Cracks that go below the cemento-enamel junction and are not able to be completely removed when the buildup is placed or completely covered by the new crown will likely affect the long term prognosis of the tooth. These types of cracks are best evaluated under the magnification of the microscope. Additional tools such at staining and transilluination are also frequently used tools in the endodontist's evaluation of a crack.
Patients should be given the options and prognosis and helped to make the treatment decision that is in their best interests and meets their desires.
The following case demonstrates this process and usefulness of the microscope.
|Pt is referred for endodontic evaluation/treatment. Tooth is diagnosed with irreversible pulpitis, normal periapex and gross distal decay. RCT recommended.
|Distal decay is removed, mesial amalgam removed. Crack identified on the mesial wall of the pulp chamber.