This patient started getting sharp pain every time they bit on this tooth. It had never been filled but it started to split This can happen from grinding (bruxing) at night, clenching, eating hard foods, or often old fillings have weakenbed the tooth. In this case the patient admitted a very stressful period over the previous 6 months and an awareness of heavy clenching.
You can see natural grooves and small enamel cracks in both teeth. The pain was localised to the second premolar by biting on a hard object.
After removing the enamel a verticle crack can be seen extending into the tooth. Without support this will continue down through the nerve and root of the tooth and the tooth will need to be removed. Below is an image of a tooth where this has already occured.
I have used eMax for this crown. As it is cosmetic and translucent, I don’t have to agressively remove tooth structure all the way to the gumline like a traditional crown. This leaves the tooth much stronger in the long term.