Vertical root fracture in endodontically versus nonendodontically treated teethA survey of 315 cases in Chinese patients,☆☆,

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Abstract

Objective. The purpose of this study was to compare endodontically versus nonendodontically treated teeth with respect to clinical features, including patient age and gender and tooth types of vertical root fractures. Study design. A total of 315 consecutive cases of vertical root fracture occurring in 274 Chinese patients during a 13-year period were reviewed. Age and gender, as well as tooth type and root distribution of vertical root fractures, were presented and compared in endodontically versus nonendodontically treated teeth. Results. Most patients (87%) had 1 fractured tooth; the others had 2 or 3 fractured teeth. Of all vertical root fractures, 40% occurred in nonendodontically treated teeth. In comparison with those in endodontically treated teeth, vertical root fractures in nonendodontically treated teeth tended to occur in patients with a higher mean age (55 years vs 51 years) and were more frequent in male patients (78% vs 58%). Vertical root fractures occurred in nonendodontically treated teeth more often in molars (84% vs 53%), less often in premolars (16% vs 33%), and seldom in anteriors (1 tooth vs 27 teeth). Conclusions. Vertical root fractures in nonendodontically treated teeth are not uncommon and comprise a large proportion of such fractures in Chinese patients. Differences between endodontically and nonendodontically treated teeth in patient age and gender, as well as in tooth types of vertical root fractures, were demonstrated. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;87:504-7)

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MATERIAL AND METHODS

Reviewed were 315 consecutive cases of vertical root fractures observed in 274 Chinese patients between January 1985 and June 1998. The final diagnosis of VRF in all uncertain cases was confirmed by surgical exploration. Cases of root fractures that might be related to cracked or split teeth were excluded. Accordingly, only true VRF cases confined to the root were included. Information was collected from each patient’s dental history, clinical examination, and radiographic findings. The

RESULTS

There were 315 cases (teeth) of VRFs documented in 274 patients. The distribution of VRFs in endodontically and/or nonendodontically treated teeth is shown in Table I.

. Distribution of VRFs in endodontically and/or nonendodontically treated teeth

 Total no. of fractured teethNo. of patients (%)
Endodontically treated teeth onlyNonendodontically treated teeth onlyTeeth treated both endodontically and nonendodonticallyTotal
 1137 (50)100 (36)0 (0)237 (87)
 221 (8)10 (4)2 (1)33 (12)
 32 (1)1 (0.4)1 (0.4)4 (1)

DISCUSSION

Diagnosis of VRF is a problem inasmuch as the condition is easily misdiagnosed as a periodontal or endodontic lesion. It is possible that many teeth with VRFs are extracted without being identified as such, especially among nonendodontically treated teeth. Though this retrospective clinical study was carried out over a period of 13 years, most of the cases were collected during recent years; this is due both to increasing awareness of VRF occurrence on the part of dentists and to confirmation

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Reprint requests: Jiiang-Huei Jeng, DDS, PhD, School of Dentistry, College of Medicine, National Taiwan University, No 1, Chang-Te Street, Taipei, Taiwan, Republic of China

☆☆

This study was supported by grants from the National Science Council (Republic of China) and Chang Gung Memorial Hospital (NSC872314-BI82A-049 and CMRP9665).

1079-2104/99/$8.00 + 0  7/15/96705

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