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Yao Q, Zhuang Y, Aji Y, Zhang Q, Luo Y, Li S. Biomechanical impact of different isthmus positions in mandibular first molar root canals: a finite element analysis. Clin Oral Investig 2024; 28:311. [PMID: 38743171 DOI: 10.1007/s00784-024-05715-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 05/07/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE This study used image-based finite element analysis (FEA) to assess the biomechanical changes in mandibular first molars resulting from alterations in the position of the root canal isthmus. METHODS A healthy mandibular first molar, characterized by two intact root canals and a cavity-free surface, was selected as the subject. A three-dimensional model for the molar was established using scanned images of the patient's mandibular teeth. Subsequently, four distinct finite element models were created, each representing varied root canal morphologies: non-isthmus (Group A), isthmus located at the upper 1/3 of the root (Group B), middle 1/3 of the root (Group C), and lower 1/3 of the root (Group D). A static load of 200 N was applied along the tooth's longitudinal axis on the occlusal surface to simulate regular chewing forces. The biomechanical assessment was conducted regarding the mechanical stress profile within the root dentin. The equivalent stress (Von Mises stress) was used to assess the biomechanical features of mandibular teeth under mechanical loading. RESULTS In Group A (without an isthmus), the maximum stress was 22.2 MPa, while experimental groups with an isthmus exhibited higher stresses, reaching up to 29.4 MPa. All maximum stresses were concentrated near the apical foramen. The presence of the isthmus modified the stress distribution in the dentin wall of the tooth canal. Notably, dentin stresses at specific locations demonstrated differences: at 8 mm from the root tip, Group B: 13.6 MPa vs. Group A: 11.4 MPa; at 3 mm from the root tip, Group C: 14.2 MPa vs. Group A: 4.5 MPa; at 1 mm from the root tip, Group D: 25.1 MPa vs. Group A: 10.3 MPa. The maximum stress in the root canal dentin within the isthmus region was located either at the top or bottom of the isthmus. CONCLUSION A root canal isthmus modifies the stress profile within the dentin. The maximum stress occurs near the apical foramen and significantly increases when the isthmus is located closer to the apical foramina.
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Affiliation(s)
- Qingting Yao
- Department of Stomatology, Xuchang Central Hospital, Xuchang, 461000, China
| | - Youmei Zhuang
- Department of Endodontics, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, 830001, China
| | - Yaerken Aji
- Department of Dentoalveolar Surgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, 830001, China
| | - Qilin Zhang
- Postgraduate College of Xinjiang Medical University, Urumqi, 830054, China
| | - Yixiang Luo
- Postgraduate College of Xinjiang Medical University, Urumqi, 830054, China
| | - Shuhui Li
- Department of Endodontics, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, 830001, China.
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Haupt F, Wiegand A, Kanzow P. Risk factors for and clinical presentations indicative of vertical root fracture in endodontically treated teeth - a systematic review and meta-analysis. J Endod 2023:S0099-2399(23)00323-0. [PMID: 37307871 DOI: 10.1016/j.joen.2023.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/31/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
INTRODUCTION The aim of this study was to identify specific clinical signs or symptoms and potential risk factors which are most likely associated with the presence of a vertical root fracture (VRF) in endodontically treated teeth (ETT). METHODS Electronic databases (MEDLINE via PubMed, EMBASE via Ovid, Scopus, and Web of Science) were searched by two reviewers in October 2022 for clinical studies, in which at least either the clinical presentation or potential risk factors associated with a VRF were assessed. Risk of bias was assessed using the Newcastle-Ottawa scale. Meta-analyses of odds ratios (ORs) were performed separately for several signs or symptoms and risk factors. RESULTS Fourteen sources reporting on 2,875 teeth (489 with VRF and 2,388 without VRF) were included in the meta-analyses. Regarding the clinical presentation, the presence of sinus tracts (OR=4.87; 95%-CI: 1.58-15.0), increased periodontal probing depths (OR=13.24; 95%-CI: 5.44-32.22), swelling/abscess (OR=2.86; 95%-CI: 1.74-4.70), and tenderness to percussion (OR=1.74; 95% CI: 1.18-2.61) were significantly associated with the presence of a VRF (Padj. value<.05). None of the assessed risk factors (sex, type of teeth, tooth location, posts, indirect restoration, apical extension of the root canal filling), were found to be significantly associated with the presence of a VRF (Padj. value>.05). CONCLUSIONS Four clinical presentations were identified to be the most significant signs or symptoms for a VRF in ETT: presence of sinus tracts, increased probing depths, swelling/abscess, tenderness to percussion. None of the assessed risk factors pointed out to be significantly associated with a VRF. REGISTRATION CRD42022354108 (PROSPERO).
