Int J Stomatol

Int J Stomatol ›› 2020, Vol. 47 ›› Issue (4): 373-382.doi: 10.7518/gjkq.2020056

• Expert Forum •     Next Articles

Spontaneous vertical root fracture: a diagnosis and treatment challenge

Li Jiyao1(),Zheng Guangning2   

  1. 1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Oral Radiology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2020-02-21 Revised:2020-03-27 Online:2020-07-01 Published:2020-07-10
  • Contact: Jiyao Li E-mail:jiyaoliscu@163.com
  • Supported by:
    This study was supported by Sichuan Province Science and Technology Support Program(2017SZ0030)

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Abstract:

Vertical root fracture in non-endodontically treated teeth, also known as spontaneous vertical root fracture (SVRF), is an intractable disease for most dental practitioners. Due to the lack of pathognomonic clinical manifestation and radiographic presentation in the early stage, the diagnosis of SVRF is extremely challenging even for experienced dentists. Even if SVRF is determined to be present, it is hard to make decision between treatment options including root resection, repairing the fractured root or tooth extract. Timing and method of restoration after tooth extraction also need to be considered. The aim of this paper was to discuss early diagnosis, differential diagnosis, the principles of treatments and the specific treatment plans of SVRF in the light of literature review and a 3-years clinical study, to help clinician to discern SVRF and to act as a reference for better clinical diagnosis and treatment.

Key words: spontaneous vertical root fracture, clinical diagnosis, differential diagnosis, treatment strategy, radiographic featur

CLC Number: 

  • R781.05

TrendMD: 

Fig 1

Vertical root fractures in endodontically treated teeth"

Fig 2

SVRF in non-endodontically treated teeth"

Fig 3

Asymptomatic SVRF (histological VRF)"

Fig 4

Periodontal probing of VRF pocket and periodontal pockets"

Fig 5

Coronally located sinus tract caused by SVRF"

Fig 6

Radiographic presentation in the early stage of SVRF"

Fig 7

SVRF-associated bone defect appears as J-shaped radiolucency"

Fig 8

An angular resorption associated with SVRF on one sides in the mesial root of a first right mandibular molar"

Fig 9

An angular resorption associated with SVRF on both sides in the mesial root of a first left mandibular molar"

Fig 10

Radiographs of longstanding SVRF with separation of the fragments"

Fig 11

Internal root resorption related to early-stage SVRF"

Fig 12

Internal root resorption with SVRF"

Fig 13

Changes of root and periradicular bone of molar with SVRF"

Fig 14

Periapical radiographs exposed from different horizontal angulations and different planes of CBCT scan of a right mandibular molar with SVRF"

Fig 15

Progressive bone destruction caused by delayed extraction of tooth with SVRF"

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