Longitudinal tooth fracture indicating a questionable prognosis for an endodontist

Abstract

Introduction and Objectives: Longitudinal fracture or vertical fracture of a tooth occurs at any level in the root and extends vertically. It has a high incidence of occurrence in the first molars. The most frequent sites to occur are the buccolingual surface and proximal surfaces of teeth. The etiology of fracture involves different factors in endodontically treated and non-endodontically treated teeth. Longitudinal fractures become the most challenging to diagnose and treat. This paper reviews these aspects of challenges and discusses the advantages and limitations of dental materials used for the treatment. Review Methods: PubMed and Google Scholar databases were searched for articles on longitudinal tooth fractures between 2007 and 2022. The 16 current articles were selected. Brief Description of the State of Knowledge: As per the review of the literature, longitudinal fracture of the tooth is the most common fracture to occur due to excessive forces on the root canal-treated tooth. This occurs in endodontically treated teeth due to long-term application of calcium hydroxide, cracks caused during root canal preparation extended by the pressure of root canal obturation, and in non-endodontically treated teeth due to cyclic and heavy masticatory stress, and habitual chewing of hard food especially in males. Summary: Functional and esthetic outcomes following longitudinal fracture treatment are important considerations in the case of anterior teeth. Longitudinal fracture or vertical fracture of a tooth occurs mostly in the first molars. It is crucial to identify and manage actors for good prognosis, as restoration at a time can reduce fracture extension prevent microleakage.