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Affiliation(s)
- Franziska Haupt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany.
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany
| | - Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Germany
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3
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Ashi T, Richert R, Mancino D, Jmal H, Alkhouri S, Addiego F, Kharouf N, Haïkel Y. Do the Mechanical Properties of Calcium-Silicate-Based Cements Influence the Stress Distribution of Different Retrograde Cavity Preparations? MATERIALS (BASEL, SWITZERLAND) 2023; 16:ma16083111. [PMID: 37109947 PMCID: PMC10145818 DOI: 10.3390/ma16083111] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 05/13/2023]
Abstract
The aim of the present study was to investigate the influence of the mechanical properties of three different calcium-silicate-based cements on the stress distribution of three different retrograde cavity preparations. Biodentine™ "BD", MTA Biorep "BR", and Well-Root™ PT "WR" were used. The compression strengths of ten cylindrical samples of each material were tested. The porosity of each cement was investigated by using micro-computed X-ray tomography. Finite element analysis (FEA) was used to simulate three retrograde conical cavity preparations with an apical diameter of 1 mm (Tip I), 1.4 mm (Tip II), and 1.8 mm (Tip III) after an apical 3 mm resection. BR demonstrated the lowest compression strength values (17.6 ± 5.5 MPa) and porosity percentages (0.57 ± 0.14%) compared to BD (80 ± 17 MPa-1.22 ± 0.31%) and WR (90 ± 22 MPa-1.93 ± 0.12%) (p < 0.05). FEA demonstrated that the larger cavity preparation demonstrated higher stress distribution in the root whereas stiffer cement demonstrated lower stress in the root but higher stress in the material. We can conclude that a respected root end preparation associated with cement with good stiffness could offer optimal endodontic microsurgery. Further studies are needed to define the adapted cavity diameter and cement stiffness in order to have optimal mechanical resistance with less stress distribution in the root.
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Affiliation(s)
- Tarek Ashi
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France; (T.A.); (D.M.)
| | - Raphaël Richert
- Hospices Civils de Lyon, PAM Odontologie, 69100 Lyon, France;
- Laboratoire de Mécanique des Contacts et Structures, UMR 5259 CNRS/INSA Lyon, 69100 Lyon, France
| | - Davide Mancino
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France; (T.A.); (D.M.)
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
| | - Hamdi Jmal
- ICube Laboratory, Mechanics Department, UMR 7357 CNRS, University of Strasbourg, 67000 Strasbourg, France;
| | | | - Frédéric Addiego
- Department Materials Research and Technology (MRT), Luxembourg Institute of Science and Technology (LIST), ZAE Robert Steichen, 5 Rue Bommel, L-4940 Hautcharage, Luxembourg;
| | - Naji Kharouf
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France; (T.A.); (D.M.)
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Correspondence: (N.K.); (Y.H.); Tel.: +33-(0)6-6752-2841 (N.K.)
| | - Youssef Haïkel
- Department of Biomaterials and Bioengineering, INSERM UMR_S, Strasbourg University, 67000 Strasbourg, France; (T.A.); (D.M.)
- Department of Endodontics, Faculty of Dental Medicine, Strasbourg University, 67000 Strasbourg, France
- Pôle de Médecine et Chirurgie Bucco-Dentaire, Hôpital Civil, Hôpitaux Universitaire de Strasbourg, 67000 Strasbourg, France
- Correspondence: (N.K.); (Y.H.); Tel.: +33-(0)6-6752-2841 (N.K.)
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Nasiri K, Wrbas KT. Managing vertical root fracture in dentistry during the SARS-CoV-2 pandemic. J Dent Sci 2023; 18:929-930. [PMID: 36620518 PMCID: PMC9808416 DOI: 10.1016/j.jds.2022.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 01/04/2023] Open
Affiliation(s)
| | - Karl-Thomas Wrbas
- Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Oral and Maxillofacial Surgery, Medical Center, University of Freiburg, Freiburg i.Br., Germany
- Division of Endodontics, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
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Salem Milani A, Ganjpour S, Dehghani F, Rahimi S, Sabanik P. Comparison of the fracture resistance of the teeth prepared with ProTaper Universal, ProTaper Next, and ProTaper Gold rotary files. Clin Exp Dent Res 2022; 8:1421-1425. [PMID: 36053566 PMCID: PMC9760132 DOI: 10.1002/cre2.660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 08/10/2022] [Accepted: 08/16/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES Root canal preparation can lead to cracks on the roots by creating stresses on the root canal walls, which decreases the fracture resistance of the tooth. The present study compared the fracture resistance of the teeth prepared by the ProTaper Universal (PTU), ProTaper Next (PTN), and ProTaper Gold (PTG) rotary file systems. MATERIALS AND METHODS Fifty-six single-canal premolar teeth were sectioned 14 mm from the root apex. The roots were standardized based on the buccolingual and mesiodistal diameter and randomly assigned to three experimental (n = 14) and one control group (n = 14). The teeth in three experimental groups were instrumented with PTU, PTN, and PTG rotary files. The roots in the control group were not instrumented. A vertical force was applied to each root in a universal testing machine until the root fractured. The data were statistically analyzed by one-way analysis of variance. RESULTS There was no significant difference in the fracture resistance of the teeth between the control, PTU, PTN, and PTG groups (p = .115). CONCLUSIONS Root canal preparation with ProTaper files manufactured with conventional NiTi (PTU) and heat-treated alloys (PTN and PTG) did not affect the fracture resistance of teeth.
