Vertical Root Fractures

It is a severe crack in the tooth that extends longitudinally down the long axis of the root often extending through the pulp into the periodontium.

Etiology of Vertical Root Fracture

a) They may arise from physical traumatic injuries.

b) Occlusal prematurities.

c) Excessive parafunctional habit.

d) Resorption induced pathologic root fractures.

e) Most common cause is iatrogenic dental treatment like placement of posts and pins or placing a tightly fitting post or intracoronal restoration. Most common dental procedure leading to vertical root fracture is endodontic treatment.

Diagnosis

History of facial trauma – patients with seizure disorders may be prone to dental trauma history of ice chewing or parafunctional habits or complaint of pain only on biting. A well performed endodontic procedure may suggest a vertical fracture if the tooth does not heal after retreatment or apical surgery.

Transillumination and Dyes

Methylene blue dyes when painted on tooth surface with cotton tip penetrates into cracks and helps in its location. Directing a high intensity light directly on the exterior surface of the tooth a CEJ (cementoenamel function) indicates the extent of fracture. Teeth with fractures block transilluminated light.

Radiographic Evaluation 

Mostly, the fracture is in a plane that is not perceptible from a periapical radiograph. Using a CT scan has shown to be superior to dental radiography in detection of a vertical fracture.