Vertical Root Fracture : A Review

Vertical root fractures associated with endodontically treated teeth present as one of the most difficult clinical problems to diagnose and treat .Prognosis most often is hopeless and differential diagnosis from other pathoses may be difficult at times. Nevertheless, proper diagnosis is critical to distinguish a fracture from clinical manifestations of periodontal and endodontic diseases. In as much as there are no specific symptoms, diagnosis can be as difficult. Clinical detection of this condition by endodontists is becoming more frequent, where as it is rather underestimated by the general practitioners. Early detection of a fractured root and extraction of the tooth maintain the integrity of alveolar bone for placement of a future implant with better prognosis. Since, vertical root fractures almost exclusively involve endodontically treated teeth; it often becomes difficult to differentiate a tooth with this condition from an endodontically failed one or one with simultaneous periodontal involvement. The diagnosis of vertical root fracture is difficult because of the delayed appearance of the signs and the appearance of pure endodontic or periodontal problems. Also, a tooth diagnosed for vertical root fracture is usually extracted, though attempts to reunite fractured root have been attempted in various studies with varying success rates.. Cone beam computed tomography has been shown to be very accurate in this regard. This article focuses on the diagnostic and treatment strategies, and discusses about predisposing factors which can be useful in the prevention of vertical root fractures.