The Journal
Clinical Presentation
It varies depending upon factors like:
1.position of fracture
2.tooth type
3.time after fracture
4.periodontal condition of tooth
5.architecture of bone adjacent to
fracture
Sharp cracking sound or bleeding during
condensation of gutta percha are signs of
vertical root fracture.
Long history of variable discomfort or soreness
associated with local chronic infection with mild
to moderate pain. Acute pain is usually not
present. History of pain on biting accompanied
by bad taste can be present in some cases.
• vertical radiolucent line running across root or
root filling
• Change iin horizontal angulation can render
fracture undetectable.
• Radiographic appearance of vertical space
adjacent to root filling in an otherwise well
obturated canal
• Step like bone defects
• Widening of pdl space
• Unexplained bifurcation bone loss
• Isolated bone loss in posterior teeth
•Diffuse V shaped radiolucency widest at
crestal bone narrowing towards apex
• Separated root fragments
• Double images of external root surface
• J-SHAPED APICAL LESION
Clinical Signs and Symptoms:
• Sensitivity to vertical percussion (vp) and
digital palpation (dp).
• Broad based midroot swelling of soft tissue
with little swelling of periapical region.
Presence of sinus tract in or close to attached
gingiva rather than apical region.
• A deep, narrow and isolated periodontal
pocket. Pocket is usually present adjacent to
fracture site. Pattern of probing of pocket of
tooth is different from tooth with periodontal
disease. In periodontal disease pocket is
consistent in depth over large part of tooth.
Deep probing in one position around the
circumference of tooth in otherwise normal
attachment is indicative of fractured root.
• Repeated dislodgement of post or post crown
occurs in fractured roots.
Radiographically, signs vary depending on
angle of xray beam in relation to plane of
fracture and on the amount 0f degree of
separation of fragments
• periapical and lateral radiolucency is present
with a “halo” shape
10
3
1
16
5
At times the fracture line may be invisible and
can only be detected by a tooth sloth, a burlew
disk, transillumination test, disclosing dye,
surgical exploration, or by removal of an
existing restoration.
Vol. 13
12 No. 2
3
May-August
Sept-Dec 2016
May-August
2016
2017