A Root fracture is defined as fractures that involve the dentin, cementum, and pulp. These fractures of the root are clinically challenging and are considered to be emergencies in the dental hospital.
Among all tooth-related fractures crown fractures, crown root fractures and root fractures are the third most common cause of tooth loss.
Know the layers of the teeth
In tooth, there are layers that many are not aware of. Underneath the enamel is the dentin, which is the second layer of the tooth and it contains the dental pulp. This dental pulp is the center of the tooth and contains the nerves and blood vessels. When any damage occurs and affects these layers it will cause severe pain. Any injury or broken teeth is left untreated it can lead to catastrophic results. A general dentist can help you in preventing infection and keep teeth healthy but, there are certain types of problems that only a specialist can treat. An endodontist is a specialist who can treat various types of infections, cracks, chips, breaks, injuries or fractures.
Types of Tooth fractures
When a tooth fracture happens, it can jeopardize the entire tooth and the surrounding teeth can cause infection. The fracture may cause damage to the enamel which protects the teeth against infection. The various types of fractures are
• Oblique supragingival fracture
• Oblique subgingival fracture
• Oblique root fracture
• Vertical furcation fracture
• Vertical apical root fracture
• Vertical root fracture
Causes of root fractures
In non-endodontically treated teeth, the fractures are caused due to diet patterns or chewing habits. Physical trauma is the most common cause of tooth fracture in vital teeth.
Treatment for root fractures
The objective of the treatment is to reposition and stabilize the coronal fragment at the earliest in its anatomically correct position to optimize healing of the neurovascular supply and periodontal ligament and maintain esthetic and functional integrity.
Primary teeth- the treatment depends on the stability of the coronal fragment of the injured tooth. If the patient’s tooth is stable and not causing any discomfort, the dentist will keep monitoring the tooth by clinical and radiographic examination after the trauma. The observation will be continued until the permanent tooth erupts.
If the tooth is moving and causing discomfort then the coronal fragment should be extracted. If the apical is difficult to retrieve then it should be left and so that it will not disturb the developing permanent tooth.
Permanent teeth- if the coronal fragment is stable and not moving then treatment is not required. If it is mobile then reposition and stabilize the fragment with rigid splinting of composite resin and wire or orthodontic appliances for four weeks. If splinting is unsuccessful, then the coronal fragment is extracted and endodontic therapy is performed on the apical fragment. For subgingival root fracture, the treatment options are gingivectomy, orthodontic extrusion or surgical extrusion.
Vertical root fractures are identified when the surrounding bone and gum are infected. The treatment for this will be the extraction of the tooth. Endodontic surgery may be suitable if the tooth can be saved by removing the fractured portion.
How does a fractured tooth root feel?
It will cause pain while eating, chewing or biting. The gums will be swollen around the cracked tooth. Teeth will be sensitive towards sweet, hot, or cold foods.