Root Fractures

Hi, just a tip on detecting root fractures which i learnt from an endodontist today.

1. Look at the aetiology: Roots don't fracture just because. There needs to be something weakening the tooth structure to predispose to the fracture. even heavy occlusal loading on a sound tooth is (i believe) more likely to fracture the crown than it is the root. Look for big things such as root canal treatment, large posts etc which would lead to a root fracture
2. radiographs: a pt of mine had a suspicious looking line on her PA radiograph which i then showed to an endodontist. He said that it may or may bot be a fracture since the pt only had a crown and no root treatment prior. If it wasn't causing her undue problem then it was best to let sleeping dogs lie.
3. pocket depths: when you are doing routine PSR or even when you suspect a root fracture the probing depths around the fracture will be exceptionally large when compared to the surrounding areas due to the attachment loss around the fracture. when there is a constant probing depth around the tooth but a sudden massive drop you sohuld suspect a root fracture and confirm with radiographs (or the other way around)

as for treatments for the root fracture, i have no idea... but miight be something like pull the tooth out... dunnoz

Edit 12/9/2018:
Res indeed for vertical root fractures it is a hopeless prognosis for the tooth resulting in extraction. For multi rooted teeth one could consider a RCT and hemisection with prosthodontic replacement of the gap or untimately, implant replacement.