The relationship of root canal enlargement to finger-spreader induced vertical root fracture

A vertical root fracture (VRF) is a complex complication that usually leads to tooth extraction. The aim of this article is to review the prevalence, demography, distribution, diagnostic methods, etiology and predisposing factors, clinical features, radiographic characteristics and treatment strategies of VRFs in non-endodontically treated teeth (VRFNETT) and endodontically treated teeth (VRFETT). Search terms for each subject related to VRFNETT and VRFETT were entered into MEDLINE, PubMed and Google Scholar. Systematic reviews, retrospective cohort studies, demographic research, clinical studies, case reports and case series were reviewed. Most of the VRFs were found in patients older than 40 years old. Older populations were discovered in the non-endodontically treated VRF group when compared to the endodontically treated VRF group. Male patients were found at a greater prevalence than females in the non-endodontically treated VRF group. The initial occurrence of a VRF may accompany radiolucent lines within the root canal, unusual space between the canal wall and intracanal material, a widening of the PDL space along the periradicular surfaces, angular bony destruction, step-like bone defects, V-shaped diffuse bone defects, or root resorptions corresponding to the fracture line before the clear separation of the fractured fragment. The indicative clinical and radiographic signs of VRF included a coronally positioned sinus tract, deep-narrow periodontal defects, the displacement of a fractured fragment, periradicular radiolucent halos and the widening of the root canal space. Interestingly, VRFNETT are more often observed in the Chinese population. Some patients with multiple VRFs were observed, suggesting possible predisposing factors in genetics and tooth development. The management of a VRF usually involves a multidisciplinary approach. The common distribution and features of VRFNETT and VRFETT were elucidated to facilitate recognition and diagnosis. Besides extraction, variable therapeutic schemes, such as the repair of the VRF, root amputation and others reported in earlier literature, are available. A long-term prognosis study of the various therapeutic strategies is needed.

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The relationship of the root canal sealer to the dentine wall.

International Endodontic Journal ◽

10.1111/j.1365-2591.1976.tb01244.x ◽

1976 ◽

Vol 9 (2) ◽

pp. 81-86 ◽

Cited By ~ 14

Author(s):

A. ABRAMOVICH ◽

F. GOLDBHRG

Keyword(s):

Root Canal ◽

Root Canal Sealer ◽

Relationship Of ◽

The Relationship

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Effects of Root Canal Sealers on Vertical Root Fracture Resistance of Endodontically Treated Teeth

Journal of Endodontics ◽

10.1097/00004770-200203000-00018 ◽

2002 ◽

Vol 28 (3) ◽

pp. 217-219 ◽

Cited By ~ 34

Author(s):

V LERTCHIRAKARN ◽

A TIMYAM ◽

H MESSER

Keyword(s):

Root Canal ◽

Fracture Resistance ◽

Endodontically Treated Teeth ◽

Root Fracture ◽

Vertical Root Fracture ◽

Root Fracture Resistance ◽

Root Canal Sealers

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Effect of Super-Bond C&B and self-adhesive dual-cured resin cement on the fracture resistance of roots with vertical root fracture

Journal of Dental Research Dental Clinics Dental Prospects ◽

10.15171/joddd.2019.024 ◽

2019 ◽

Vol 13 (2) ◽

pp. 153-157

Author(s):

Ezgi Doğanay Yıldız ◽

Hakan Arslan ◽

Nilay Ayaz ◽

Mustafa Gündoğdu ◽

Alper Özdoğan ◽

...

Keyword(s):

Root Canal ◽

Fracture Resistance ◽

Resin Cement ◽

Control Group ◽

Human Teeth ◽

Root Fracture ◽

Vertical Root Fracture ◽

Root Canals ◽

Chi Squared ◽

Post Hoc

Background. Vertical root fracture might occur during root canal preparation, obturation, post procedures or endodontic treatment. Methods. Fifty-four single-rooted human teeth were decoronated to obtain a standardized length. The root canals were enlarged up to #50 and obturated with gutta-percha and root canal sealer. Eighteen teeth were used as a control group, and vertical root fracture was induced in the remaining teeth. The samples were randomly divided into three groups, as follows: control group (without vertical root fracture), Super-Bond C&B group (fragments were attached with Super-Bond C&B), and self-adhesive dual-cured resin cement group (fragments were attached with self-adhesive dual-cured resin cement). Each specimen was subjected to a fracture resistance test, and data were statistically analyzed using chi-squared test, one-way ANOVA and post hoc Tukey tests (P=0.05). Results. The fracture resistance values of the control and Super-Bond C&B groups were higher than those of the self-adhesive dual-cured resin cement group (P<0.05). However, there were no significant differences between the control and Super-Bond C&B groups (P>0.05). Conclusion. Within the limitations of the present study, Super-Bond C&B was beneficial in obtaining higher fracture resistance in endodontically treated roots with vertical root fracture.

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Impact of apical extent of root canal filling on vertical root fracture: a case–control study

International Endodontic Journal ◽

10.1111/iej.13134 ◽

2019 ◽

Vol 52 (9) ◽

pp. 1283-1289 ◽

Cited By ~ 1

Author(s):

A. R. PradeepKumar ◽

H. Shemesh ◽

C. van Loveren ◽

S. JothiLatha ◽

F. Shireen ◽

...

