Hidden Split in a Mandibular Central Incisor

Terry Pannkuk, DDS, MScD Clinical Endodontic Technique Instruction, Diagnosis, Complications: Advanced Management, Fractured Roots

hidden split in a tooth

Patient: 61year-old female with a history of colitis and hypothyroidism

Chief Complaint: biting and cold sensitivity

Dental History: The patient reported no recent dental procedures and started experiencing discomfort 5 days prior to the endodontic examination

Significant Findings: Severe localized percussion sensitivity was associated with the mandibular left central incisor (tooth #24). Sharp transient sensitivity was also noted with tooth #24 with the adjacent teeth responding within normal limits. Periodontal findings as well as all other clinical tests and findings were within normal limits. Fiberoptic transillumination of the tooth demonstrated a break of the beam through the incisal edge with the labial half of the crown remaining dark.

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Commenting Guidelines Please make scholarly cited references or expert opinions suitable for publication. The comments can either be "pro" or "con" with references to the treatment philosophy. We encourage objectivity and detailed demonstration of knowledge/literature.
Jan Skrybant commented 8 years ago.

Hi Terry, nice work, if you were to restore this yourself how much tooth tissue would you remove lingually ? I used to do these myself and when cementing the post I would utilise the buccal composite excess as the core, which I assume you have done likewise. I would prep for a crown immediately and fit a crown either as a temporary or permanent within 4 days. I would remove as little tooth tissue as I could lingually to maximise strength and use a metal backing to keep the bucco-lingual thickness as sensible as possible, I found the more I removed the weaker the end result. Jan Skrybant

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