Root Fractures and Cracks

Root Fractures

It is unfortunate to come across root fracture as you are here to save a tooth and if the root of tooth is broken the prognosis is poor. You do come across them in various positions and depths. Following is figure to give you an idea of root fracture classification as given by Hithersay & Morlie.

Hithersay & Morlie's Classification of subgingival fracture

The literal meaning of crack is “breach in continuity”. Following trauma, cracks can be observed in tooth. The cracks can be classified as:

a) Craze lines

b) Fractures

c) Split roots

• Craze lines are merely cracks in enamel, not extending into the dentin. They may occur naturally or secondary to trauma. They are more common in adult teeth and in posterior region. On transillumination these show up as fine lines in the enamel with light being able to transmit through them. They are

mostly asymptomatic and no treatment is necessary unless they do not create a cosmetic problem.

• Fractures (cracks) extend deeper into the dentin primarily extending mesially to distally involving the marginal ridges. Dyes and transillumination help in visualizing potential root fractures.

Crack line on the root

• Split roots – Occur when fracture extends from one surface of the teeth to another surface of the tooth, with the teeth separating into two segments. If the split is oblique, it is possible that smaller fragment may be removed and other saved. But if the split extends below the osseous level, the tooth may not be restorable and endodontic treatment may not result in a favourable prognosis.