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Occurrence of Vertical Root Fractures after Apical Surgery: A Retrospective Analysis
Thomas von Arx1, Paola Maldonado1, Michael M Bornstein2
1Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Journal of Endodontics
|October 25, 2020
Summary
A low rate of vertical root fractures (VRFs) occurred after apical surgery, with most fractures affecting mandibular molars and maxillary premolars. These findings align with previous studies on endodontically treated teeth.
Area of Science:
- Endodontics
- Oral Surgery
- Dental Research
Background:
- Vertical root fractures (VRFs) are a leading cause of tooth loss, particularly in endodontically treated teeth.
- Limited data exists on the incidence of VRFs subsequent to apical surgery.
Purpose of the Study:
- To investigate the occurrence and influencing factors of vertical root fractures (VRFs) after apical surgery.
- To identify specific tooth types and root locations most susceptible to VRFs post-apical surgery.
Main Methods:
- Retrospective evaluation of 1058 teeth from 864 patients undergoing apical surgery between 1999 and 2018.
- Analysis of factors including patient demographics, tooth type, surgical history, and root-end preparation technique.
- Tracking of endpoints such as tooth extraction or last follow-up.
Main Results:
- An overall VRF rate of 4% (42 of 1058 teeth) was observed following apical surgery.
- Mandibular first molars (33.3%) and maxillary second premolars (26.2%) were most frequently affected.
- The mesial root of mandibular first molars showed the highest fracture incidence (28.6%); tooth type was the only significant factor.
Conclusions:
- Apical surgery is associated with a low incidence of vertical root fractures (4%).
- Maxillary premolars and mandibular molars, especially the mesial root of mandibular first molars, are most prone to VRFs after this procedure.
- Findings are consistent with existing literature on VRFs in endodontically treated teeth.
