Cracked tooth syndrome is most commonly associated with which tooth?

Correct answer: C. Mandibular second molar

• A. Mandibular canines have a bulky, single-rooted form and are rarely involved.
• B. Maxillary premolars do rank among the commonly affected teeth, but they follow the mandibular molars in frequency.
• C. CORRECT. The MANDIBULAR SECOND MOLAR is the most frequently affected, followed by the mandibular first molar and then the maxillary premolars. The mandibular molars bear the highest occlusal loads, are often heavily restored with wide isthmuses, and their cusps act as wedges against the opposing dentition.
• D. Maxillary central incisors are far more commonly affected by direct trauma than by the fatigue cracking of cracked tooth syndrome.

Note: Classic presentation: sharp pain on RELEASE of biting pressure (rebound pain) plus sensitivity to cold, in a tooth with a large restoration and no obvious caries. Definitive management is cuspal coverage.