110 – Most Common Root Fractures in Teeth

Most Common Root Fractures in Teeth
There are many types of root and tooth fractures. In all cases, it is important to contact your trusted dentist as soon as possible, to obtain a timely diagnosis and an adequate treatment and follow-up plan. However, immediately recognizing the type of damage caused by the accident and following correct practices helps to avoid more serious consequences. Fractures involving the root of the tooth are particularly troublesome, so it is important that you visit the dentist if you are experiencing mouth pain.
Fracture of the crown and root without exposure of the pulp
The fracture also extends under the gum, there is no exposure of the pulp, there is no pain on percussion and the broken fragment is mobile but not detached. Even in this case you need to go to the dentist immediately and the treatment can vary greatly depending on how far the fracture has penetrated under the gum. Treatments can range from simple reconstruction of the tooth preceded by gingivectomy to expose the fracture line, to orthodontic or surgical treatment before definitive reconstruction, always to bring the fracture margin above the gum. The most serious cases require extraction followed by prosthetic replacement or prosthetic implantation of the dental element. The situation must be monitored in the period following the accident also by means of x-rays.
Root fracture
The tooth may appear intact yet be mobile and cause pain with chewing, touching, or pressure. You may notice bleeding from the gum around the tooth, which may turn gray or red. To diagnose a root fracture, an x-ray is needed, as it is not visible on physical examination. Going to the dentist immediately is essential to reposition the tooth as soon as possible and correctly. Subsequently the tooth will be fixed in that position and connected to the adjacent teeth with a wire. The element will have to remain blocked for a period ranging from 4 weeks to 4 months, depending on the height at which the root fracture occurred. Subsequently, clinical and radiographic checks will be performed to verify whether the pulp remains viable or not.
Root fractures involve dentin, cementum and sometimes the dental pulp. They are often classified succinctly as horizontal or vertical fractures, but on closer inspection we realize that several scenarios can arise. Root fractures can be:
* horizontal (oblique or transverse): from the apical third, the middle third or the cervical third;
* vertical (longitudinal);
* on an intact tooth or on an endodontically treated tooth;
* root fractures with associated coronal fracture (coronoradicular fracture)
* fractures on a single-rooted or multi-rooted tooth; anterior or posterior.
The therapeutic approach is necessarily distinct for each of these cases. Your dentist will plan your care based on which of these types of root fractures you have. Be prepared, oftentimes, the treatment for a fractured root is extraction, but this doesn’t always have to be the case. Root fractures can be complex to manage, because most often multi-disciplinary treatment is necessary. A root fracture can easily go unnoticed clinically and radiographically, so if you are experiencing pain or symptoms, make sure you visit a trusted dentist.