Crack Assessment - Technique - Courtesy ROOTS
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From: Terry Pannkuk
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