A Clinical Study of Vertical Root Fracture after Canal Obturation

—The Development of Early Diagnosis and Protection for Root Fractures—

Abstract

 Introduction: The presence of a vertical root fracture (VRF) in an endodontically treated tooth has an immense impact on the treatment outcome. Early diagnosis of a VRF is imperative to avoid overtreatment and extensive bone loss. The purpose of this study was to develop a method for the early diagnosis and protection for VRF, by investigating the clinical symptoms of VRF in endodontically treated teeth.
 Methods: Four hundred fifty-nine endodontically treated teeth in 420 patients (27-84 years old) with clinical signs and symptoms suggestive of VRF teeth were included in the study after informed consent was obtained. The 459 VRF teeth were examined and evaluated based on the clinical findings of radiography, and the condition of the post and core. A final decision on VRF was made based on dental microscope findings and surgical inspection.
 Results: VRF teeth were observed most frequently in patients aged 50-59, and the mandibular molars were the most frequently fractured. All VRF teeth were found to have percussion pain, although 20% of VRF teeth had detected the effectiveness radiographs (perilateral radiolucency, “halo” radiolucency) with confirmed fractures. A dental microscope can provide valuable diagnostic information in the detection of VRFs. Eighty percent of VRF was within one fourth short post core teeth.
 Conclusion: Percussion response and dental radiographs in routine examination after endodontics were effective for the early diagnosis of VRF, and a dental microscope can be used to make the final decision. The results of this study showed that long post core teeth had higher fracture resistance than short post core teeth in endodontically treated teeth.