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

Rosen E, Tsesis I, Tamse A, Bjorndal L, Taschieri S, Givol N. Medico-legal aspects of vertical root fractures in root filled teeth. International Endodontic Journal, 45, 7-11, 2012. Aim To analyse the medico-legal aspects of vertical root fracture (VRF) following root canal treatment (RCT). Methodology 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.