Medico-legal aspects of vertical root fractures in root filled teeth. 2012

E Rosen, and I Tsesis, and A Tamse, and L Bjørndal, and S Taschieri, and N Givol
Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.

OBJECTIVE To analyse the medico-legal aspects of vertical root fracture (VRF) following root canal treatment (RCT). METHODS A comprehensive search in a professional liability insurance database was conducted to retrospectively identify cases of VRF following RCT. The complaints were categorized as either financial risk bearing or financial nonrisk bearing, and related demographic, prosthetic and endodontic variables were analysed. RESULTS Seventy-seven legal cases of patients with VRFs following RCT were identified. Most of the cases were either in premolars or in mandibular molar teeth (P<0.05). Poor-quality root filling was associated with an extended delay of diagnosis (P<0.05). The presence of a post significantly increased the financial risk assessment (P<0.05). CONCLUSIONS Poor quality root fillings complicate the diagnosis of VRF, which in turn extends the time for achieving an accurate diagnosis and increasing the medico-legal risk. Premolar and mandibular molar teeth were more prone to medico-legal claims related to VRF following RCT. Post should be placed only when essential for additional core support to avoid medico-legal risk.

UI MeSH Term Description Entries
D007557 Israel A country in the Middle East, bordering the Mediterranean Sea, between Egypt and Lebanon. The capital is Jerusalem.
D008297 Male Males
D008318 Malpractice Failure of a professional person, a physician or lawyer, to render proper services through reprehensible ignorance or negligence or through criminal intent, especially when injury or loss follows. (Random House Unabridged Dictionary, 2d ed) Professional Negligence,Negligence,Negligence, Professional,Professional Negligences
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D008963 Molar The most posterior teeth on either side of the jaw, totaling eight in the deciduous dentition (2 on each side, upper and lower), and usually 12 in the permanent dentition (three on each side, upper and lower). They are grinding teeth, having large crowns and broad chewing surfaces. (Jablonski, Dictionary of Dentistry, 1992, p821) Molars
D011176 Post and Core Technique Use of a metal casting, usually with a post in the pulp or root canal, designed to support and retain an artificial crown. Dental Dowels,Dental Dowel,Dowel, Dental,Dowels, Dental,Post Technic,Post Technique,Post and Core Technic,Post-Core Technic,Post Technics,Post Techniques,Post-Core Technics,Technic, Post,Technic, Post-Core,Technics, Post,Technics, Post-Core,Technique, Post,Techniques, Post
D003815 Dentists Individuals licensed to practice DENTISTRY. Dentists, Pediatric,Dentists, Prosthetic,Dentists, Restorative,Periodontists,Prosthodontists,Dentist,Dentist, Pediatric,Dentist, Prosthetic,Dentist, Restorative,Pediatric Dentist,Pediatric Dentists,Periodontist,Prosthetic Dentist,Prosthetic Dentists,Prosthodontist,Restorative Dentist,Restorative Dentists
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001641 Bicuspid One of the eight permanent teeth, two on either side in each jaw, between the canines (CUSPID) and the molars (MOLAR), serving for grinding and crushing food. The upper have two cusps (bicuspid) but the lower have one to three. (Jablonski, Dictionary of Dentistry, 1992, p822) Premolar,Bicuspids,Premolars

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