Vertical root fractures (VRF):
- are associated with endodontically treated teeth.
- are commonly directed bucco-lingually.
- are mostly diagnosed by localized probing defects (+/- sinus tract) that are usually present around the fractured root.
- show periradicular bone loss that is more pronounced in the middle and cervical 1/3 compared to the apical 1/3
- are not always detectable clinically (they can happen in the apical, middle or cervical area).
- are associated with the roots that are curved and are wide buccally and lingually but are narrow mesially and distally.
Etiologies: wedging posts, excessive root-dentin removal (using large tapered files, orifice shapers, gates glidden drills, etc.), obturation forces.
If vertical root fracture is detected in single-rooted tooth, it’s game over. In multi-rooted teeth, other options (such as, root amputation or hemisection) can be considered before extraction.
Mahmoud! It is amazing that you post these beautiful cases along with useful information for everyone. You work is excellent, just like it was in residency, and your documentation (pictures and radiographs) is priceless. Thank you for finding time to post interesting and educational cases. YOU ARE GREAT!!!!
[…] Excessive root dentin removal during endodontic treatment and use of posts are the predominant risk factors for root fractures. Common clinical findings associate with root fractured teeth have been discussed in a previous post (It is ‘Game Over’!) […]