Treating cracks in teeth can still feel ambiguous for many dentists. Is it better to observe? Is it better to crown? Is there a less invasive treatment option? In this episode, Dr. David Alleman discusses a key piece of research that offers practitioners more insight into crack diagnosis and treatment: cracks that cause decay.

Occlusal effect caries is a carious lesion that forms from cracks that extend into dentin, creating a pathway for bacteria to enter the tooth. These cracks, called peripheral rim fractures, occur mostly around large restorations that leave the surrounding tooth structure unsupported, making crack initiation easier in the tooth. By understanding how these cracks form, practitioners can better learn how to detect and restore teeth affected by peripheral rim fractures.

Articles referenced in this episode:

  • Milicich G, Rainey J T. Clinical presentations of stress distribution in teeth and the significance in operative dentistry. Pract Periodont Aesthet Dent. 2000;12(7):695-700.
  • Walker et al. Enamel cracks the role of enamel lamella in caries initiation. Australian Dent J. 1998;43(2) 110-116.

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