Vertical root fractures in endodontically treated teeth

Vertical root fractures in endodontically treated teeth were considered for a long time a vexing and frustrating issue both for the clinician and the patient alike. In recent years this complication of root canal treatment had showed both advances in VRF diagnosis and in saving from extraction in some of these teeth. The diagnosis of a vertically fractured tooth has to be done accurately and in timely manner due to the destructive results in the supporting bone if not achieved in time. The use of CBCT as an additional diagnostic tool, enhances the possibility to achieve accurate VRF diagnosis, although some drawbacks in this imaging modality still exists. When considering saving a tooth with a vertical root fracture (VRF), it's important to take into account endodontic, periodontal, and prosthetic considerations. Treatment options of a VRF tooth vary from simple root amputation in multirooted teeth to a more complex surgical management in order to retain the fractured tooth.

Learning objectives:

• Describe the importance of achieving accurate and timely manner VRF diagnosis.
• List the recent advances in VRF diagnosis imaging modalities.
• Discuss the various considerations to save a vertically fractured tooth.