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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.
Introduction:
Vertical root fractures (VRFs) are among the most frequent causes of tooth loss, mainly of endodontically treated teeth. However, very few data is available about the occurrence of VRFs following apical surgery.
Methods:
Patient charts from 864 patients with 1058 teeth treated with apical surgery (September 1999 to December 2018) were retrospectively evaluated, if a VRF had occurred after surgery. The following, possibly influencing factors were analyzed: sex and age, type of treated tooth, primary versus resurgery, technique of root-end preparation, and timepoint of VRF diagnosis. Endpoints were either tooth extraction or the last follow-up.
Results:
The study cohort (55% women, 45% men) had a mean age of 52.00 ± 13.97 years (range 9-93 years). The overall rate of VRFs after apical surgery was 4% (42 of 1058 teeth). Among these 42 teeth, 33.3% were mandibular first molars and 26.2% were maxillary second premolars. The most frequently affected root was the mesial root of mandibular first molars (28.6%). With regard to the study parameters, significant differences of VRF rates were observed only for the type of tooth treated.
Conclusions:
A low VRF rate of 4% was observed in this study. VRFs commonly occurred in maxillary premolars and mandibular molars, with the mesial root of mandibular first molars affected most frequently. This is in line with previous reports about VRFs in endodontically treated teeth without additional apical surgery.
