A root fracture is a serious condition that can lead to infection of the bone and gums. In this article, you will learn everything you need to know about this type of tooth fracture: what it is, how it occurs, how it can be identified, and how it can be treated.
What is a root fracture?
A root fracture is a vertical crack in the tooth that extends from the root to the crown. The fracture can be complete or incomplete and may affect the enamel, dentin, cementum, and pulp.
A root fracture is often difficult to diagnose, as it usually does not cause symptoms. However, it can lead to inflammation and infection of the surrounding tissue, causing pain, swelling, pus formation, or gum recession.
How does a root fracture occur?
A root fracture can have various causes, such as:
- Trauma: A blow or fall onto the tooth can cause a crack in the root.
- Bruxism: Nighttime grinding or clenching of teeth can lead to increased pressure on the root, which may contribute to a crack.
- Endodontic Treatment: A root canal procedure can weaken the root, especially if excessive tooth structure is removed or a post is placed.
- Restorative Treatment: A filling or crown can put stress on the root if it is not properly fitted or is too large.
- Biting on hard foods or objects: Chewing on ice, nuts, bones, or other hard materials can cause a crack in the root.
How is a root fracture detected?
A root fracture is often difficult to detect, as it is not always visible and does not exhibit typical symptoms. To diagnose a root fracture, the dentist must perform a thorough clinical examination, which may include the following:
- Soft tissue examination: To check for swelling or fistulas that may indicate an infection.
- Percussion: To test the tooth's sensitivity to tapping.
- Palpation: To assess pressure sensitivity on the tooth and surrounding tissue.
- Bite test: To evaluate pain during biting or releasing.
- Vitality test: To measure the tooth's response to electrical or thermal stimuli.
- Periodontal probing: To measure the depth of gum pockets, which may be irregular in the case of a root fracture.
- Restoration removal: To better visualize the root if a filling or crown is present.
- Transillumination: To shine light through the tooth and look for interruptions in light transmission, which are common with a root fracture.
- Dye staining: To highlight the crack using a special dye, such as methylene blue.
- Surgical assessment: To directly visualize the crack if it is located beneath the gum line.
- Radiographic examination: To take both periapical images and cone-beam computed tomography (CBCT), which provides a three-dimensional view of the tooth and bone.
How is a root fracture treated?
A root fracture is usually irreparable and requires the extraction of the tooth. However, in some cases, an attempt can be made to preserve the tooth by performing one of the following treatments:
- Root-end resection: A surgical removal of the portion of the root containing the crack, while preserving the rest of the tooth.
- Root amputation: A surgical removal of one root of a multi-rooted tooth while preserving the remaining roots.
- Hemisection: A surgical division of a multi-rooted tooth into two halves, where one half is removed, and the other half is preserved.
These treatments require subsequent restorative care with a filling, crown, or bridge to restore the function and aesthetics of the tooth.
How can a root fracture be prevented?
To reduce the risk of a root fracture, you can take some preventive measures, such as:
- Wear a mouthguard during sports or activities that could cause trauma.
- Avoid grinding or clenching your teeth, or use a splint to reduce pressure on the root.
- Have your endodontic or restorative treatments performed by a qualified dentist who uses the appropriate materials and techniques.
- Avoid biting on hard foods or objects that could cause a crack in the root.
- Maintain good oral hygiene and visit your dentist regularly for check-ups and cleanings.
Conclusion
A root fracture is a serious condition that is often difficult to detect. It can lead to infection of the bone and gums, causing pain and complications. Treatment usually involves extracting the tooth, but in some cases, an attempt may be made to preserve it. To prevent a root fracture, you should take preventive measures and visit your dentist regularly. If you suspect you have a root fracture or want to learn more, don’t hesitate to contact us. We are a team of experienced dentists ready to assist you. Schedule an appointment with us today!