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Affiliation(s)
- Amin Salem Milani
- Endodontic Department, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
| | | | - Fatemeh Dehghani
- Endodontic Department, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
| | - Saeed Rahimi
- Dental and Periodontal Research CentreTabriz University of Medical SciencesTabrizIran
| | - Pouya Sabanik
- Dental and Periodontal Research CenterTabriz University of Medical SciencesTabrizIran
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Multifactorial Analysis of Endodontic Microsurgery Using Finite Element Models. J Pers Med 2022; 12:jpm12061012. [PMID: 35743798 PMCID: PMC9224708 DOI: 10.3390/jpm12061012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 06/17/2022] [Accepted: 06/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background: The present study aimed to classify the relative contributions of four biomechanical factors—the root-end filling material, the apical preparation, the root resection length, and the bone height—on the root stresses of the resected premolar. Methods: A design of experiments approach based on a defined subset of factor combinations was conducted to calculate the influence of each factor and their interactions. Sixteen finite element models were created and analyzed using the von Mises stress criterion. The robustness of the design of experiments was evaluated with nine supplementary models. Results: The current study showed that the factors preparation and bone height had a high influence on root stresses. However, it also revealed that nearly half of the biomechanical impact was missed without considering interactions between factors, particularly between resection and preparation. Conclusions: Design of experiments appears to be a valuable strategy to classify the contributions of biomechanical factors related to endodontics. Imagining all possible interactions and their clinical impact is difficult and can require relying on one’s own experience. This study proposed a statistical method to quantify the mechanical risk when planning apicoectomy. A perspective could be to integrate the equation defined herein in future software to support decision-making.
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Lahoud P, Jacobs R, Boisse P, EzEldeen M, Ducret M, Richert R. Precision medicine using patient-specific modelling: state of the art and perspectives in dental practice. Clin Oral Investig 2022; 26:5117-5128. [PMID: 35687196 DOI: 10.1007/s00784-022-04572-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 05/30/2022] [Indexed: 12/25/2022]
Abstract
The dental practice has largely evolved in the last 50 years following a better understanding of the biomechanical behaviour of teeth and its supporting structures, as well as developments in the fields of imaging and biomaterials. However, many patients still encounter treatment failures; this is related to the complex nature of evaluating the biomechanical aspects of each clinical situation due to the numerous patient-specific parameters, such as occlusion and root anatomy. In parallel, the advent of cone beam computed tomography enabled researchers in the field of odontology as well as clinicians to gather and model patient data with sufficient accuracy using image processing and finite element technologies. These developments gave rise to a new precision medicine concept that proposes to individually assess anatomical and biomechanical characteristics and adapt treatment options accordingly. While this approach is already applied in maxillofacial surgery, its implementation in dentistry is still restricted. However, recent advancements in artificial intelligence make it possible to automate several parts of the laborious modelling task, bringing such user-assisted decision-support tools closer to both clinicians and researchers. Therefore, the present narrative review aimed to present and discuss the current literature investigating patient-specific modelling in dentistry, its state-of-the-art applications, and research perspectives.
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Affiliation(s)
- Pierre Lahoud
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Periodontology and Oral Microbiology, Department of Oral Health Sciences, KU Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Philippe Boisse
- Laboratoire de Mécanique Des Contacts Et Structures, UMR 5259, CNRS/INSA, Villeurbanne, France
| | - Mostafa EzEldeen
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Oral Health Sciences, KU Leuven and Paediatric Dentistry and Special Dental Care, University Hospitals Leuven, Leuven, Belgium
| | - Maxime Ducret
- Hospices Civils de Lyon, PAM d'Odontologie, Lyon, France.,Faculty of Odontology, Lyon 1 University, Lyon, France.,Laboratoire de Biologie Tissulaire Et Ingénierie Thérapeutique, UMR5305 CNRS/UCBL, Lyon, France
| | - Raphael Richert
- Laboratoire de Mécanique Des Contacts Et Structures, UMR 5259, CNRS/INSA, Villeurbanne, France. .,Hospices Civils de Lyon, PAM d'Odontologie, Lyon, France. .,Faculty of Odontology, Lyon 1 University, Lyon, France.
