First described by Cameron in 1964, it refers to an incomplete fracture of a vital posterior tooth — a structural compromise that often escapes early detection.
The condition is characterized by intermittent pain on biting, sensitivity to cold, and difficulty in pinpointing the affected tooth, making its diagnosis particularly challenging.
Recent literature emphasizes that CTS is multifactorial. Occlusal overload, parafunctional habits such as bruxism, and extensive restorations are among the main etiologic factors. Mandibular molars are the most frequently affected, especially in patients aged 30 to 50 years.
Failure to detect the crack in time may lead to pulpal involvement, vertical root fractures, or eventual tooth loss.
Diagnosis typically relies on clinical examination, transillumination, selective biting tests, magnification, and sometimes CBCT imaging when the fracture line extends subgingivally.
Early intervention—through adhesive restorations, full-coverage crowns, or endodontic treatment when pulpal symptoms appear—remains essential to preserve function and prevent catastrophic fractures.
Understanding the subtle signs of CTS is fundamental for every dental practitioner.
Early recognition and stabilization not only determine the prognosis but also prevent unnecessary endodontic or surgical complications.
