Endodontic Management of a Cracked Tooth: A Case Report

Aim: This case report presents an overview of clinical presentation, diagnosis, and non-surgical endodontic management of a cracked tooth. Background: The cracked tooth is a distinct type of longitudinal tooth fracture. Clinical diagnosis is difficult because the signs and symptoms are variable. Timely and proper management of cracked teeth is necessary to save the tooth. Case description: A 67-year-old male patient reported pain in the upper left back tooth. On examination tooth-26 presented with a crack line in the palatal aspect. The case was diagnosed as pulp necrosis with symptomatic apical periodontitis in relation to 26 due to crack. The case was managed by sealing of crack, banding of the tooth, nonsurgical endodontic treatment, and a full metal crown. Conclusion: Treatment of cracked tooth depends on the position and extent of the crack. Management options vary from routine monitoring, occlusal adjustments, placement of a cast restoration, and endodontic treatment. This case report presents a successful management of a cracked tooth by combined use of restorative sealing of crack, banding of the tooth to prevent further crack propagation, followed by endodontic and prosthodontic intervention. Clinical significance: Cracks can act as a pathway for the bacterial penetration which has the potential to cause pulpal and periapical pathology. They should be addressed both biologically and mechanically for the successful management. Early diagnosis and appropriate treatment plans are equally important.