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8
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Patel S, Bhuva B, Bose R. Vertical root fractures in root treated teeth-current status and future trends. Int Endod J 2022; 55 Suppl 3:804-826. [PMID: 35338655 PMCID: PMC9324143 DOI: 10.1111/iej.13737] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/22/2022] [Accepted: 03/23/2022] [Indexed: 11/28/2022]
Abstract
Vertical root fracture (VRF) is a common reason for the extraction of root filled teeth. The accurate diagnosis of VRF may be challenging due to the absence of clinical signs, whilst conventional radiographic assessment is often inconclusive. However, an understanding of the aetiology of VRFs, and more importantly, the key predisposing factors, is crucial in identifying teeth that may be susceptible. Thorough clinical examination with magnification and co-axial lighting is essential in identifying VRFs, and although CBCT is unable to reliably detect VRFs per se, the pattern of bone loss typically associated with VRF can be fully appreciated, and therefore, increases the probability of correct diagnosis and management. The prevalence of VRFs in root filled teeth is significantly greater than in teeth with vital pulps, demonstrating that the combination of loss of structural integrity, presence of pre-existing fractures and biochemical effects of loss of vitality, are highly relevant. Careful assessment of the occlusal scheme, presence of deflective contacts and identification of parafunctional habits is imperative in both preventing and managing VRFs. Furthermore, anatomical factors such as root canal morphology, may predispose certain teeth to VRF. The influence of access cavity design and root canal instrumentation protocols should be considered although the impact of these on the fracture resistance of root filled teeth is not clearly validated. The post-endodontic restoration of root filled teeth should be expedient and considerate to the residual tooth structure. Posts should be placed 'passively' and excessive 'post-space' preparation should be avoided. This narrative review aims to present the aetiology, potential predisposing factors, histopathology, diagnosis and management of VRF and present perspectives for future research. Currently, there are limited options other than extraction for the management of VRF, although root resection may be considered in multi-rooted teeth. Innovative techniques to 'repair' VRFs using both orthograde and surgical approaches require further research and validation. The prevention of VRFs is critical; identifying susceptible teeth, utilizing conservative endodontic procedures, together with expedient and appropriate post-endodontic restorative procedures is paramount to reducing the incidence of terminal VRFs.
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Affiliation(s)
- Shanon Patel
- Department of Endodontology, King's College London Dental Institute, London, UK.,Specialist Practice, London, UK
| | - Bhavin Bhuva
- Department of Endodontology, King's College London Dental Institute, London, UK
| | - Raul Bose
- Department of Endodontology, King's College London Dental Institute, London, UK
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Gund MP, Wrbas KT, Hannig M, Rupf S. Apical periodontitis after intense bruxism. BMC Oral Health 2022; 22:91. [PMID: 35331220 PMCID: PMC8951715 DOI: 10.1186/s12903-022-02123-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 03/16/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Bruxism is known to cause masticatory muscle pain, temporomandibular joint pain, headaches, mechanical tooth wear, prosthodontic complications and cracked teeth. Less known to the practitioner, and described only experimentally in literature, is that bruxism can also damage the pulp. To our knowledge, this is the first known clinical case of a patient developing apical periodontitis due to bruxism. CASE PRESENTATION This article presents the case and successful treatment of a 28-year-old healthy male patient with apical periodontitis on teeth 36 and 46 requiring root canal treatment after an intense phase of bruxism. Due to an unclear diagnosis, treatment had been delayed. CONCLUSIONS Incomprehensible tooth pain can be the result of bruxism. Practitioners need to be informed that intense bruxism can possibly lead to apical periodontitis. It is important, therefore, that a thorough anamnesis is collected and taken into account during diagnostics.
