The following case is an example of the successful root canal treatment of a cracked tooth. Tooth #19 was diagnosed as necrotic pulp with acute apical abscess. RCT was recommended to save the tooth.
There was a large 10mm buccal probing depth, however, since the tooth was diagnosed as necrotic, this deep pocket is assumed to be endodontic rather than a true perio defect.
During treatment, a crack is found on the distal under the resin. Using a microscope, the extent of the crack is evaluated. In this particular case, the crack extended to the level of the pulpal floor. This is an important part of the evaluation of a crack, and in my opinion, can really only be done with a microscope. A crack that goes into the furcation or down into the attachment below has a poorer prognosis. Pt is informed the the crack and the potential effect on the long term prognosis of the tooth. Pt is given the choice to continue RCT and save the tooth or extract.
Bone has healed completely, tooth is fully functional and asymptomatic. This is successful endodontic therapy on a tooth with a crack above the crestal bone.
For more information regarding managing a teeth with a cracks, click here.