6 month review of cracked tooth
Review of case 6 months ago:
http://dental-tidbits.blogspot.com/2018/12/case-report-cracked-tooth.html
The lower 6 remains asymptomatic but the upper 6 has become symptomatic with cracked tooth syndrome. The other dentist in the practice has seen her and will perfom cuspal coverage of this tooth. On followup if I were seeing her I would consider taking follow up photos, pulp test and a PA radiograph.
Muscles of mastication are painful to tenderness. She is likely a bruxer due to the significant wear on the 7, multiple cracks and pain in her muscles. The sign of heavy occlusion on the 7 is also a good sign that she may have her MIP anterior to her CR postition. Seating of the condyles into CR will result in posterior traction of the mandible and a slight separation of the anterior teeth. This tends to bring the most posterior tooth i.e the lower 7s into heavy contact. This can be reproduced by adding leaves in a leaf gauge to the anterior teeth and checking the occlusion of the posterior teeth. Heavy forces of the masseter and the temporalis will overcome the weak lateral pterygoid and seat the condyle into CR. If the posteriors are still touching despite anterior disclusion you know there will be heavy forces on these teeth during bruxism and mastication.
http://dental-tidbits.blogspot.com/2018/12/case-report-cracked-tooth.html
The lower 6 remains asymptomatic but the upper 6 has become symptomatic with cracked tooth syndrome. The other dentist in the practice has seen her and will perfom cuspal coverage of this tooth. On followup if I were seeing her I would consider taking follow up photos, pulp test and a PA radiograph.
Muscles of mastication are painful to tenderness. She is likely a bruxer due to the significant wear on the 7, multiple cracks and pain in her muscles. The sign of heavy occlusion on the 7 is also a good sign that she may have her MIP anterior to her CR postition. Seating of the condyles into CR will result in posterior traction of the mandible and a slight separation of the anterior teeth. This tends to bring the most posterior tooth i.e the lower 7s into heavy contact. This can be reproduced by adding leaves in a leaf gauge to the anterior teeth and checking the occlusion of the posterior teeth. Heavy forces of the masseter and the temporalis will overcome the weak lateral pterygoid and seat the condyle into CR. If the posteriors are still touching despite anterior disclusion you know there will be heavy forces on these teeth during bruxism and mastication.
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