Endodontic Miscellany : 1. An unusual vertical root fracture

*, Dua K K and *, Kundabala M and Bhat , KS (2004) Endodontic Miscellany : 1. An unusual vertical root fracture. Endodontology, 16. pp. 23-26.

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Introduction Vertical root fractures have been described as longitudinally oriented fractures of the root, extending from the root canal to the periodontium.1 Vertical root fractures represent 2-5 % of crown/root fractures, with the greatest incidence occurring in endodontically treated teeth and in patients older than 40 years of age2. Leubke3 described two types of root fractures based on the separation of the fragments: • Where total separation is visible or fragments can be moved independently. This is defined as a complete fracture. • An incomplete fracture is said to occur in the absence of visible separation. In addition, Luebke3 has defined root fractures relative to the position of the alveolar crest. He suggests that intra osseous fractures (i.e., those terminating below the level of the alveolar bone) will result in periodontal problems whereas supra osseous fractures would not. Root fractures may originate at coronal tooth structure or at the apex. The vertical root fracture may involve the whole length of the root or only a section of it and may involve only one or both sides of the root.4-6 The cause of vertical root fractures is mainly iatrogenic, attributable to dental treatment such as excessive canal shaping, excessive pressure during compaction of gutta percha, 7-8 excessive width and length of a post space in relation to the tooth’s anatomy or excessive pressure during placement of dowel9-11. The clinical presentation of vertical root fracture is extremely variable. The clinical signs and symptoms vary according to the position of the fracture, tooth type, time elapsed since fracture, periodontal condition of the tooth and the architecture of the bone adjacent to the fracture. Local chronic infection leads to a variable combination of discomfort and soreness, mild to moderate pain, pain on biting, bad taste, swelling of soft tissues, sinus tract and deep, narrow, isolated periodontal pockets.12 Radiographs may reveal the existence of a fracture line, separated root fragments, space beside a root filling, double images of external root surface, bone destruction, widening of periodontal ligament, radiolucent halos which may mimic periodontal disease. The purpose of this paper is to present a case of vertical root fracture in an endodontically treated mandibular second premolar in which the displaced fractured fragment appeared in the radiograph like an additional root which is unusual for a lower premolar.

Item Type: Article
Additional Information: Case Report
Subjects: Dentistry > MCODS Mangalore > Conservative Dentistry
Depositing User: KMCMLR User
Date Deposited: 09 Oct 2012 09:56
Last Modified: 09 Oct 2012 09:56
URI: http://eprints.manipal.edu/id/eprint/76912

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