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Affiliation(s)
- Madline P Gund
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Saarland University, Kirrberger Str. 100, Building 73, 66421, Homburg, Saar, Germany.
| | - Karl-Thomas Wrbas
- Department of Operative Dentistry and Periodontology, Centre for Dental Medicine, Oral and Maxillofacial Surgery, Medical Centre, University of Freiburg, Freiburg i.Br., Germany.,Division of Endodontics, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, 3500, Krems, Austria
| | - Matthias Hannig
- Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University Hospital, Saarland University, Kirrberger Str. 100, Building 73, 66421, Homburg, Saar, Germany
| | - Stefan Rupf
- Chair of Synoptic Dentistry, Saarland University, Kirrbergerstr. 100, Building 73, 66421, Homburg, Germany
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Liao WC, Chen CH, Pan YH, Chang MC, Jeng JH. Vertical Root Fracture in Non-Endodontically and Endodontically Treated Teeth: Current Understanding and Future Challenge. J Pers Med 2021; 11:jpm11121375. [PMID: 34945847 PMCID: PMC8707645 DOI: 10.3390/jpm11121375] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 09/22/2021] [Accepted: 10/25/2021] [Indexed: 12/12/2022] Open
Abstract
A vertical root fracture (VRF) is a complex complication that usually leads to tooth extraction. The aim of this article is to review the prevalence, demography, distribution, diagnostic methods, etiology and predisposing factors, clinical features, radiographic characteristics and treatment strategies of VRFs in non-endodontically treated teeth (VRFNETT) and endodontically treated teeth (VRFETT). Search terms for each subject related to VRFNETT and VRFETT were entered into MEDLINE, PubMed and Google Scholar. Systematic reviews, retrospective cohort studies, demographic research, clinical studies, case reports and case series were reviewed. Most of the VRFs were found in patients older than 40 years old. Older populations were discovered in the non-endodontically treated VRF group when compared to the endodontically treated VRF group. Male patients were found at a greater prevalence than females in the non-endodontically treated VRF group. The initial occurrence of a VRF may accompany radiolucent lines within the root canal, unusual space between the canal wall and intracanal material, a widening of the PDL space along the periradicular surfaces, angular bony destruction, step-like bone defects, V-shaped diffuse bone defects, or root resorptions corresponding to the fracture line before the clear separation of the fractured fragment. The indicative clinical and radiographic signs of VRF included a coronally positioned sinus tract, deep-narrow periodontal defects, the displacement of a fractured fragment, periradicular radiolucent halos and the widening of the root canal space. Interestingly, VRFNETT are more often observed in the Chinese population. Some patients with multiple VRFs were observed, suggesting possible predisposing factors in genetics and tooth development. The management of a VRF usually involves a multidisciplinary approach. The common distribution and features of VRFNETT and VRFETT were elucidated to facilitate recognition and diagnosis. Besides extraction, variable therapeutic schemes, such as the repair of the VRF, root amputation and others reported in earlier literature, are available. A long-term prognosis study of the various therapeutic strategies is needed.
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Affiliation(s)
- Wan-Chuen Liao
- School of Dentistry, College of Medicine, National Taiwan University, Taipei 100229, Taiwan; (W.-C.L.); (C.-H.C.)
- Department of Dentistry, National Taiwan University Hospital, Taipei 100229, Taiwan
| | - Chi-Hung Chen
- School of Dentistry, College of Medicine, National Taiwan University, Taipei 100229, Taiwan; (W.-C.L.); (C.-H.C.)
- Department of Dentistry, National Taiwan University Hospital, Taipei 100229, Taiwan
| | - Yu-Hwa Pan
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei 105406, Taiwan;
| | - Mei-Chi Chang
- Department of Dentistry, Chang Gung Memorial Hospital, Taipei 105406, Taiwan;
- School of Nursing, Chang Gung University of Science and Technology, Taoyuan 333324, Taiwan
- Correspondence: (M.-C.C.); (J.-H.J.)
| | - Jiiang-Huei Jeng
- School of Dentistry, College of Medicine, National Taiwan University, Taipei 100229, Taiwan; (W.-C.L.); (C.-H.C.)
- Department of Dentistry, National Taiwan University Hospital, Taipei 100229, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807378, Taiwan
- Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung 807377, Taiwan
- Correspondence: (M.-C.C.); (J.-H.J.)
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11
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Azarpazhooh A, Diogenes AR, Fouad AF, Glickman GN, Kishen A, Levin L, Roda RS, Tay FR, Hargreaves KM. Insights Into the February 2021 Issue of the JOE. J Endod 2021; 47:159-160. [PMID: 33478726 DOI: 10.1016/j.joen.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Amir Azarpazhooh
- Faculty of Dentistry University of Toronto, Toronto, Ontario, Canada
| | - Anibal R Diogenes
- University of Texas Health San Antonio School of Dentistry, San Antonio, Texas
| | - Ashraf F Fouad
- University of North Carolina, Chapel Hill, North Carolina
| | | | | | | | - Robert S Roda
- The Dental College of Georgia, Augusta University, Augusta, Georgia
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, Georgia
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