4 Things You Need To Know About Vertical Root Fractures

Dentist Articles

Your teeth are strong, but there are many ways they can fracture. The visible part of your tooth (the crown) can break, and so can the part you can't see — the roots that anchor your teeth to your jawbone. If these roots fracture lengthwise, the result is a vertical root fracture. Here are four things you need to know about this serious dental injury.

What causes vertical root fractures?

Vertical root fractures usually occur in teeth that have undergone root canal treatments in the past. The crack begins at the inside of the root canal wall and then spreads downwards into the root of the tooth. This can happen if the dentist that performed your root canal used too much force when they removed your infected pulp or when they compressed the filling material into your tooth. It can also occur if the endodontic post inside your tooth corrodes, or if nearby teeth are pressing against the tooth that underwent the root canal.

Root canal treatments aren't the only thing that can lead to vertical root fractures, though. These fractures can also occur due to restorations like fillings or crowns. This can happen if your filling material expands or contracts and puts pressure on your tooth; it can also happen if your crown doesn't fit properly or wasn't installed properly.  

What are the signs of vertical root fractures?

If the root of your tooth is fractured, you may experience mild pain in the affected tooth. You may also experience pain when you bite or chew. The affected tooth may also be sensitive to changes in temperature, so you may find it difficult to drink cold water or eat hot foods. You may also have sensitive gums near the affected tooth; this may be mistaken for gum disease and it is caused by chronic inflammation along the fractured root.

Sometimes, the site of the pain is hard to pinpoint, so it can take you a long time to realize which tooth is the problem and to get it examined by a dentist. If you have a vague pain inside your mouth and you aren't sure where it's coming from, see your dentist for help. Your dentist can take x-rays of your mouth, and if the cause is a vertical root fracture, treatment can begin.

Can dentists treat this injury?

Vertical root fractures are one of the hardest problems for dentists to fix, but that doesn't mean it's impossible. The main treatment options are root amputation and tooth extraction. During root amputation, the fractured root of your tooth will be surgically removed through an incision in your gum tissue; the goal of this surgery is to save your tooth from extraction. If root amputation doesn't work or you aren't a good candidate for the procedure, your dentist will opt to extract (pull out) your tooth. If your teeth needs to be extracted, it can be replaced later with a dental implant.

An Iranian study reported that resin could be successfully used to repair vertical root fractures. The study authors extracted a tooth with a vertical root fracture, reconstructed the broken roots with resin, a type of dental glue, and then replanted the tooth in the socket. This is an ideal treatment because it allows you to retain the entire structure of your tooth.

How common are vertical root fractures?

Vertical root fractures are a fairly common complication of root canal treatments. Studies in Israel and Belgium have shown that vertical root fractures occur in between 11% and 20% of teeth that have been treated with root canal therapy.

Vertical root fractures are serious, but they can be treated. If you are suffering from dental pain and think you might have this condition, see your dentist right away for diagnosis and treatment. 

4 August 2015