CRACKED TOOTH SYNDROME AND THE ROLE OF CONE-BEAM COMPUTED TOMOGRAPHY IN THE DIFFERENTIAL DIAGNOSIS: A CASE REPORT

Year 2015, Supplement 10, 19 - 24, 21.05.2015

Cüneyt Aral , Evren Ok

https://doi.org/10.17567/dfd.67691

Abstract

Cracked tooth syndrome is a problem frequently encountered in dental practice and requires immediate diagnosis and treatment in order to eliminate the symptoms of severe pain. In this report; a case of delayed diagnosis and treatment is presented. A 40-year-old male patient who had no health problem referred to our clinic. In his history, the patient complained about an electric shock-like pain in the right upper teeth especially during chewing, and also during eating cold and hot foods and also he stated that his complaints couldn’t be diagnosed over a year. In intraoral examination; generalized attrition and abrasion, and gingival recessions of the teeth were detected. Cracks were observed on the palatal surface of maxillary first and second premolar, and first molar teeth, through visual inspection, transillumination, and staining methods. Examination of the Cone-beam Computed Tomography revealed that the crack of the maxillary fist premolar tooth reached the pulp. Root canal treatment was performed to the maxillary fist premolar tooth which had hyperemia and sensitivity to bite test. In the control sessions, it was observed that the complaints of the patient disappeared completely. Usage of a mouth guard was recommended for the treatment of bruxism which is taught to play a role in the etiology of the cracked tooth syndrome. Anxiety disorder of the patient was consulted to a psychiatrist

Keywords

Cracked tooth syndrome, Conebeam Computed Tomography, Dentine sensitivity, Bruxism

KIRIK DİŞ SENDROMU VE AYIRICI TEŞHİSİNDE KONİK IŞINLI BİLGİSAYARLI TOMOGRAFİNİN ROLÜ: OLGU SUNUMU

Abstract

Dental pratikte sıklıkla karşılaşılan Kırık diş sendromu, oluşturduğu şiddetli ağrı semptomlarını gidermek amacıyla hızlı teşhis ve tedavi yaklaşımı gerektiren bir problemdir. Bu olgu sunumunda; teşhisi ve tedavisi gecikmiş bir vaka sunulmaktadır.

: Herhangi bir sağlık problemi olmayan 40 yaşındaki bir erkek hasta kliniğimize başvurdu. Hasta hikâyesinde özellikle çiğneme esnasında, ayrıca sıcak ve soğuk yiyecekler sırasında sağ üst dişlerinde elektrik çarpması tarzında ağrılar hissettiğini ve bu şikâyetlerine bir yıldır teşhis konulamadığını belirtti. Hastanın intraoral muayenesinde; dişlerde generalize atrizyon, abrazyon ve dişeti çekilmesi bulgularına rastlandı. Gözle muayene, transillüminasyon ve boyama yöntemleriyle maksiller 1. ve 2. premolarlar ve 1. molar dişlerin palatinal yüzeylerinde çatlaklar izlendi. Konik ışınlı bilgisayarlı tomografi incelemesinde maksiller 2. premolar dişte görülen çatlağın pulpaya ulaştığı izlendi.

 Isırtma testinde hassasiyet gözlenen ve hiperemik olan maksiller 2. premolar dişe kanal tedavisi uygulandı. Kontrol seanslarında hastamızın şikâyetlerinin tamamen kaybolduğu gözlendi. Çatlakların etyolojisinde rol oynayan bruksizmin tedavisi için koruyucu plak uygulaması önerildi. Hastamızın anksiyete bozukluğu psikiyatri uzmanına konsülte edildi.

Keywords

Kırık diş sendromu, Konik Işınlı Bilgisayarlı Tomograf, Dentin hassasiyeti, Bruksizm

