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Vertical root fracture (VRF) is one of the most frustrating complications of root canal treatment. The prognosis of the root with VRF is poor therefore tooth extraction and root amputation are usually the only treatment options.
If the fracture is coronal and root, the tooth is usually recoverable, possibly with a crown to serve as reinforcement. If the root fracture is the top can be reconstructed tooth and encapsulated, so as to reinforce it and download the functional forces along the healthy root. But most of the time, unfortunately, there is nothing to do and the tooth extraction is doomed. A tooth with a fractured root must not be left in the mouth, but must be removed without delay. Leave it means meeting again after a little with severe bone deficiencies, amendable only with difficult and expensive bone reconstructive surgery.
There is no treatment of the vertical root fracture with some scientific basis: from the time of diagnosis the lesion tends to worsen. The prognosis and treatment will be different depending on the location (only coronal or more or less interesting to the root) and the trend (horizontal, oblique or vertical) of the score line or tear involving a different degree of involvement of the pulp and of the support fabrics. If you are lucky, simple therapeutic approaches (removal of supragingival fragment) or complex (lengthening of the clinical crown and / or pulpectomy) allow the dental retention element, but often the only solution remains reluctantly caliper.
In light of the success of the post-extraction implant therapy, I believe that the best treatment is still the extraction of the fractured tooth.
Hello Dr Emara, thanx for sharing your question on this platform.
Now coming to your query Well vertical root fracture has worst prognosis of all. But in some cases where the fracture is above the alveolar crest level we can try saving the tooth either by joining the the fracture segment or by removing fractured segment and and restoring the remaining tooth structure with the help of crown lengthening procedure followed by post and core and crown. Other wise if the fracture line is extending beyond crestal level than its better to go for extraction or bicuspidization in case of lower molars.
Thanx for reading this.
