Abstract
The purpose of this study was to investigate the characteristics and the detection ability of vertical root fractures in endodontically treated teeth by intraoral radiography and cone-beam computed tomography (CBCT). CBCT images of 50 patients with root fractures in endodontically treated teeth were reviewed, and 36 vertical root fractures were taken in this study. The cause of fracture, core construction, kind of teeth, and fracture direction (bucco-lingual and mesio-distal fractures) were investigated. Detection ability of vertical root fractures by intraoral radiography and CBCT was also examined. Statistical analyses concerning the characteristics were performed by χ2 test, and the detection ability was analyzed by cross-tabulation. All of the fractured teeth were nontraumatized teeth. The vertical root fracture occurrence was not differed by core construction. The vertical root fracture number was largest at the premolar teeth (p = 0.005), and the number of the bucco-lingual fracture was larger than the mesio-distal fracture (p = 0.046). Vertical root fractures were detectable using CBCT, while undetectable by intraoral radiography (p < 0.001). Vertical root fractures occurred easily in premolar teeth with bucco-lingual direction, and CBCT is an adequate radiographic method to diagnose vertical root fracture.
Highlights
In recent years, the prevention of caries or periodontal disease was developed, and causes of tooth loss changed from caries or periodontal disease to root fractures [1]
Ten nonendodontically treated teeth were examined at this time; they were excluded from this study as we were concerned with analyzing root fractures in endodontically treated teeth
The number of vertical root fractures was significantly different between the bucco-lingual fracture (Figure 1) and mesio-distal fracture (Figure 2) (χ2 (1) = 4.00, p = 0.046), and the number of the bucco-lingual fractures was twice that of the mesio-distal fractures
Summary
The prevention of caries or periodontal disease was developed, and causes of tooth loss changed from caries or periodontal disease to root fractures [1]. Most of the maxillary first molar has three separate roots [5], and the mandibular first molar mesial roots have two canals [6]. The number of vertical root fractures is reported to be greater than that of horizontal root fracture [7]. Tooth loss by the vertical root fracture increased, and the percentage of extractions due to vertical root fracture is 31.7% [8]. It is important to diagnosis the vertical root fracture timely to avoid progressive alveolar bone loss [9]. Diagnosing the vertical root fracture in a timely fashion enables to treat the root-fractured tooth and avoid extraction
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