Vertical root fractures in endodontically treated teeth--Part II: Etiology and prevention

The etiologic factors for vertical fractures in endodontically treated teeth are predisposing factors, such as loss of tooth material, anatomy of the susceptible teeth, moisture loss, previous dentinal cracks, and loss of bone support; and iatrogenic factors, such as excessive removal of radicular dentin as a result of endodontic and prosthetic procedures and improper selection of dowels. Identification of susceptible teeth and roots, proper selection and cementation of dowels, and avoidance of excessive force during condensation of gutta percha and in removal of tooth structure during endodontic and prosthetic procedures, are all measures that can be taken to prevent root fractures.