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 wasn’t 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.

Here’s the key CBCT section showing the bone loss which corresponds to the observed crack.  In my opinion that’s
enough information to condemn the tooth- Terry