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Vertical Root Fracture — ORE Part 1 MCQ

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ModerateEndodonticsVertical Root FractureORE Part 1

A patient has a vertical root fracture affecting a previously root-treated lower premolar. Which clinical finding is most characteristic?

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Correct answer: AAn isolated deep periodontal probing defect

Answer: A. A vertical root fracture in an endodontically treated tooth characteristically produces a localised, isolated deep periodontal probing defect, often adjacent to the fracture line. Increased probing depth is strongly associated with vertical root fracture and is a useful discriminating sign. Generalised deep probing defects suggest generalised periodontal disease rather than a fracture-related lesion. Uniform shallow probing depths do not fit the typical local periodontal breakdown. Marked mobility without bone loss is not characteristic, as fracture-associated periodontal destruction may produce local bone loss. A previously root-treated tooth should not give a positive cold sensibility response because its pulp has been removed.

Reference: Haupt F, Wiegand A, Kanzow P. Risk Factors for and Clinical Presentations Indicative of Vertical Root Fracture in Endodontically Treated Teeth: A Systematic Review and Meta-analysis. Journal of Endodontics. 2023. https://pubmed.ncbi.nlm.nih.gov/37307871/