Methods: During a six-year period, all extracted vertically fractured teeth were examined. Upon conclusive VRF diagnosis, data collection was performed regarding the patient, tooth location and clinical as well as radiographic characteristics of the tooth. Radiographic changes were classified according to location (peri-radicular, peri-apical and PDL widening), configuration ("hallo" radiolucency, lateral and peri-apical) and extension (coronal, middle and apical root thirds).
Results: A total of 107 VRF teeth in 91 patients were included. The mean patient age was 34.3+11.2 (range 19-59). Overall, 44 (41.1%) teeth were maxillary and 63 (58.9%) were mandibular; 66 (61.7%) were molars and 29 (27.1%) premolars. Post extraction evaluation of the fracture site revealed that most fractures were in the mesial aspect (38.3%) followed by the buccal aspect (28%). Sinus tract was evident in 55 teeth (51.4%). The vast majority of the sinus tracts were present in the buccal aspect (72.7%). Tooth mobility was evident in 31 (29%) of the cases, vestibular tenderness in 37 (34.6%), sensitivity upon percussion in 34 (31.8%) and solitary periodontal pocket in 77 (72%). The finding of sinus tract was correlated with the presence of a solitary periodontal pocket (p=0.011). Ninety-five (88.7%) of the VRF teeth showed various radiographic changes: 77(81.1%) peri-radicular rarification, 12(12.6%) periapical rarification and 6(6.3%) periodontal ligament widening. The most prevalent radiographic configuration was "halo" shaped radiolucency (69 teeth, 72.6%). The presence of radiographic changes was correlated with the findings of a solitary periodontal pocket (p=0.002) and a sinus tract, though the later did not reach statistical significance (p=0.089).
Conclusion: Diagnosis of VRF is rather complex and should combine meticulous clinical and radiographic evaluation. Further studies and development of diagnostic tools for VRF are warranted.