Categorization of Dental Fractures


Categorization of dental fractures should take into account the origin, the location, and the direction of fracture progression. Identifying the fracture category will influence the selection of treatment options. The type of fracture category to be covered in this book will be that primarily occurring in endodontically treated teeth; the fracture is of a chronic nature and characterized as having a vertical direction over time and identified as vertical root fracture (VRF). The other two fracture types—crown-originating fractures (COFs) and trauma-related fractures—will be briefly described in this chapter to differentiate them from VRFs.


  1. 1.
    Solomon L, Warwick D, Nayagam D. Apley’s concise system of orthopaedics and fractures. 3rd ed. London: Hodder & Arnold; 2005. p. 687.Google Scholar
  2. 2.
    Andreasen FM, Andreasen JO. Crown fractures. In: Andreasen JO, Andreasen FM, Andersson L, editors. Textbook and color atlas of traumatic injuries to the teeth. 4th ed. Oxford: Blackwell; 2007. p. 280–313.Google Scholar
  3. 3.
    Colleague for Excellence. Cracking the crack tooth code. Detection and treatment of various longitudinal tooth fractures. Chicago: American Association of Endodontists; 2008.Google Scholar
  4. 4.
    Andreasen JO. Traumatic injuries of the teeth. 2nd ed. Copenhagen: Denmark Munksgaard; 1981.Google Scholar
  5. 5.
    Rivera EM, Walton RE. Longitudinal tooth fractures: findings that contribute to complex endodontic diagnosis. Endod Top. 2009;16:82–111.CrossRefGoogle Scholar
  6. 6.
    Brynjulfsen A, Fristad I, Grevstad T, Hals-Kvinsland I. Incompletely fractured teeth associated with diffuse longstanding orofacial pain: diagnosis and treatment outcome. Int Endod J. 2002;35:461–6.CrossRefPubMedGoogle Scholar
  7. 7.
    Bakland LK. Tooth infractions. In: Ingle JI, Bakland LK, Baumgartner J, editors. Ingle’s endodontics. 6th ed. Hamilton: BC Decker Inc.; 2008. p. 660–75.Google Scholar
  8. 8.
    Berman LH, Kuttler S. Fracture necrosis : diagnosis, prognosis assessment, and treatment recommendations. J Endod. 2010;36(3):442–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Vered M, Tamse A, Tsesis I, Rosen E. Zebra Hunt: clinical reasoning and misdiagnosis. In: Tsesis I, editor. Complications in endodontic surgery prevention, identification and management. Heidelberg: Springer; 2014.Google Scholar
  10. 10.
    Taschieri S, Tamse A, Del Fabbro M, Rosano G, Tsesis I. A new surgical technique for the preservation of endodontically treated teeth with coronally located vertical root fractures: a prospective case series. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110:45–52.CrossRefGoogle Scholar
  11. 11.
    Chen CP, Lin CP, Tseng SC, Jeng JH. Vertical root fractures in endodontically treated teeth versus non- endodontically treated teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;87:504–7.CrossRefGoogle Scholar
  12. 12.
    Fuss Z, Lustig J, Katz A, Tamse A. An evaluation of endodontically treated vertically fractured roots: impact of operative procedures. J Endod. 2001;1:46–8.CrossRefGoogle Scholar
  13. 13.
    Fuss Z, Lustig J, Tamse A. Prevalence of vertical root fractures in extracted endodontically treated teeth. Int Endod J. 1999;32:283–6.CrossRefPubMedGoogle Scholar
  14. 14.
    Tsesis I, Rosen E, Tamse A, Taschieri S, Kfir A. Diagnosis of vertical root fractures in endodontically treated teeth base on clinical and radiographic indices: a systematic review. J Endod. 2010;36(9):1455–8.CrossRefPubMedGoogle Scholar
  15. 15.
    Seo DG, Young AY, Su JS, Jeong WP. Analysis of factors associated with cracked teeth. J Endod. 2012;38:288–92.CrossRefPubMedGoogle Scholar
  16. 16.
    Tamse A. Vertical root fractures of endodontically treated teeth. In: Ingle JI, Bakland LK, Baumgartner J, editors. Ingle’s endodontics. 6th ed. Hamilton: BC Decker Inc; 2008. p. 676–89.Google Scholar
  17. 17.
    Tamse A, Fuss Z, Lustig J, Kaplavi J. An evaluation of endodontically treated vertically fractured teeth. J Endod. 1999;25:506–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Gher ME, Dunlap RM, Anderson MH, Huhl LV. Clinical survey of fractured teeth. J Am Dent Assoc. 1987;117:174–7.CrossRefGoogle Scholar
  19. 19.
    Chai H, Tamse A. Fracture mechanics analysis of vertical root fracture from condensation of gutta-percha. J Biomech. 2012;45(9):1673–8.CrossRefPubMedGoogle Scholar
  20. 20.
    Karygianni L, Krengel M, Winter M, Stampf S, Wrbas KT. Comparative assessment of the incidence of vertical root fractures between conventional versus surgical endodontic treatment. Clin Oral Investig. 2014;18(8):2015–21.CrossRefPubMedGoogle Scholar
  21. 21.
    DiAngelis AJ, et al. International Association of Dental Traumatology guidelines for the management of traumatic dental injuries: 1. Fractures and luxations of permanent teeth. Dent Traumatol. 2012;28:2–12.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.School of DentistryLoma Linda UniversityLoma LindaUSA
  2. 2.Department of EndodontologySchool of Dental MedicineTel AvivIsrael

Personalised recommendations