Does a cracked cusp affect the longevity or feasibility of a root canal treatment on a molar?

Joined
Jul 1, 2024
Messages
54
Cusp in the distal part of the tooth.

Tooth eventually started developing an infection/abscess, so can't really chew on it anymore.

Mark Scanlon, 10.09.2024..JPG


I think the bite wings show cracks and decay better, but the distal/occlusive cusp, you can kind of see the appearance of a crack moving upward?

It's more evident on the bite wing, it seems to culminate in the small darkened area about half way up the distal side - again the bite wing shows that as being darker.

The dentist put his explorer in and push it slightly, which in combination with the abscess making it already sensitive, caused intense pain.

Pic, 2nd molar, top left, facial, 7th Nov '24.jpg


This is the facial side, that upside down curve that looks like a shadow in the middle of the tooth surface, I can get my finger nail in there - unsure does that qualify as a crack?
Also if you see the gum just above the mesio-facial end, it's red and inflamed looking just exactly adjacent to where the tooth meets the gum, that typically bleeds unless I water floss it twice daily - I have no idea what that's indicative of, but it feels painful.

IMG_20240702_173205.jpg


This is the lingual side of the tooth, unsure if that's considered heavily filled, you can kind of see the composite in the above x-ray as a shade on the far side.

It was testing positive for the bite test on release before the abscess set in, now it's just painful to touch even.

.......

All that being said, could a root canal and crown be viable here?

Nothing untoward showed up on the CBCT scan, though I understand they're ineffective for showing cracks anyways?
 
Last edited:
Joined
Sep 6, 2024
Messages
27
The “shadow” you described on the facial side of the tooth surface could indeed represent a crack or a defect in enamel or dentin. If you can insert your fingernail into this area, it raises concern about structural integrity; however, whether it qualifies as a crack would depend on its depth and extent. A crack typically extends into dentin or deeper layers, while superficial defects may not.

The “shadow” you described on the facial side of the tooth surface could indeed represent a crack or a defect in enamel or dentin. If you can insert your fingernail into this area, it raises concern about structural integrity; however, whether it qualifies as a crack would depend on its depth and extent. A crack typically extends into dentin or deeper layers, while superficial defects may not.

The bite wing radiograph likely shows signs of decay or cracks in your tooth.
Intense pain upon probing suggests possible pulpitis or an abscess.
The shadow-like curve could indicate a significant defect in enamel or dentin.
Inflamed gums suggest gingivitis, which requires attention to prevent progression.
 

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