{"title":"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。","authors":"Phachara Promchouy, Kanet Chotvorrarak, Sittichoke Osiri","doi":"10.1016/j.joen.2025.07.020","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"Phachara Promchouy, Kanet Chotvorrarak, Sittichoke Osiri\",\"doi\":\"10.1016/j.joen.2025.07.020\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":15703,\"journal\":{\"name\":\"Journal of endodontics\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2025-08-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of endodontics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.joen.2025.07.020\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of endodontics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.joen.2025.07.020","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
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.
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.
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.