However other clinical signs which may lead to the diagnosis of CTS includes wear faceting indicating excessive forces perhaps from clenching or grinding or the presence of an isolated deep periodontal pocket which may symbolise a split tooth. Removing restorations may help to visualise fracture lines but should only be carried out after gaining informed consent from the patient, as removing a restoration may prove to be of little diagnostic benefit. Tactile examination with a sharp probe may also aid diagnosis. Gentian Violet or Methylene Blue Stains
Dyes may be used to aid visualisation of fractures. The technique requires 2–5 days to be effective and a temporary restoration may be required. The structural integrity can be weakened by this method, leading to crack propagation. Transillumination
Transillumination is best performed by placing a fibre optic light source directly onto the tooth and optimal results can be achieved with the aid of magnification. Cracks involving dentine interrupt the light transmission. However, transillumination may cause cracks to appear enlarged as well as causing colour changes to become invisible. Radiographs
Radiographs offer little benefit in visualising cracks. This is due to the fact that cracks propagate in a direction which is parallel to the plane of the film (Mesiodistal) however radiographs can be useful when examining the periodontal and pulpal status. Bite Test
Different tools can be used when carrying out a bite test which produce symptoms associated with cracked tooth syndrome. Patients bite down followed by sudden release of pressure. CTS diagnosis is confirmed by pain on release of pressure.
Sinecatechins (USAN, trade names Veregen and Polyphenon E) is a specific water extract of green tea leaves from Camellia sinensis that is the active ingredient in an ointment approved by the FDA in 2006 as a botanical drug to treat genital warts. Sinecatechins are mostly catechins, 55% of which is epigallocatechin gallate. It was the first botanical drug approved by the US FDA. == References ==