Objective: The purpose of this article was to report the finding of the disappearance of intracanal medica- tion as a supporting evidence of vertical root fracture (VRF) through non-surgical intervention.
Methods: A retrospective review of the dental records of patients seen by an endodontist in a private end- odontic office from September 2013 to September 2016 was conducted by the same endodontist. Cases that met the inclusion and exclusion criteria were assigned as the subjects of this study, and data were ex- tracted from their clinical and radiographic records. Patients demographic features, pre-operative signs and symptoms, details of rendered clinical procedures, follow-up visits, clinical and radiographic findings were recorded. Seventeen teeth for which non-surgical exploratory re-treatment was initiated were included in this study. Calcium hydroxide-based intracanal medication was placed for 2-4 weeks. Obturation of the root canals was performed if the tooth showed improvement of clinical signs and symptoms. If not, a cone-beam computed tomography (CBCT) scan was proposed to the patient to rule out VRF.
Results: After the non-surgical re-treatment was initiated, 13 teeth showed improvement of clinical symp- toms and the re-treatment was therefore completed. The remaining 4 teeth presented with unresolved clin- ical presentations (deep pocket, presence of sinus tract and/or tender to percussion and palpation). Four teeth showed partial disappearance of intracanal medication where VRF was confirmed using CBCT in 3 teeth and with a conventional periapical (PA) radiograph in 1 tooth.
Conclusion: The disappearance of intracanal medication during non-surgical intervention was often associ- ated with VRF. Thus, this feature may serve as an aid in diagnosing VRF.