Cuspal fracture

Cuspal fractures usually begin as dentine microfractures (dentinal infractions) before the actual loss of a cusp. Sharp, short lasting pain is a usual symptom of an early stage of a cuspal fracture, when the patient bites on cusp at risk because of dentinal microfracture. After the physical loss of the cusp, symptoms usually gradually disappear, unless the fracture face is close to a vital pulp.
Fiber optic light and removal of old fillings are often required to locate cuspal fracture lines.