Diagnosis of Vertical Root Fractures

Vertical root fracture in an endodontically treated tooth originates from the root at any level and is considered a frustrating and vexing complication in endodontic therapy. Many times, it is difficult to achieve an accurate diagnosis and to differentiate the fracture from other clinical entities. However, usually combination of cervicaly located sinus tract combined with a narrow deep periodontal defect present is highly suggestive of a vertical root fracture. When the diagnosis of a vertical root fracture is made, usually years after all endodontic and restorative procedures have been completed, extraction of the tooth or root should be done in a timely manner to minimize the bone loss in the surrounding bone. This bone loss may compromise subsequent implant placement in the area. This chapter will emphasize the importance of achieving an accurate and timely vertical root fracture diagnosis and will describe the more typical signs, symptoms, and radiographic features that are suggestive for vertical root fracture diagnosis in the susceptible teeth and roots.