Scardini Iandara de Lima, Zamalloa Stephanie Isabel Diaz, Paiva Hermano Camelo, Santos Caroline Carvalho, Dos Santos Marcelo, Caldeira Celso Luiz, Gavini Giulio
Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
J Clin Exp Dent. 2025 Aug 1;17(8):e980-e988. doi: 10.4317/jced.63012. eCollection 2025 Aug.
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.
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 (<0.05).
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 (<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 (<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 (<0.05).
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. Cone Beam Computed Tomography, Endodontics, Questionnaire-based Study, Radicular Fracture, Vertical Root Fracture.
诊断和临床处理垂直根折（VRF）对牙医来说一直是挑战。本研究旨在评估巴西牙医在面对疑似VRF病例时所采用的诊断方法和临床处理方式。
通过社交媒体和电子邮件向牙医发送在线问卷。问卷包含七个关于疑似VRF病例诊断和临床处理的问题。使用卡方检验、费舍尔精确检验和克鲁斯卡尔 - 沃利斯检验（<0.05）对数据进行描述性和统计学评估。
共有517名牙医回答了问卷，72.3%为牙髓病医生，17.41%为全科医生，10.25%为其他牙科领域的专科医生。窄而深的牙周袋是最常报告的临床体征（71.8%），而晕圈状透射影是最常见的影像学表现（59.3%）。85.7%的参与者报告对疑似VRF病例要求进行锥形束计算机断层扫描（CBCT），牙医最常选择四项补充检查的组合（23.59%）。专业资质影响疑似VRF病例中报告的临床体征数量和辅助检查数量（<0.05）。91.9%的参与者报告同时使用图像和CBCT报告来评估扫描，且未观察到牙医资质与CBCT评估方法之间的关联（<0.05）。308名参与者表示对疑似VRF的牙齿进行拔除，而90人建议手术暴露，其中79人为牙髓病医生。在疑似VRF病例中，观察到牙医资质与临床处理之间存在显著关联（<0.05）。
在疑似VRF病例中报告了多种临床和影像学体征及症状。CBCT是最常要求的辅助检查。专业资质影响疑似VRF病例中报告的体征和症状数量、辅助检查数量以及临床处理策略。锥形束计算机断层扫描、牙髓病学、基于问卷的研究、牙根折裂、垂直根折
