Diagnosis Approaches and Clinical Management of Suspected Vertical Root Fractures: A Questionnaire-Based Study.

Background: Diagnosing and clinically managing vertical root fractures (VRF) present ongoing challenges for dentists. This study aimed to assess the diagnostic approaches and the clinical management employed by Brazilian dentists when confronted with suspected cases of VRF.

Material and methods: Online questionnaires were sent to dentists via social media and email. The questionnaire consisted of seven inquiries about the diagnosis and clinical management of suspected VRF cases. The data were evaluated descriptively and statistically using the Chi-square, Fisher's exact and Kruskal-Wallis tests (p<0.05).

Results: A total of 517 dentists answered the questionnaire, 72.3% were Endodontists, 17.41% were general practitioners, and 10.25% were specialists in other dental fields. A narrow and deep periodontal pocket was the most frequently reported clinical sign (71.8%), while a halo-shaped radiolucency was the most common radiographic finding reported (59.3%). 85.7% of the participants reported requesting a cone-beam computed tomography (CBCT) scan to VRF suspected cases, and the combination of four complementary exams was most frequently selected by dentists (23.59%). Professional qualification influenced the number of clinical signals and of auxiliary exams reported in VRF suspected cases (p<0.05). 91.9% of the participants reported using both the image and the CBCT report to evaluate the scan, and no association was observed between dentist qualifications and CBCT evaluation methods (p<0.05). 308 participants indicated extraction for teeth suspected of VRF, whereas 90 suggested surgical exposure, with 79 of them being Endodontists. A significant association was observed between dentist qualifications and clinical management in suspected VRF cases (p<0.05).

Conclusions: A variety of clinical and radiographic signals and symptoms were reported in suspected VRF cases. CBCT was the most commonly requested auxiliary exam. Professional qualification influenced the number of reported signals and symptoms, the number of auxiliary exams, and the clinical management strategies in suspected VRF cases. Key words:Cone Beam Computed Tomography, Endodontics, Questionnaire-based Study, Radicular Fracture, Vertical Root Fracture.