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Fracture necrosis: A risk indicator for tooth loss
Journal of the American Dental Association (1939)
|April 20, 2020
Summary
Fracture necrosis, a tooth fracture from the crown, leads to poor prognosis. Extraction is often the best treatment, as root canal therapy may not fully resolve the infection and prevent further tooth damage.
Area of Science:
- Endodontics
- Periodontics
- Dental Traumatology
Background:
- Fracture necrosis describes pulpal vitality loss due to crown-originating fractures in unrestored teeth.
- Teeth with fracture necrosis often present with poor prognoses and may necessitate extraction.
Observation:
- Two cases of adult men with mandibular second molars exhibited crown-originating fractures and suspected fracture necrosis.
- Symptoms included localized periodontal bone/attachment loss and severe masticatory pain.
Findings:
- Nonsurgical root canal therapy and a crown only prolonged survival for 30 months in one case.
- Virulent microorganisms can persist post-root canal therapy, leading to periodontal tissue loss.
Implications:
- Extraction and tooth replacement may be a more sound clinical approach for fracture necrosis than retention therapies.
- Characteristic radiographic findings associated with fracture necrosis support extraction as a primary treatment option.
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