An evaluation of endodontically treated vertical root fractured teeth: Impact of operative procedures

Vertical root fractures of endodontically treated teeth are a frustrating c omplication that leads to extraction. The aim of the current survey was to evaluate the role of operative procedures in the etiology of this complicat ion. A total of 154 endodontically treated vertical root fractured teeth we re cleaned and washed after extraction and maintained in individual vials. Periapical radiographs before extraction, clinical findings and previous op erative procedures were recorded. A post was observed in 95 teeth (61.7%), with 66 of these ending at the coronal third of the root. Most were screw p osts of the Dentatus type (n = 64) and tapered cast posts (n = 14), A full crown was observed in 118 teeth, and 65 of these (55%) were extracted betwe en 1 to 5 yr after final restoration. In 24 crowned teeth extraction was co nducted within 1 yr after restoration and in 28 teeth after >5 years. It wa s concluded that post placement and root canal treatment are the major etio logical factors for root fractures. Because signs and symptoms can appear y ears after the operative procedures in the root have been completed, corona l restorations would not interfere with the correct clinical diagnosis of v ertical root fractures. Frequent recalls are recommended to diagnose vertic al root fractures early, especially in susceptible teeth, such as premolars and mesial roots of mandibular molars.