Treatment Alternatives for the Preservation of Vertically Root Fractured Teeth

When a vertical root fracture (VRF) is diagnosed in an endodontically treated tooth, in most cases, extraction of the VRF tooth or root is still the treatment of choice. However, in certain cases, modern endodontics provides new treatment alternatives to treat and maintain some VRF teeth. The dilemma of whether to extract a VRF tooth and replace it with an implant or to adopt a more conservative treatment planning of an additional endodontic treatment aimed to preserve the natural tooth is complex and requires a multifactorial clinical decision- making process. This process should encapsulate endodontic, prosthetic, periodontal, and esthetic considerations as well as take into account patient values. Treatment options for VRF teeth vary from a simple root amputation in multirooted teeth to a complex surgical management in order to retain a fractured tooth.