A cracked tooth is diagnosed with no pulpal involvement — the pulp is vital and there is no lingering pain. What is the appropriate treatment?

Correct answer: C. A cuspal-coverage restoration such as an onlay or crown

• A. Extraction is reserved for cracks that extend subgingivally into the root or that split the tooth.
• B. Root canal treatment is indicated only if the pulp is irreversibly inflamed or necrotic — signalled by lingering thermal pain or spontaneous pain. It is not the first-line treatment for a vital cracked tooth.
• C. CORRECT. The mechanism of pain in a cracked tooth is FLEXURE — the segments move independently under load, and that movement transmits fluid shifts to the pulp. The treatment is therefore to SPLINT the segments with a restoration that encircles and covers the cusps. An onlay or full crown eliminates the flexure and, with it, the symptoms. The pulp is left alone as long as it is vital.
• D. An intracoronal restoration, even a bonded one, does nothing to prevent cuspal flexure and may act as a wedge that propagates the crack.

Note: Sequence: diagnose with a bite test and transillumination, place a provisional crown or orthodontic band to test whether splinting relieves the symptoms, then restore definitively with cuspal coverage.