Which radiographic technique best demonstrates a suspected horizontal root fracture?

Correct answer: B. Several periapical films taken at differing vertical angulations

• A. A panoramic film lacks the resolution and has too much superimposition and distortion in the anterior region to reveal a fine fracture line.
• B. CORRECT. A horizontal root fracture is visible only when the X-ray beam passes nearly PARALLEL to the fracture plane. A beam even 15–20° off will project the two fragments superimposed and the fracture will be invisible. Taking MULTIPLE periapicals at different VERTICAL angulations — typically 0°, +15° and −15° — greatly increases the chance of catching the plane.
• C. An occlusal film is a useful ADJUNCT, particularly for anterior teeth, but on its own it does not provide the range of angulations needed.
• D. Bitewings image the crowns and crestal bone; the apical two-thirds of the root are not included at all.

Note: CBCT is the definitive investigation when the diagnosis remains uncertain, though a small field of view should be selected to limit dose — especially in children.