Vertical root fracture (VRF) in molars is a complex and frequently encountered dental condition. Successful management relies on accurate diagnosis, sequential treatment strategies, and systematic care. This paper provides a comprehensive review of the sequential therapeutic approaches and systematic management models for molar VRF over the past five years. Particular attention is given to the diagnostic value of cone-beam computed tomography (CBCT), recent advances in tooth-preserving techniques, and the establishment of full-course management frameworks. By constructing an integrated pathway encompassing diagnostic assessment, treatment decision-making, clinical intervention, and long-term maintenance, a "dentist–nurse–patient community" model is proposed to promote standardized clinical guidance. This collaborative model aims to extend the lifespan of affected teeth and restore optimal masticatory function.