References

• Cameron CE. Cracked-Tooth Syndrome. J Am Dent Assoc 1964;68:405-11.
• Geurtsen W, Schwarze T, Gunay H. Diagnosis, therapy, and prevention of the cracked tooth syndrome. Quintessence Int 2003;34:409-17.
• Sümbüllü MA, Çakur B, Çağlayan F. Prevalence of Pituitary Calcifications Using Cone Beam Computed Tomography In Turkish Subpopulation. Atatürk Üniv Diş Hek Fak Derg 2013;21:289-92.
• De Vos W, Casselman J, Swennen GR. Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: a systematic review of the literature. Int J Oral Maxillofac Surg 2009;38:609-25.
• Lynch CD, McConnell RJ. The cracked tooth syndrome. J Can Dent Assoc 2002;68:470-5.
• Batalha-Silva S, Gondo R, Stolf S, Baratieri L. Cracked tooth syndrome in an unrestored maxillary premolar: a case report. Oper Dent 2014;39:460- 8.
• Banerji S, Mehta SB, Millar BJ. Cracked tooth syndrome. Part 1: aetiology and diagnosis. Br Dent J 2010;208:459-63.
• Greven M. TMD, bruxism, and occlusion. Am J Orthod Dentofacial Orthop 2011;139:424-5.
• Friedman J, Marcus MI. Transillumination of the oral cavity with use of fiber optics. J Am Dent Assoc 1970;80:801-9.
• Udoye CI, Jafarzadeh H. Cracked tooth syndrome: characteristics and distribution among adults in a Nigerian teaching hospital. J Endod 2009;35:334- 6.
• Kalyan Chakravarthy PV, Telang LA, Nerali J, Telang A. Cracked tooth: a report of two cases and role of cone beam computed tomography in diagnosis. Case Rep Dent 2012;1:1-6.
• Scarfe WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography in dental practice. J Can Dent Assoc 2006;72:75- 80.
• Lee CY, Koval TM, Suzuki JB. Low Dose Radiation Risks of CT and CBCT: Reducing the Fear and Controversy. J Oral Implantol 2014;[Basım Aşamasında].
• Loubele M, Bogaerts R, Van Dijck E, Pauwels R, Vanheusden S, Suetens P, Marchal G, Sanderink G, Jacobs R. Comparison between effective radiation dose of CBCT and MSCT scanners for dentomaxillofacial applications. Eur J Radiol 2009;71:461-8.
• Mah JK, Danforth RA, Bumann A, Hatcher D. Radiation absorbed in maxillofacial imaging with a new dental computed tomography device. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96:508-13.
• Seltzer S, Boston D. Hypersensitivity and pain induced by operative procedures and the "cracked tooth" syndrome. Gen Dent 1997;45:148-59.
• Dowell P, Addy M. Dentine hypersensitivity--a review. Aetiology, symptoms and theories of pain production. J Clin Periodontol 1983;10:341-50.
• Fukumoto Y, Horibe M, Inagaki Y, Oishi K, Tamaki N, Ito HO, Nagata T. Association of gingival recession and other factors with the presence of dentin hypersensitivity. Odontology 2014;102:42- 9.
• Ünal M, Tuğut F, Demir H. Travmatik Komplike Kuron Kırığı ve Lateral Lüksasyon Tedavisinin Üç Yıllık Takibi: Olgu Raporu. Atatürk Üniv Diş Hek Fak Derg 2013;23:380-4.
• Üstün Y, Dinçer AN, Aslan T, Sağsen B. Bir Komplike Restorasyonu: Vaka Raporu. Atatürk Üniv Diş Hek Fak Derg 2013;23:235-8. Kırığının Koruyucu
• Banerji S, Mehta SB, Millar BJ. Cracked tooth syndrome. Part 2: restorative options for the management of cracked tooth syndrome. Br Dent J 2010;208:503-14.
• Walton RE, Leonard LA. Cracked tooth: an etiology for "idiopathic" internal resorption? J Endod 1986;12:167-9.
• Abou-Rass M. Crack lines: the precursors of tooth diagnosis Quintessence Int Dent Dig 1983;14:437-47. and treatment.
• Lobbezoo F, Naeije M. Bruxism is mainly regulated centrally, not peripherally. J Oral Rehabil 2001;28:1085-91.
• Abe Y, Suganuma T, Ishii M, Yamamoto G, Gunji T, Clark GT, Tachikawa T, Kiuchi Y, Igarashi Y, Baba K. Association of genetic, psychological and behavioral factors with sleep bruxism in a Japanese population. J Sleep Res 2012;21:289-96.
• Clark GT, Ram S. Four oral motor disorders: bruxism, dystonia, dyskinesia and drug-induced dystonic extrapyramidal reactions. Dent Clin North Am 2007;51:225-43.
• Huynh N, Manzini C, Rompre PH, Lavigne GJ. Weighing the potential effectiveness of various treatments for sleep bruxism. J Can Dent Assoc 2007;73:727-30.
• Johansson A, Omar R, Carlsson GE. Bruxism and prosthetic treatment: a critical review. J Prosthodont Res 2011;55:127-36.
• Fernandes G, Franco AL, Siqueira JT, Goncalves DA, Camparis CM. Sleep bruxism increases the risk for depression and non-specific physical symptoms. J Oral Rehabil 2012;39:538-44. disorder,
• Liebenberg WH. Use of resin-bonded partial coverage ceramic restorations to treat incomplete fractures in posterior teeth: a clinical report. Quintessence Int 1996;27:739-47.
• Bearn DR, Saunders EM, Saunders WP. The bonded amalgam restoration--a review of the literature and report of its use in the treatment of four Quintessence Int 1994;25:321-6. syndrome.
• Banerji S, Mehta S, Kamran T, Kalakonda M, Millar B. A multi-centred clinical audit to describe the efficacy of direct supra-coronal splinting–A minimally invasive approach to the management of cracked tooth syndrome. J Dent 2014;42:862-71.
• Rechenberg DK, Kruse A, Gratz KW, Attin T, Lubbers HT. Chronic orofacial pain (OFP) of different origin. A case report. Schweiz Monatsschr Zahnmed 2011;121:839-48.
• Çağırankaya L, Erbudak H, Akçiçek G. Çatlak Diş Sendromu. Hac Dis Hek Fak Derg 2008;32:25-9.