Prevalence of Vertical Root Fractures in Root Filled Teeth and Their Clinical and Radiographic Risk Factors: A Modern Case-Control Analysis Based on Surgical Diagnosis.

IF 3.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Phachara Promchouy, Kanet Chotvorrarak, Sittichoke Osiri
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Abstract

Introduction: Vertical root fractures (VRFs) are challenging in endodontic diagnosis. This study determined VRF prevalence and risk factors in root-filled teeth (RFT) requiring endodontic surgery.

Methods: From 411 RFT that underwent endodontic surgery (2005-2022), 130 VRF cases and 260 randomly selected controls were analyzed. Demographic, clinical, and radiographic data were collected from dental records and images. Multiple imputations addressed missing data. Univariable and multivariable logistic regression analyses with robust standard errors to account for the clustering of multiple teeth within the same patient were performed, with subanalyses for teeth with intraradicular posts and molars. VRF characteristics were analyzed in individuals with available cone beam computed tomography images.

Results: VRF prevalence was 31.63% among RFT undergoing endodontic surgery. Significant risk factors included age (adjusted odds ratio [aOR] = 1.02), probing depth ≥5 mm (aOR = 2.37), isolated perilateral radiolucency (aOR = 4.05), halo radiolucency (aOR = 2.70), overfilled root canal (aOR = 2.11), and root canal space-to-root-width ratio >1/3 (aOR = 1.52). For teeth with posts, a post space-to-root-width ratio >1/3 increased VRF risk (unadjusted OR [uOR] = 2.46). Cone beam computed tomography findings revealed the absence of the buccal plate (uOR = 1.74) and space between the cortical plate and root surface (uOR = 2.73) as significant factors.

Conclusions: VRFs affected nearly one-third of RFT requiring endodontic surgery; major risk factors included older age, overfilled root canals, and excessive root canal space-to-root-width ratio. VRF-associated clinical and radiographic signs included probing depth ≥5 mm, isolated perilateral radiolucency, and halo radiolucency.

根充填牙纵根骨折的患病率及其临床和影像学危险因素:基于外科诊断的现代病例对照分析。
垂直根骨折(VRFs)在牙髓学诊断中具有挑战性。本研究确定了需要进行牙髓手术的补根牙(RFT)中VRF的患病率和危险因素。方法:对2005-2022年接受根管手术的411例RFT患者,130例VRF患者和260例随机选择的对照组进行分析。从牙科记录和图像中收集人口统计学、临床和放射学数据。多重输入处理缺失的数据。单变量和多变量逻辑回归分析具有稳健的标准误差,以解释同一患者中多颗牙齿的聚类,并对具有根内桩和磨牙的牙齿进行亚分析。利用可用的锥束计算机断层扫描(CBCT)图像分析个体的VRF特征。结果:接受牙髓手术的RFT患者VRF患病率为31.63%。显著危险因素包括年龄(校正优势比[aOR] = 1.02)、探测深度≥5 mm (aOR = 2.37)、孤立的周围放射透光率(aOR = 4.05)、晕放射透光率(aOR = 2.70)、根管过度填充(aOR = 2.11)、根管空间-根宽比>1/3 (aOR = 1.52)。对于有桩的牙齿,桩间距与根宽之比bbbb1 /3增加VRF风险(未调整OR [uOR] = 2.46)。CBCT结果显示颊板缺失(uOR = 1.74)和皮质板与根表面间隙(uOR = 2.73)是显著因素。结论:vrf影响了近三分之一需要进行牙髓手术的RFT;主要危险因素包括年龄较大、根管填充过度、根管空间与根宽比过大。vrf相关的临床和影像学征象包括探探深度≥5mm,孤立的外周放射透光率和光晕放射透光率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of endodontics
Journal of endodontics 医学-牙科与口腔外科
CiteScore
8.80
自引率
9.50%
发文量
224
审稿时长
42 days
期刊介绍: The Journal of Endodontics, the official journal of the American Association of Endodontists, publishes scientific articles, case reports and comparison studies evaluating materials and methods of pulp conservation and endodontic treatment. Endodontists and general dentists can learn about new concepts in root canal treatment and the latest advances in techniques and instrumentation in the one journal that helps them keep pace with rapid changes in this field.
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