Root Fracture Under a Crown

This was a case that was presented today

• Intermittent pain
• Sensitivity
• Resulting in Pain on Biting
• Swelling

So, what is a Root Fracture?

A root fracture under a crown is a dental condition where the root of a tooth, concealed beneath a dental crown, has suffered a crack or break. It can be a severe dental problem that requires prompt attention to prevent further damage and potential tooth loss. The symptoms of a root fracture under a crown may include:

1. Persistent pain: You may experience ongoing and localised pain in the affected tooth, even when not chewing or applying pressure.
2. Sensitivity: The tooth may become sensitive to hot or cold temperatures, and you might feel discomfort when eating or drinking something hot or cold.
3. Swelling and inflammation: The area around the affected tooth and gum might become swollen and tender. In the case today, that is how initially this presented
4. Discomfort when biting or chewing: The tooth might feel uncomfortable or painful when you bite or chew on food.
5. Mobility: In some cases, the tooth may become slightly loose due to the fracture, which can be detected when you move it with your tongue or finger.
6. Abscess formation: In severe cases, a root fracture can lead to an infection in the root canal, resulting in the formation of an abscess. This can cause throbbing pain and sometimes drainage of pus.

If you suspect a root fracture under a crown, you must visit a dentist as soon as possible for a proper diagnosis and treatment. The dentist will likely perform a thorough examination, including taking dental X-rays, to confirm the presence of a root fracture. In this case, we took X-rays.

Treatment: The appropriate treatment for a root fracture under a crown depends on the extent and location of the fracture. Here are some potential treatment options:

1. Root Canal Treatment: If the fracture has affected the tooth’s inner pulp and caused infection or inflammation, a root canal treatment may be necessary. During this procedure, the dentist will remove the damaged pulp, clean the root canal, and seal it to prevent further infection. In this case, the tooth was root-treated, and hence extraction was the only option
2. Crown Replacement: In some cases, the existing crown may need to be removed to assess the damage fully. If the crown is damaged, it will be replaced with a new one after the root canal treatment or other necessary procedures.
3. Surgical Intervention: Surgical treatment might be necessary if the fracture is severe and extends below the gum line. The dentist may attempt to stabilise the tooth or remove the fractured portion of the root.
4. Tooth Extraction: In cases where the root fracture is extensive, irreparable, or causing severe pain, tooth extraction might be the only option. After extraction, the dentist may discuss tooth replacement options, such as dental implants, bridges, or partial dentures.

It’s essential to promptly address a root fracture under a crown to avoid complications and preserve the tooth if possible.

Sometimes like in this case, extraction is the only option and fracture is just one of those things.

Regular dental check-ups and good oral hygiene can help detect such issues early on and prevent their progression, but in some cases, if the tooth is brittle, receives trauma – fracture happens.

If you experience any symptoms or suspect a root fracture, contact your dentist immediately for a proper evaluation and personalised treatment plan.