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Tofangchiha M, Bakhshi M, Fakhar HB, Panjnoush M. Comment on vertically fractured teeth without root canal fillings. Dent Traumatol 2011;27:143-6. doi: 10.1111/j.1600-9657.2010.00973.x. Epub 2011 Feb 1.I read the above article written by Tofangchiha et al. with great interest. I would congratulate the authors for their effort in the preparation of the article. Authors compared two different intra-oral radiographic systems (CCD and film) in the detection of vertical root fracture (VRF). No significant difference was found between both techniques.Vertical root fracture (VRF) is a complication that can occur during or after root canal treatment and requires extraction. VRF is usually iatrogenic and can occur after the insertion of retention screws or pins. Another etiology of VRF is excessive occlusal force, particularly in restored teeth. Endodontically treated uncrowned posterior teeth are most at risk (1–3).However, in this study design, no endodontic filling materials were placed after preparation of root canals. Apart from the two-dimensional nature of intra-oral radiographic systems, the most important limiting factor in the detection of VRF is the masking effect of root canal fillings, screws, and pins. As VRF is almost always a complication seen in endodontically treated teeth, this study design is debatable and it cannot be applicable to the real clinical conditions. In this study, masking effect of filling materials was not an issue, which can be considered as a flaw of the design.In addition, it can be understood from the reference list that not all the relevant literature was discussed or cited. Considering the publication date of the article, there are several articles concerning VRF detection in terms of diagnostic abilities of different radiographic systems which could be discussed. Most recent literature used endodontically treated teeth when evaluating VRF diagnosis. I hope that the authors will consider my constructive comments in their future work.

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