Vertical root fractures in curved roots under simulated clinical conditions

The purpose of this study was to determine the incidence of vertical root fractures in the mesial roots of extracted human mandibular molars that were endodontically prepared by hand or ultrasonic instrumentation and obturated with laterally condensed gutta-percha and sealer using finger and hand spreaders. One-hundred twenty mesiofacial canals were prepared by hand or ultrasonic instrumentation. After placing the teeth in a simulated alveolus, they were obturated by laterally condensing gutta-percha and sealer with B-finger or D11T hand spreaders. Teeth were obturated using forces in the range of 1 to 3 kg or 4.5 to 7.5 kg. Three teeth obturated with the D11T hand spreader using 7.0 to 7.3 kg of force demonstrated vertical root fractures. The results suggest that in vitro the range of forces reported as most commonly used by endodontists to laterally condense gutta-percha (1.0 to 3.0 kg) and those of a higher magnitude up to 4.9 kg are safe and will not result in vertical root fractures of mesial roots of mandibular molars.