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

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.

scholarly journals Vertical Root Fracture in Non-Endodontically and Endodontically Treated Teeth: Current Understanding and Future Challenge

2021 ◽  
Vol 11 (12) ◽  
pp. 1375
Author(s):  
Wan-Chuen Liao ◽  
Chi-Hung Chen ◽  
Yu-Hwa Pan ◽  
Mei-Chi Chang ◽  
Jiiang-Huei Jeng
Keyword(s):  
Root Canal ◽  
Case Reports ◽  
Case Series ◽  
Bone Defects ◽  
Predisposing Factors ◽  
Diagnostic Methods ◽  
Endodontically Treated Teeth ◽  
Root Fracture ◽  
Vertical Root Fracture ◽  
Bony Destruction

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.

Implant-associated Vertical Root Fracture in Adjacent Endodontically Treated Teeth: A Case Series and Systematic Review

2016 ◽  
Vol 42 (6) ◽  
pp. 948-952 ◽  
Author(s):  
Eyal Rosen ◽  
Ilan Beitlitum ◽  
Aviad Tamse ◽  
Silvio Taschieri ◽  
Igor Tsesis
Keyword(s):  
Systematic Review ◽  
Case Series ◽  
Endodontically Treated Teeth ◽  
Root Fracture ◽  
Vertical Root Fracture

DOUBLE SEAL TECHNIQUE IN THE MANAGEMENT OF VERTICAL ROOT FRACTURE

2021 ◽  
pp. 14-15
Author(s):  
Sindhuja Panthangi ◽  
Harikumar Vemisetty ◽  
Jayaprada Reddy ◽  
Jaya Nagendra Krishna ◽  
Rajani Rajani ◽  
...  
Keyword(s):  
Treatment Option ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Endodontically Treated Teeth ◽  
Root Fracture ◽  
Vertical Root Fracture ◽  
Alternative Treatment Option ◽  
Clinical Signs And Symptoms ◽  
One Year ◽  
Type Of Fracture

Vertical root fracture (VRF) is one of the common etiologies for tooth loss . The usual treatment option for this clinical scenario is extraction. The incidence of this type of fracture is higher in an endodontically treated teeth compared to a non endodontically treated tooth. As this type of fracture usually does not present with any specic clinical signs and symptoms , it is usually difcult to diagnose and depends on the endodontist's expertise . The aim of this case report is to suggest an alternative treatment option in conserving the tooth with vertical root fracture of a tooth that did not undergo any root canal treatment by using novel calcium silicate based cement and reinforcement with owable composite with a successful one year follow up.

scholarly journals A Comparative Evaluation of the Vertical Root Fracture Resistance of Endodontically Treated Teeth using Different Root Canal Sealers: An in vitro Study

2012 ◽  
Vol 13 (3) ◽  
pp. 351-355 ◽  
Author(s):  
MB Prashanth ◽  
Pradeep N Tavane ◽  
BM Annapoorna ◽  
NT Prashanth ◽  
BS Deepak ◽  
...  
Keyword(s):  
Root Canal ◽  
Fracture Resistance ◽  
Negative Control ◽  
Endodontically Treated Teeth ◽  
Root Fracture ◽  
Vertical Root Fracture ◽  
Gutta Percha ◽  
Root Fracture Resistance ◽  
Experimental Group

