Vertical root fractures and their management

Vertical root fracture is a longitudinal crack of the tooth root, most commonly seen in endodontically treated teeth. It usually results from excessive obturation forces, post placement, or loss of dentin during root canal procedures. Clinically, it presents with pain on biting, isolated deep periodontal pockets, and recurrent sinus tracts, often mimicking periodontal or endodontic failure. Radiographic signs such as J-shaped radiolucency are suggestive but not always evident; CBCT aids diagnosis, though definitive confirmation may require surgical exploration. The prognosis is generally poor, and extraction is the treatment of choice in single-rooted teeth, while root resection or hemisection may be considered in multi-rooted teeth. Early diagnosis and preventive endodontic techniques are key to reducing incidence and improving outcomes.