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From: Terry Pannkuk
Sent: Monday, December 19, 2011 11:55 PM
Subject: [roots] Crack-Internal Resorption
I see some of these cracked teeth also associated with resorption.
In this case, there was a very small inconsequential pulp chamber
floor internal resorptive defect - Terry
Fantastic case! Amazing apical control. Did you see this crack
line traveling thru the floor? What do you
think about the prognosis? - Hongsheng
The crack was limited to the crown and didnít go anywhere near
the pulpal floor. It was basically to the level of the free
That isnít a core, jus solid Cavit. The referring dentist insists
on doing the cores - Terry
Thank you, Dr.Pannkuk. I haven't seen that many cases with both
resorption and cracking line. I am just wondering if it was the
resorption weakened the tooth structure and caused the crack, or
the cracking line start first and brings bacteria into pulp tissue,
and caused the pulpal defensive response--odontoclast
differentiation. What do you think? - Hongsheng
I think chronic stimulation of the pulp , whether a crack, long
standing caries, a previous pulp cap, chemical, trauma, etc. etc.
has the potential to create dystrophic pulpal changes leading to
this type of path. Pulp capping infuriates me because no one
considers the long term, or subtle pulpal changes which complicate
later treatment unnecessarily.
Clinical endodontic treatment should be implemented by one who
has a long-term astute perspective of what type of pathological
progression their decision-making may, may not be committing the
patient to during their
lifetime - Terry