ABSTRACT Objective The objective of this study is to evaluate the vertical root fracture resistance of endodontically treated teeth obturated with – Tubli-Seal EWT/Gutta-percha, AH Plus/Gutta-percha, Epiphany SE sealer/Epiphany point. Study design Sixty-five single rooted premolars were decoronated and root length was 14 mm for each specimen. Fifty five teeth were enlarged up to ISO size 40 master apical file with stainless steel K-files using standardized preparation and remaining ten teeth were served as negative control. Then teeth were randomly assigned into different groups depending on sealer used for obturation as follows: Group 1 Negative control—no instrumentation was performed. Group 2 Positive control—gutta-percha with out the use of any sealer. Group 3 Experimental group—gutta-percha and Tubli-Seal EWT root canal sealer. Group 4 Experimental group—gutta-percha and AH Plus. Group 5 Experimental group—epiphany SE sealer and epiphany points. After 72 hours, the specimens were embedded in autopolymerizing resin leaving 7 mm of each root exposed and were subjected to fracture testing under universal testing machine at a crosshead speed of 1.0 mm per minute until the root fractured. Results were statistically analyzed using one-way ANOVA and independent t-test. Results Showed that Epiphany SE sealer/Epiphany points showed highest mean fracture resistance and Tubli-Seal EWT group showed the least fracture resistance of all the materials tested. There was no statistically significant difference among experimental groups. Conclusion Epiphany SE sealer/Epiphany points demonstrated highest fracture resistance values than the other materials tested and intact tooth had highest resistance against vertical root fracture. Clinical significance Epiphany SE sealer/Epiphany points may be one of the materials of choice in the endodontic treatment of teeth. How to cite this article Nagpal A, Annapoorna BM, Prashanth MB, Prashanth NT, Singla M, Deepak BS, Singh A, Tavane PN. A Comparative Evaluation of the Vertical Root Fracture Resistance of Endodontically Treated Teeth using Different Root Canal Sealers: An in vitro Study. J Contemp Dent Pract 2012;13(3):351-355.

scholarly journals Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Stefano Granieri ◽  
Francesco Sessa ◽  
Alessandro Bonomi ◽  
Sissi Paleino ◽  
Federica Bruno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Symptoms ◽  
Rare Complication ◽  
Meta Analysis ◽  
Treatment Options ◽  
Palliative Surgery ◽  
Review Of The Literature ◽  
Colovesical Fistula ◽  
Level Of Evidence ◽  
Meta Analyses

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).

Resistance to vertical root fracture of apicoected teeth using different devices during two root canal irrigation procedures

2018 ◽  
Vol 33 (8) ◽  
pp. 1685-1691 ◽  
Author(s):  
Ferhat Ayrancı ◽  
Leyla Benan Ayrancı ◽  
Alper Özdoğan ◽  
Serkan Özkan ◽  
Mutlunur Önder Peker ◽  
...  
Keyword(s):  
Root Canal ◽  
Root Fracture ◽  
Canal Irrigation ◽  
Vertical Root Fracture ◽  
Root Canal Irrigation

scholarly journals Differentiating spontaneous vertical root fracture in endodontically treated tooth

2017 ◽  
Vol 11 (01) ◽  
pp. 122-125 ◽  
Author(s):  
Myung-Jin Lim ◽  
Jung-Ae Kim ◽  
Yoorina Choi ◽  
Chan-Ui Hong ◽  
Kyung-San Min
Keyword(s):  
Endodontic Treatment ◽  
Fracture Line ◽  
Endodontically Treated Teeth ◽  
Root Fracture ◽  
Vertical Root Fracture ◽  
Gutta Percha ◽  
Endodontically Treated Tooth ◽  
Mandibular First Molar ◽  
Irreversible Pulpitis ◽  
Time Point

ABSTRACTAlthough vertical root fracture (VRF) is mostly found in endodontically treated teeth, it also occurs spontaneously. If VRF is recognized after endodontic treatment, it is considered to be iatrogenic and can lead to legal trouble. However, legal problems can be averted if the dentist can prove that the VRF existed before endodontic treatment. This case report describes an unusual, spontaneous VRF in an endodontically treated tooth and presents a useful tip for determining whether a fracture is iatrogenic. We performed nonsurgical endodontic treatment on a mandibular first molar with irreversible pulpitis. After 6 months, the patient revisited with localized swelling, and we diagnosed VRF of the mesial root. We extracted the tooth and prepared it for microscopic examination. We found gutta-percha in the fracture line of the transversely sectioned root, and it appeared to have penetrated to the fracture line through the force generated from the filling. The patient was informed and agreed that the fracture occurred spontaneously before treatment. This case demonstrates the time point of VRF occurrence by identifying the presence of gutta-percha in the fracture line. We suggest that this procedure can be used to demonstrate whether VRFs in endodontically treated teeth are spontaneous or iatrogenic.

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