Vertical root fractures are a type of fracture of a
tooth
A tooth ( : teeth) is a hard, calcified structure found in the jaws (or mouths) of many vertebrates and used to break down food. Some animals, particularly carnivores and omnivores, also use teeth to help with capturing or wounding prey, tear ...
. They can be characterized by an incomplete or complete fracture line that extends through the long axis of the root toward the apex. Vertical root fractures represent between 2 and 5 percent of crown/root fractures. The greatest incidence occurs in endodontically treated teeth, and in patients older than 40 years of age.
The occurrence of a complete vertical root fracture is often catastrophic for the individual tooth as
tooth extraction
A dental extraction (also referred to as tooth extraction, exodontia, exodontics, or informally, tooth pulling) is the removal of teeth from the dental alveolus (socket) in the alveolar bone. Extractions are performed for a wide variety of reason ...
is usually the only reasonable treatment.
Vertical root fracture is more likely where teeth have undergone extensive prior treatment. It is thought that excessive removal of
dentine
Dentin () (American English) or dentine ( or ) (British English) ( la, substantia eburnea) is a calcified tissue of the body and, along with enamel, cementum, and pulp, is one of the four major components of teeth. It is usually covered by ena ...
during procedures such as
root canal treatment
Root canal treatment (also known as endodontic therapy, endodontic treatment, or root canal therapy) is a treatment sequence for the infected pulp of a tooth which is intended to result in the elimination of infection and the protection of ...
weakens the tooth. For this reason excessive canal shaping should be avoided. Fracturing may be caused by excessive forces placed on the tooth, such as during compaction of
gutta-percha
Gutta-percha is a tree of the genus ''Palaquium'' in the family Sapotaceae. The name also refers to the rigid, naturally biologically inert, resilient, electrically nonconductive, thermoplastic latex derived from the tree, particularly from ' ...
during the
obturation
In the field of firearms and airguns, obturation denotes necessary barrel blockage or fit by a deformed soft projectile (obturation in general is closing up an opening). A bullet or pellet, made of soft material and often with a concave base, ...
phase of
endodontics
Endodontics (from the Greek roots ''endo-'' "inside" and ''odont-'' "tooth") is the dental specialty concerned with the study and treatment of the dental pulp.
Overview
Endodontics encompasses the study (practice) of the basic and clinical ...
.
Trauma
Trauma most often refers to:
* Major trauma, in physical medicine, severe physical injury caused by an external source
* Psychological trauma, a type of damage to the psyche that occurs as a result of a severely distressing event
*Traumatic i ...
can also cause crack formation.
Symptoms and signs
Symptoms include: Short duration pain on biting, sensitivity to temperature change. Fracture lines may be visibly evident.
Transillumination
Transillumination is the technique of sample illumination by transmission of light through the sample. Transillumination is used in a variety of methods of imaging.
Microscopy
In microscopy transillumination refers to the illumination of a sample ...
may reveal unseen fractures.
Radiographic
Radiography is an imaging technique using X-rays, gamma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of an object. Applications of radiography include medical radiography ("diagnostic" and "therapeut ...
changes such as radiolucencies in the region of the fracture may be seen.
Diagnosis
Vertical root fracture can be a difficult diagnosis to make where the fracture line is not evident.Use of cone-beam computerized tomography has been described.
Regenerative Dentistry
A recent discovery shows that dentin can be regenerated,
if the patient can be provided with some lithium which is available in
many foods such as tomato and potato.
Inside the dentin is the pulp chamber,
which contains the nerves and blood vessels; new odontoblast-like cells can be produced in response to damage or trauma.
References
External links
{{DEFAULTSORT:Vertical Root Fracture
Bone fractures
Injuries of head