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Differentiating spontaneous vertical root fracture in endodontically treated tooth.
Myung-Jin Lim1, Jung-Ae Kim1, Yoorina Choi2
1Department of Conservative Dentistry, School of Dentistry, Chonbuk National University, Jeonju, Korea.
European Journal of Dentistry
|April 25, 2017
Summary
Vertical root fractures (VRF) can occur spontaneously, even in endodontically treated teeth. Identifying gutta-percha within the fracture line can help determine if the VRF predated endodontic treatment, avoiding iatrogenic claims.
Area of Science:
- Endodontics
- Dental Traumatology
Background:
- Vertical root fracture (VRF) is a common complication in endodontically treated teeth.
- Distinguishing spontaneous VRF from iatrogenic VRF is crucial for clinical and legal reasons.
Observation:
- A case of spontaneous VRF in a mandibular first molar, previously treated nonsurgically, is presented.
- The patient presented with localized swelling six months post-endodontic treatment.
Findings:
- Microscopic examination revealed gutta-percha within the fracture line of the mesial root.
- The presence of gutta-percha suggested it had penetrated the fracture line due to filling forces, indicating a spontaneous fracture prior to treatment.
Implications:
- This finding provides a method to differentiate spontaneous from iatrogenic VRF.
- Identifying gutta-percha in the fracture line can help dentists prove pre-existing fractures, potentially averting legal issues.
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