Clinical observation in 2 representative cases of vertical root fracture in nonendodontically treated teeth

Wang, Ping; Su, Lingyun

doi:10.1016/j.tripleo.2008.12.014

Cited by 13 publications

(21 citation statements)

References 6 publications

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“…However, VRFs in non-endodontically treated teeth, known as spontaneous VRFs, have received little attention. Indeed, they have a high frequency in Chinese people, who constitute a population with a dietary pattern of chewing hard foods, 4,5 and 40% of VRFs occur in non-endodontically treated teeth. 6 Clinical studies have found that spontaneous VRFs always occur in severely attrited first molars.…”

Section: Introductionmentioning

confidence: 99%

“…6 Clinical studies have found that spontaneous VRFs always occur in severely attrited first molars. 4 It is noteworthy that cracks initiate at the root apex and propagate coronally. 4,5 On the one hand, stress might be concentrated at the apical area during mastication for root geometry; on the other hand, the intrinsic properties of the apex itself might constitute the weakest point of the root.…”

Section: Introductionmentioning

confidence: 99%

“…4 It is noteworthy that cracks initiate at the root apex and propagate coronally. 4,5 On the one hand, stress might be concentrated at the apical area during mastication for root geometry; on the other hand, the intrinsic properties of the apex itself might constitute the weakest point of the root. 6 However, to our knowledge, there has been no scientific research that has demonstrated the variations in mechanical behaviour of different portions of root materials and their effects on VRFs.…”

Section: Introductionmentioning

confidence: 99%

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The effects of ageing on the biomechanical properties of root dentine and fracture

Zheng

Shao

et al. 2014

Journal of Dentistry

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j o u r n a l o f d e n t i s t r y 4 2 ( 2 0 1 4 ) 3 0 5 -3 1 1 a r t i c l e i n f o Objectives: Knowledge of the mechanical behaviour of root dentine can facilitate better understanding of spontaneous vertical root fracture (VRF), an age-related disease initiated mainly at the root apex. We tested the hypothesis that the biomechanical properties of root dentine change with ageing.Methods: Sixteen human premolars were divided into ''old'' (17-30 years) and ''young'' (50-80 years) groups. The elastic modulus, nano-hardness, micro-hardness, elemental contents, tubular density/area of root dentine in cervical, middle and apical root regions were evaluated using atomic force microscopy-based nano-indentation, Knoop indentation, scanning electron microscopy and energy dispersive X-ray spectroscopy, respectively. Results:The apical dentine showed a lower nano-hardness, a lower elastic modulus, a lower calcium content, a lower calcium-to-phosphorus ratio and a smaller tubular density/area than the cervical dentine in both age groups, whereas spatial differences in micro-hardness were observed only in old roots. Compared with young dentine, old dentine showed a greater hardness, a higher elastic modulus, a greater mineral content and a smaller tubular size in the cervical portion, whereas the age-induced changes in tubular density were insignificant. Finite element analysis revealed that due to its higher elastic modulus, old apical dentine has a higher stress level than young dentine. Conclusions:The intrinsic material properties of root dentine have spatial variations, and they are altered by ageing. The higher stress level in old apical dentine may be one reason, if not the most important one, why spontaneous VRFs are more likely to occur in the elderly population.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The effects of ageing on the biomechanical properties of root dentine and fracture

Zheng

Shao

et al. 2014

Journal of Dentistry

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“…According to Chan et al . [9] and Wang and Su[10] spontaneous VRF showed consistent patterns, occurring most often in mandibular first molars of patients between 40 and 69 years old, with a higher incidence in males than in females. Most spontaneous VRF teeth had severe attrition with no or minimal restoration.…”

Section: Discussionmentioning

confidence: 85%

“…[6] There have been some reports of spontaneous VRF, especially in literature from eastern Asia. [678910] Yang et al . [7] and Chan et al .…”

Section: Introductionmentioning

confidence: 99%

Differentiating spontaneous vertical root fracture in endodontically treated tooth

et al. 2017

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Although vertical root fracture (VRF) is mostly found in endodontically treated teeth, it also occurs spontaneously. If VRF is recognized after endodontic treatment, it is considered to be iatrogenic and can lead to legal trouble. However, legal problems can be averted if the dentist can prove that the VRF existed before endodontic treatment. This case report describes an unusual, spontaneous VRF in an endodontically treated tooth and presents a useful tip for determining whether a fracture is iatrogenic. We performed nonsurgical endodontic treatment on a mandibular first molar with irreversible pulpitis. After 6 months, the patient revisited with localized swelling, and we diagnosed VRF of the mesial root. We extracted the tooth and prepared it for microscopic examination. We found gutta-percha in the fracture line of the transversely sectioned root, and it appeared to have penetrated to the fracture line through the force generated from the filling. The patient was informed and agreed that the fracture occurred spontaneously before treatment. This case demonstrates the time point of VRF occurrence by identifying the presence of gutta-percha in the fracture line. We suggest that this procedure can be used to demonstrate whether VRFs in endodontically treated teeth are spontaneous or iatrogenic.

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Cross-sectional study of posterior tooth root fractures in 2015 and 2019 in a Chinese population

et al. 2022

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Clinical observation in 2 representative cases of vertical root fracture in nonendodontically treated teeth

Cited by 13 publications

References 6 publications

The effects of ageing on the biomechanical properties of root dentine and fracture

The effects of ageing on the biomechanical properties of root dentine and fracture

Differentiating spontaneous vertical root fracture in endodontically treated tooth

Cross-sectional study of posterior tooth root fractures in 2015 and 2019 in a Chinese population

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