Keyword(s):

Root Canal ◽

Case Control Study ◽

Case Control ◽

Root Canal Filling ◽

Root Fracture ◽

Vertical Root Fracture ◽

Control Study

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Pathognomonic Combination of Clinical Signs for Diagnosis of Vertical Root Fracture: Systematic Review of the Literature

Applied Sciences ◽

10.3390/app112210893 ◽

2021 ◽

Vol 11 (22) ◽

pp. 10893

Author(s):

Tomer Goldberger ◽

Eyal Rosen ◽

Nuphar Blau-Venezia ◽

Aviad Tamse ◽

Dan Littner

Keyword(s):

Systematic Review ◽

Root Canal ◽

Clinical Symptoms ◽

Clinical Signs ◽

Sinus Tract ◽

Reference Standard ◽

Review Of The Literature ◽

Endodontically Treated Teeth ◽

Root Fracture ◽

Vertical Root Fracture

Introduction: Vertical root fracture (VRF) is a root-canal treatment complication and is a major reason for extraction of the root-canal-treated teeth. The diagnosis of VRF can be complicated because of absence of specific signs, symptoms, and radiographic features. A combination that includes the presence of deep pocket and a sinus tract in root-canal-treated tooth was proposed as a pathognomonic for VRF. The purpose of this study was to systematically search and evaluate the literature regarding the correlation between the clinical signs considered pathognomonic for the diagnosis of VRF, with the actual reference standard by means of systematic review of the literature. Methods: A systematic search of the literature was performed to identify studies evaluating the clinical signs considered pathognomonic for the diagnosis of VRF. The following databases were searched: Medline (PubMed), Scopus, and Cochrane Central. The identified studies were subjected to strict inclusion and exclusion criteria. Results: Initially, 1141 possible relevant articles were identified. After title and abstract screening, 40 articles were subjected to a full-text evaluation, 3 articles met the inclusion criteria and contained data regarding the prevalence of the pathognomonic combination in VRF’s-confirmed teeth. The presence of deep pocket and a sinus tract in endodontically treated teeth was found in 28% of the cases. Conclusion: To date, the current scientific knowledge regarding the correlation between the clinical symptoms considered pathognomonic for VRF diagnosis in the root-canal-treated tooth and the actual reference standard is quite low.

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Effects of root canal preparation, various filling techniques and retreatment after filling on vertical root fracture and crack formation

Dental Traumatology ◽

10.1111/edt.12154 ◽

2014 ◽

Vol 31 (4) ◽

pp. 302-307 ◽

Cited By ~ 21

Author(s):

Ismail Davut Capar ◽

Gokhan Saygili ◽

Hazal Ergun ◽

Tuba Gok ◽

Hakan Arslan ◽

...

Keyword(s):

Root Canal ◽

Crack Formation ◽

Root Canal Preparation ◽

Root Fracture ◽

Vertical Root Fracture

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Influence of Root Canal Sealers and Obturation Techniques on Vertical Root Fracture Resistance. An In Vitro Experiment

Applied Sciences ◽

10.3390/app11178022 ◽

2021 ◽

Vol 11 (17) ◽

pp. 8022

Author(s):

Mazen F. Alkahtany ◽

Khalid H. Almadi ◽

Fahad A. Alahmad ◽

Abdullah M. Alshehri ◽

Abdulrahman A. AlSwayyed ◽

...

Keyword(s):

Fracture Strength ◽

Root Canal ◽

Fracture Resistance ◽

Positive Control ◽

Negative Control ◽

Root Fracture ◽

Vertical Root Fracture ◽

Single Cone ◽

Ah Plus ◽

Root Fracture Resistance

The aim of the present study was to determine the vertical root fracture (VRF) resistance of roots obturated with TotalFill BC Sealer and AH Plus sealer using lateral condensation and single cone techniques in comparison to untreated controls. Sixty single rooted mandibular premolars were sectioned and divided into six groups. Ten teeth were left untreated (positive control-Gp 1) and fifty teeth were cleaned and shaped. Ten root specimens were left unfilled (negative control-Gp 2) and the remaining roots were divided into 4 groups. Gp 3, GP and AH Plus sealer (AH Plus) using the cold lateral compaction (LC) technique; Gp 4, GP and AH Plus using the Single Cone (SC) technique; Gp 5: TotalFill GP and TotalFill BC sealer using the LC technique; Gp 6: TotalFill GP and TotalFill BC sealer with SC. VRF was performed for all specimens using a universal testing machine. Analysis of variance (ANOVA) and Tukeys post-hoc multiple comparison test was used to compare the means among tested study groups. Group 1 (positive control) displayed the highest fracture resistance (946.61 ± 166.465 N); however, the lowest fracture strength was demonstrated by the specimens in group 2 (negative control) (433.31 ± 129.350 N). Specimens treated with AH plus using different obturation techniques (group 3 and 4) showed comparable outcomes (p > 0.05). Similarly, specimens treated with TotalFill BC sealer with different obturation techniques showed statistically similar outcomes (p > 0.05). It was also observed that specimens in groups 3, 4, 5 and 6 demonstrated comparable outcomes of fracture strength (p > 0.05). The use of TotalFill-BC sealer showed similar vertical root fracture resistance as AH plus sealer in root canal treated teeth. Use of total fill-BC and AH Plus sealer in root canal treatment showed vertical root fracture resistance comparable to untreated natural teeth (positive controls).

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