Vertical Root Fractures

Abstract

In his February JADA article, Dr. Richard E. Walton presented an elucidating article titled “Vertical Root Fracture: Factors Related to Identification” about vertical root fractures (VRF) (JADA. 2017;148[2]:100-105). However, throughout the article, the author equated VRF with past endodontic treatment often enough to imply that root canal therapy causes root fractures. Stating that “The VRF is invariably associated with endodontic therapy …,” “All VRFs [studied] had received endodontic therapy …,” and “… all VRF roots had a history of endodontic treatment,” add up to a good example of the expression “correlation does not imply causation.” As such, it is certainly possible that most of the teeth included in this study were in need of root canal therapy because of a fractured root. Vertical root fracture: Factors related to identificationThe Journal of the American Dental AssociationVol. 148Issue 2PreviewVertical root fracture (VRF) requires root removal. Diagnostics for proper identification are critical. The author conducted a study to relate subjective, objective, and radiographic findings for VRF identification. They noted visual changes of root and overlying bone patterns after flap reflection. Full-Text PDF Author’s responseThe Journal of the American Dental AssociationVol. 148Issue 6PreviewI appreciate the compliment from Dr. Iadarola that my article on vertical root fractures (VRF) is elucidating. I concur with his quote, “correlation does not imply [prove] causation.” However, that does not apply to the relationship of VRF as a direct result of intracanal procedures (root canal therapy) and post placement; these have been shown to include significant wedging forces. The authors of a 2015 textbook, which represents the sum knowledge of VRF, stated “root canal therapy is a precursor to VRF.”1 To verify this, there are no reports of VRF occurring in nonendodontically treated roots in western and European populations. Full-Text PDF