what the rubber dam was when I started to put it on 
(she had never had one before).

The pulp chamber was extremely calcified and to properly explore the 
extent of the fracture I had to dissect away all the irritational 
dentin, open the orifices of the canals, achieve direct line access, 
and smooth all the walls and floors, then clear with EDTA.  The crack 
extended a few millimeters into the DB orifice and into the ML groove
off the MB.  It wasnít worth it to explore any further at this point 
because the CBCT saggital plane shows incipient furcation bone loss 
with a distal vertical perio defect.  These areas are not going to 
heal and only get worse with an associated crack.

Hereís the key CBCT section showing the bone loss which corresponds to 
the observed crack.  In my opinion thatís enough information to condemn 
the tooth- Terry

crack assessment technique

crack assessment technique

Protaper flaring

6 yr old Empress

Cvek pulpotomy

Middle mesial

Endo misdiagnosis

MTA retrofill

Resin core

BW importance

Bicuspid tooth

Necrotic #8 treatment

Finding MB2 / MB3

Deep in a canal

Broken file retrieval

Molar cases

Pushed over apex

MB2 and palatal canal

Long lower third

Veneer cases

CT Implant surgury

Weird Anatomy

Apical trifurcation

Canal and Ultrasonics

Cotton stuffed chamber

Pulp floor sandblasting

Silver point removal

Difficult acute curve

Marked swelling

5 canaled premolar

Sealer overextension

Complex anatomy

Secondary caries

Zygomatic arch

Confluent mesials

LL 1st molar (#19)

Shaping vs Cleaning

First bicuspid

In Vivo mesial view

Inaccesible canals

Premolar 45

Ortho and implant

Radioluscency

Lateral incisor

Obturation

Churning irrigant

Cold lateral

Tipped to lingual

Acute pulpitis images

Middle distal canal

Silver point

Crown preparation

Epiphany healing

Weird anatomy

Dual Xenon

Looking for MB2

Upper molar resorption

Acute apical abcess

Finding MB2

Gingival inflammation

Irreversible pulpitis

AG BU ortho band

TF Files

using TF files

Broken bur

Warm technique

Restorative prognosis

Tooth # 20 and #30

Apical third

3 canal premolar

Severe curvature

Interesting anatomy

Chamber floor

Zirconia crown

Dycal matrix

Cracked tooth

Tooth structure loss

Multiplanar curves