110 – How Serious is Fractured Root

How Serious is Fractured Root?

A tooth consists of a crown and a root. The crown is the part you see. The root is anchored in the jaw under the gums and attaches the tooth to the tooth socket. Sometimes it is necessary to extract the tooth root for health reasons or because your tooth has broken down too far. A root fracture is a serious but relatively rare injury that may involve the dentin, pulp and root cement. Most often, it occurs as a result of an accidental hit, a traffic accident, a fall, playing sports or an assault.

A tooth root fracture may affect three planes:
* vertical – this injury is generally a complication of endodontic treatment. It occurs when the tool gets stuck in the canal or when too much force is used when filling or cleaning the canal. Vertical root fracture most often affects lower molars and upper premolars. The risk of this type of injury increases in the case of teeth damaged by abrasion or erosion, periodontal disease or malocclusion of the patient. Treatment generally involves extracting the tooth whose root has broken and inserting an implant in place of the gap left by the tooth;
* oblique – in this case, the fracture line most often runs from the root to the crown of the tooth. If the fracture line runs inside the dental fossa and the diagnosis is made quickly, it is possible to cure and save the tooth. In other situations, a tooth with an oblique root fracture should be removed;
* horizontal – the type of treatment depends on the height of the fracture line. If the root is broken at the neck level, root canal treatment is performed, a fiberglass post is cemented and a porcelain crown is made. The treatment in this situation very often includes orthodontic extrusion (crown lengthening using an orthodontic appliance), thanks to which the appropriate length of the tooth pillar for the porcelain crown is obtained. If the root is broken in the middle, the tooth is splinted, endodontic treatment is implemented or the tooth is extracted. If the root is fractured at the apical part, the tooth is splinted, and if the pulp dies, root canal treatment of the coronal fragment is performed. The apical fragment is left or removed by microsurgical resection.

The worst prognosis is in the case of a vertical fracture. This type of mechanical damage occurs mainly in teeth treated with root canal treatment. The only treatment method is extraction and implant insertion.

In the case of an oblique fracture, the fracture line often runs from the root to the crown of the tooth. In this case, the prognosis is usually not favorable and tooth extraction is necessary. However, when the diagonal fracture line runs inside the dental fossa and the specialist makes a quick and correct diagnosis, there is a chance to heal and save the tooth.

In the case of a horizontal fracture, the height of the fracture line is important. When the damage runs along the tooth neck, endodontic treatment is performed, the post is cemented, and an artificial crown is made.

When the middle part of the root is fractured, splinting, endodontic treatment or removal is performed.