These are diagnostically, the most complicated of all endodontic issues. Diagnosis of vertical root fractures (fracture lines that extend along the vertical axis of the tooth) is accomplished best by combining information of X-Rays, 3D scans, pain history, and evaluating the pattern of bone damage. Often VRFs are misdiagnosed as being present or being absent when in fact the opposite is true. At times, suspicion of a fracture is a reason that teeth get unwarranted extractions. Often a retreatment of the root canal could have saved the tooth. It is important to have confidence in the diagnosis of this type of situation.
A diagnosis of vertical root fractures is more of an art than it is a science.
Contrary to popular opinion, dentists typically cannot see fractures on an x-ray and/or scan because they are too small to notice. In addition, the direction and extent of the fracture may be obscured by the filing material, crown, or post that is in the tooth. Misdiagnosis of a vertical root fracture can result in the extraction of a tooth that could have been saved with root canal retreatment or surgery. Alternatively, failure to diagnose a VRF, may result in unnecessary dental procedures. You should have confidence in your endodontists knowledge, technology and ability to accurately diagnose the presence or absence of these types of fractures.