The detection and treatment of vertical root fractures.

The early detection of vertical root fractures can be difficult and treatment frequently hopeless. Texts suggest several treatment modalities, ranging from extraclion to hemisection and radisectomy in multirooted teeth. The subject is particularly well documented in articles by Bender and Freedland (1), Bouchan et al. (2), and Mori and lijima (3). Pitts and Natkin (4) have also studied the problems of diagnosis and treatment Of vertical root fractures. Their findings are similar to those of the other authors. The histopathogenesis of vertical root fractures is documented by Walton et al. (5). They concluded that Invading microorganisms and tissue breakdown prodlets cause the destruction of the supporting structures. Pitts et al. (6) have studied the forces required to cause vertical root fractures. They concluded that roots can be split during obturation with lateral condensation of gutta-percha. The first article to indicate that the potential may exist encouraging the natural healing of these fractures was presented by me in 1975 (7). After considering some factors that can produce vertical root fractures, this article will focus primarily upon the more positive approaches of treating and restoring these teeth to health and normal function.