Incomplete Crown‐Root Fracture in Pulpal‐Periodontal Disease

Incomplete tooth fracture – proposal for a new definition

“…It is evident that they arose from difficulties with diagnosis, prognosis assessment and treatment. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Cuspal fracture odontalgia, fissured fracture, incomplete tooth fracture, fissural fracture, crack lines and greenstick fractures were early descriptions, based on presenting symptoms, where there was no obvious separation of fragments. [1][2][3][4][5][6] Cameron's cracked tooth syndrome described fractures that were not easily visible but the teeth responded Visual detection may be difficult as Caufield's analysis of crack lines under a scanning electron microscope demonstrated, the width of the fracture plane can be less than 18µ.…”

“…11,18 When the fracture communicates with the external root surface microleakage produces localised periodontal repercusions. 9,29,31,39 Luebke recognised this with his protocol for the periodontal management of supra-and intra-osseous incomplete fractures (Fig. 2) whilst others have described general principles for managing periodontal defects.…”

“…40 The consensus is that clinical radiographs cannot reliably identify ITF but they are required to assess the periapical and periodontal status of teeth and any restorations present and to exclude other sources of pain/ discomfort ie root perforations or internal/ external resorption. 9,15,16,19,29,34,37,41 …”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] This array of literature may be considered to be the result of a progressive increase in the knowledge of ITFs, however, no definition to date truly reflects the clinical issues. This article aims to highlight the characteristics of, and proposes a new definition for, ITF.…”

“…This article aims to highlight the characteristics of, and proposes a new definition for, ITF. No attempt is made to revisit the aetiology 17 or the management issues 9,11,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] of diagnosis, conservation techniques, endodontic and periodontic implications nor rationale for orthodontics, root resections or extraction. It is hoped that this paper will help clinicians understand and appreciate these fractures when considering diagnosis and treatment.…”