Vertical root fracture in endodontically treated teeth: A review of 25 cases

doi:10.1067/moe.2001.117262

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology

Volume 92, Issue 5, November 2001, Pages 553-555

https://doi.org/10.1067/moe.2001.117262 Get rights and content

Abstract

Objective: We sought to examine the clinical conditions under which 25 endodontically treated teeth underwent vertical root fracture (VRF) and to relate this condition to the time elapsed from endodontic treatment to fracture. Study Design: This was a retrospective study in which we reviewed 25 case histories of patients with postendodontic VRF and studied the effect of various pretreatment and posttreatment factors as they related to VRF. Results And Conclusions: The mean time to VRF was 54 months; this was not significantly influenced by the presence or absence of prior restoration or by the presence or absence of a crown fitting. The use of a prefabricated, cylindrical, cemented intraradicular retainer increased the time between endodontics and VRF. Teeth restored with conventional amalgam took significantly longer to undergo VRF than those restored with composite or bonded amalgam. In contrast, amalgam-restored teeth suffered more coronal fractures before VRF than did teeth in the other 2 groups.(Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;92:553-5)

Section snippets

Material and methods

During a 2-year period, we reviewed patients diagnosed with VRF who had been endodontically treated by our general dentistry group practice in the past 12 years. The following parameters were evaluated: time elapsed from endodontic treatment to VRF, time elapsed from endodontic treatment to placement of restoration, fracture symptoms, tooth type, type of restorative material, type of intraradicular retainer, and type of crown. Coronal fracture before VRF was also recorded.

All teeth were

Results

Table I lists the fractured teeth included in this study.

. Distribution of tooth type among 25 teeth with VRF

Tooth	n	Percentage
Maxillary cuspid	1	4
Maxillary second premolar	9	36
Maxillary first molar	6	24
Mandibular first molar	9	36

Approximately half of the teeth had been previously restored before being endodontically treated by us. Prefabricated posts were used in 68% of the teeth. A prosthetic crown was placed in 60% of the teeth. Coronal fracture before actual VRF was recorded in 34% of the cases. The

Discussion

The factors leading to a VRF in an endodontically treated tooth are difficult to establish because the results of different studies on endodontic and restorative etiologies are inconclusive.¹² Because VRF also occurs in untreated teeth, the possibility of occlusal trauma may mandate additional consideration as a possible causal factor of fracture. A recent study assessing the frequency of VRF in a group of endodontically and nonendodontically treated teeth reported a 40% incidence of VRF. Among

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^*: Reprint requests: M^a Carmen Llena-Puy, MD, PhD, MCDH, C/ Guillem de Castro N^o 44, 3^o, 5^a, 46001 Valencia, Spain, [email protected]

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EndodonticsVertical root fracture in endodontically treated teeth: A review of 25 cases*

Abstract

Section snippets

Material and methods

Results

Discussion

J Prosthet Dent

Oral Surg Oral Med Oral Pathol

J Endod

J Endod

J Prosthet Dent

J Prosthet Dent

Oral Surg Oral Med Oral Pathol Oral Radiol Endod

J Endod

Endodontics
Vertical root fracture in endodontically treated teeth: A review of 25 cases*