A vertical root fracture is a condition where the root of a tooth cracks or splits vertically down the middle of the tooth, from top to bottom. It usually occurs years later due to chewing stress in teeth that have undergone excessive vertical compression during root canal treatment or in teeth where very thick, rigid metal posts have been placed. It is clinically difficult to diagnose because it progresses insidiously; however, a periodontal examination reveals a deep periodontal pocket (narrow pocket) at only one point along the fracture line, and X-rays show a typical “J-shaped” shadow of bone loss around the root. Vertical root fractures are virtually impossible to save because the inside of the fracture crack becomes instantly contaminated with billions of bacteria in the oral environment, and it is medically impossible to disinfect this space or chemically bond the two fractured pieces together in the bone. The only solution is extraction of the tooth.
