Salvaging Endodontically Treated Teeth with Bilateral Bone Loss and Vertical Root Fractures: A Case Report

Vertical root fractures (VRFs) are cracks in the roots of mostly endodontically treated teeth in the apico-coronal direction with simultaneous periodontal breakdown. VRFs are clinically challenging conditions that need a lot of expertise to diagnose and treat. Their clinical resemblance to endodontic failures or localised periodontal lesions makes the management even more difficult. This case report presents the management of an unusual case of bilateral VRF in a 50-year-old male patient who presented to us with localised swelling and dull, mild intermittent pain in the right and left lower back tooth region for 1 month and treatment with surgical debridement of the involved teeth with regenerative therapy. During the surgical procedure, VRFs were noticed in both the lower first molars and were treated appropriately. The patient was recalled every 6 months for the assessment of the outcome of the surgical procedure. After 18 months, there was a considerable bone fill and reduction in the probing pocket depth for both molars. The results suggested that meticulous treatment planning and execution can salvage the teeth with VRF that otherwise would have to be extracted.