Cracks, the new threat or just old sores?
Bio-mechanical considerations of crack prevention and restoration of posterior teeth.
The “molar lifecycle” or the “Circle of Death” whereby a small filling can eventually lead to loss of vitality or even extraction of a tooth is well known. Nevertheless, a clear strategy and guidelines on how to prevent this dramatic scenario to develop has not been proposed. Thorough understanding of the bio-mechanical behavior of teeth, both sound and restored, on a macro- and micro-level will allow us to come forward with effective measures to save teeth and be less aggressive in our treatment proposals. A pro-active approach will be proposed, both for vital and non-vital teeth. The importance of early diagnosis, healthy strategy , effective isolation and skillful execution will be evident in this presentation.
Both the direct and indirect approach to cuspal coverage will be dealt with. Numerous issues will be adressed: Immediate dentin sealing, deep marginal elevation, cavity design, luting. How to cummunicate with patients when dealing with cracks is the juicy cherry on the cake.
understand crack initiation and act with preventive measures to prevent crack progression
early diagnosis of different types of cracks
material choice guidelines
general cavity design guidelines
cuspal coverage or not ? Clear protocol and guidelines
communicate openly with the patiënt