{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:03:00Z","timestamp":1789470180383,"version":"build-2803163510"},"reference-count":45,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Endodontic J"],"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n To develop and validate a clinical and radiographic prediction model for diagnosing vertical root fracture (VRF) in endodontically treated teeth to assist clinical decision\u2010making.<\/jats:p>\n <\/jats:sec>\n \n Methodology<\/jats:title>\n This cross\u2010sectional diagnostic prediction study analysed data from 415 root\u2010filled roots (130 confirmed VRF and 285 non\u2010VRF) obtained from 327 patients who underwent endodontic microsurgery or surgical exploration. Fourteen candidate predictors, comprising patient demographics, tooth characteristics including clinical signs and symptoms, and radiographic features, were evaluated. A multivariable logistic regression model with backward stepwise elimination was developed to identify key predictors. Model performance was assessed using the area under the receiver operating characteristic curve (AuROC), calibration plots and internal validation was performed using a bootstrapping technique with 1000 replicates to obtain optimism\u2010corrected estimates.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The final prediction model retained seven predictors: age, tooth type, presence of sinus tract, probing depth \u2265\u20095\u2009mm, post type, periapical radiographic status and root canal space\u2010to\u2010root width ratio. Among these, five predictors demonstrated statistically significant associations (\n p<\/jats:italic>\n \u2009<\u20090.05): age (aOR 1.03), probing depth \u2265\u20095\u2009mm (aOR 7.64), isolated perilateral radiolucency (aOR 21.56), halo radiolucency (aOR 8.67) and root canal space\u2010to\u2010root width ratio >\u20091\/3 (aOR 3.28). The model demonstrated excellent discrimination with an AuROC of 0.84 (95% CI: 0.80\u20130.89). Internal validation provided an optimism\u2010corrected AuROC of 0.81 (95% CI: 0.76\u20130.85) with an optimism\u2010corrected calibration slope of 0.78 (95% CI 0.42\u20131.02). Risk stratification based on likelihood ratios effectively categorised patients into five risk levels, demonstrating a positive predictive value of 94.5% for roots predicted as \u2018highly suspect\u2019 category.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n The developed diagnostic prediction model, incorporating seven clinical and radiographic parameters, demonstrates excellent discriminative ability and good calibration. This tool enables accurate risk stratification of VRF in root\u2010filled teeth, supporting clinicians in making evidence\u2010based treatment decisions.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/iej.70272","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:08:58Z","timestamp":1789466938000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Developing a Clinical and Conventional Radiographic Tool for Vertical Root Fracture Prediction in Root\u2010Filled Teeth"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2180-576X","authenticated-orcid":false,"given":"Jirasin","family":"Chalermchaicharoenkit","sequence":"first","affiliation":[{"name":"Department of Operative Dentistry and Endodontics, Faculty of Dentistry Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8603-978X","authenticated-orcid":false,"given":"Kanet","family":"Chotvorrarak","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry and Endodontics, Faculty of Dentistry Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0293-3204","authenticated-orcid":false,"given":"Phachara","family":"Promchouy","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry and Endodontics, Faculty of Dentistry Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8543-6254","authenticated-orcid":false,"given":"Phichayut","family":"Phinyo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics and Clinical Epidemiology (BioCE), Faculty of Medicine Chiang Mai University Chiang Mai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8859-3810","authenticated-orcid":false,"given":"Sittichoke","family":"Osiri","sequence":"additional","affiliation":[{"name":"Department of Operative Dentistry and Endodontics, Faculty of Dentistry Mahidol University Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1100","DOI":"10.1016\/j.joen.2022.06.004","article-title":"CBCT Patterns of Bone Loss and Clinical Predictors for the Diagnosis of Cracked Teeth and Teeth With Vertical Root Fracture","volume":"48","author":"Alaugaily I.","year":"2022","journal-title":"Journal of Endodontics"},{"key":"e_1_2_10_3_1","volume-title":"Glossary of Endodontic Terms","author":"American Association of Endodontists","year":"2020"},{"key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"152","DOI":"10.14219\/jada.archive.1961.0030","article-title":"Roentgenographic and Direct Observation of Experimental Lesions in Bone: I","volume":"62","author":"Bender I. 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A Case\u2010Control Study in Two Colombian Populations","volume":"13","author":"Garc\u00eda\u2010Guerrero C.","year":"2021","journal-title":"Journal of Clinical and Experimental Dentistry"},{"key":"e_1_2_10_14_1","doi-asserted-by":"crossref","DOI":"10.1111\/jicd.12273","article-title":"Vertical Root Fractures in Endodontically\u2010Treated Teeth: A Retrospective Analysis of Possible Risk Factors","volume":"9","author":"Garc\u00eda\u2010Guerrero C.","year":"2018","journal-title":"Journal of Investigative and Clinical Dentistry"},{"key":"e_1_2_10_15_1","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1016\/j.joen.2016.10.008","article-title":"Long\u2010Term Clinical Outcomes of Endodontically Treated Teeth Restored With or Without Fiber Post\u2013Retained Single\u2010Unit Restorations","volume":"43","author":"Guldener K.","year":"2016","journal-title":"Journal of Endodontics"},{"key":"e_1_2_10_16_1","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.joen.2023.06.004","article-title":"Risk Factors for and Clinical Presentations Indicative of Vertical Root Fracture in Endodontically Treated Teeth: A Systematic Review and Meta\u2010Analysis","volume":"49","author":"Haupt F.","year":"2023","journal-title":"Journal of Endodontics"},{"issue":"1","key":"e_1_2_10_17_1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/jth.12262","article-title":"Diagnostic and Prognostic Prediction Models","volume":"11","author":"Hendriksen J. 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