Angambakkam Rajasekaran PradeepKumar1, Hagay Shemesh2, Sundaramurthy Jothilatha3, Rangarajan Vijayabharathi4, Somasundaram Jayalakshmi5, Anil Kishen6. 1. Department of Conservative Dentistry and Endodontics, Thai Moogambigai Dental College and Hospital, Dr. MGR Educational and Research Institute University, Chennai, India. Electronic address: arpradeep@vsnl.com. 2. Department of Endodontology, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands. 3. Department of Conservative Dentistry and Endodontics, Tamil Nadu Government Dental College and Hospital, Chennai, India. 4. Department of Dental and Maxillofacial Surgery, SMF-Dr. Rangarajan Memorial Hospital, Chennai, India. 5. Department of Conservative Dentistry and Endodontics, Saveetha Dental College and Hospital, Chennai, India. 6. Discipline of Endodontics, Faculty of Dentistry, Toronto, Ontario, Canada.
Abstract
INTRODUCTION: The purpose of this study was to examine different patient- and treatment-related factors associated with the time of presentation of vertical root fractures (VRFs) in endodontically treated teeth restored with crowns. METHODS: One hundred ninety-seven root-filled, crowned teeth with no post and suspected of VRFs were included in the study. Patient details with relevance to endodontic treatment and clinical signs/symptoms were documented, and radiographs were taken. A diagnosis of a VRF was confirmed after surgical flap elevation. Frequency distributions were determined, and statistical analyses were performed using Pearson chi-square analysis, Fisher exact test, cross tabulation, Pearson correlation, and multiple logistic regression. RESULTS: Mandibular molars (34%) and maxillary premolars (22.8%) were the most frequently affected teeth. The postoperative time to the diagnosis of a VRF was 4.35 (±1.96) years. Female patients, posterior teeth, overfilled canals, and patients older than 40 years were associated with the presentation of VRFs within 5 years of the postoperative period. Clinical findings most frequently observed were pain on percussion (60%), pain on palpation (62%), presence of a deep narrow pocket (81%), and sinus tract/swelling (67%). "Halo"-type radiolucency (48.7%) was the most common radiographic feature related to VRFs. CONCLUSIONS: Pain on palpation/percussion, deep narrow pocket, sinus tract, and halo-type radiolucency are characteristic features of VRFs. Posterior teeth, overfilled canals, female patients, and older patients (>40 years) presenting with the previously described clinical features in endodontically treated teeth restored with crowns are more likely to present with VRFs within 5 years postoperatively.
INTRODUCTION: The purpose of this study was to examine different patient- and treatment-related factors associated with the time of presentation of vertical root fractures (VRFs) in endodontically treated teeth restored with crowns. METHODS: One hundred ninety-seven root-filled, crowned teeth with no post and suspected of VRFs were included in the study. Patient details with relevance to endodontic treatment and clinical signs/symptoms were documented, and radiographs were taken. A diagnosis of a VRF was confirmed after surgical flap elevation. Frequency distributions were determined, and statistical analyses were performed using Pearson chi-square analysis, Fisher exact test, cross tabulation, Pearson correlation, and multiple logistic regression. RESULTS: Mandibular molars (34%) and maxillary premolars (22.8%) were the most frequently affected teeth. The postoperative time to the diagnosis of a VRF was 4.35 (±1.96) years. Female patients, posterior teeth, overfilled canals, and patients older than 40 years were associated with the presentation of VRFs within 5 years of the postoperative period. Clinical findings most frequently observed were pain on percussion (60%), pain on palpation (62%), presence of a deep narrow pocket (81%), and sinus tract/swelling (67%). "Halo"-type radiolucency (48.7%) was the most common radiographic feature related to VRFs. CONCLUSIONS:Pain on palpation/percussion, deep narrow pocket, sinus tract, and halo-type radiolucency are characteristic features of VRFs. Posterior teeth, overfilled canals, female patients, and older patients (>40 years) presenting with the previously described clinical features in endodontically treated teeth restored with crowns are more likely to present with VRFs within 5 years postoperatively.