The diagnostic challenge of vertical root fracture in endodontically treated teeth: a case report

purpose: to present the diagnostic challenge of a clinical case of vertical root fracture (vrf) in an endodontically treated mandibular left lateral incisor and discuss the diagnostic methods employed to achieve the conclusive diagnosis. case description: at 16 months after endodontic treatment, a 60-year-old female patient reported pain during mastication. clinically, she presented with an active distolingual fistula and a probing depth of 9 mm on the distal aspect of tooth 32. a radiographic examination indicated pear-shaped distal bone loss. the fistula was mapped, which confirmed that the lesion had a periodontal origin. a diagnostic hypothesis of a vrf was established. exploratory surgery revealed the vrf on the distolingual aspect of the root without separation of the root fragments. conclusion: knowledge of the diagnostic aspects and the correct interpretation of radiographic images was enough to establish the diagnostic hypothesis of a vrf. however, the conclusive diagnosis was only confirmed during exploratory surgery.