X-ray of a Horizontal Root Fracture

Horizontal fractures are usually a result of trauma. The survival of the tooth is dependent on where the fracture is located. If it is located in the apical third of the root (apical being the portion toward the tip of the root), then it may be possible to save the tooth. Otherwise it is implant time. Vertical fractures can start in the crown of the tooth, which is most common, or at the tip of the root. Root fractures may or may not have symptoms associated with it. If there are symptoms, they are usually pain while chewing.

Vertical Root Fracture

When fractures are present, they rarely will show on an x-ray, so the usual course of treatment is placing a crown to keep the pieces of the tooth from wedging apart while eating. If this does not work, then root canal treatment is performed. It is, many times, only after the symptoms don’t subside after having a root canal done will a diagnosis be made of a root fracture. Other times there may be a tell-tale thickening of the black line that surrounds the root on an x-ray giving indirect evidence of a root fracture. There is no known way to repair a root fracture and with the advent of long-lasting implants, the best solution of treating a fractured root is by removal of the tooth and placement of an implant.