Clinical analysis on the root fracture of the maxillary first molar

doi:10.7518/hxkq.2021.05.009

Abstract

Abstract: Objective

This study aimed to investigate the common types and directions of root fractures of the maxillary first molar and the influence of root canal treatment on the prevalent sites of root fractures.

Methods

A total of 274 maxillary first molars with root fractures diagnosed via cone beam computed tomography were included. The root fractures of nonendodontically and endodontically treated teeth were identified to be spontaneous and secondary root fractures, respectively. The sites, types, and directions of spontaneous and secondary root fractures were determined.

Results

Among the spontaneous root fractures, the proportion of palatal root fractures (56.1%) was higher than those of mesial buccal root fractures (36.1%) and distal buccal root fractures (7.8%). Among the secondary root fractures, the proportion of mesial buccal root fractures (52.7%) was higher than those of palatal root fractures (36.5%) and distal buccal root fractures (10.8%). The distribution of predominant fracture sites was statistically significant (P<0.05), and vertical root fracture was the most common type. Palatal and buccal roots were commonly fractured at the mesiodistal and buccal-palatal directions, respectively.

Conclusion

This study provided an epidemiological basis for the clinical features of root fractures of the maxillary first molar. During the dia-gnosis and treatment of the maxillary first molar, the possibility of palatal root fractures should be considered. The occurrence of mesial buccal root fractures may be related to root canal treatment. Therefore, the risk of mesial buccal root fractures caused by iatrogenic factors should be minimized.

Key words: maxillary first molar, root fracture, cone beam computed tomography, spontaneous root fracture, secondary root fracture

CLC Number:

R 781.2

Yuan Zhiyao, Zou Xihong, Dai Linlin, Ao Huizhi, Li Houxuan.. Clinical analysis on the root fracture of the maxillary first molar[J]. West China Journal of Stomatology, 2021, 39(5): 555-559.

Figures/Tables 3

Tab 1

Tab 2

Tab 3

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折裂牙根	例数	构成比/%
腭根	137	50.0
近中颊根	102	37.2
远中颊根	14	5.1
近中颊根+腭根	9	3.3
近中颊根+远中颊根	9	3.3
近中颊根+远中颊根+腭根	3	1.1

折裂牙根	原发性牙根折裂/n（%）	继发性牙根折裂/n（%）	χ²值	P值
腭根	115（56.1）	34（36.5）
近中颊根	74（36.1）	49（52.7）
远中颊根	16（7.8）	10（10.8）
合计	205（100.0）	93（100.0）	9.79	0.007

特征分类	原发性牙根折裂				继发性牙根折裂
特征分类	腭根/n（%）	近中颊根/n（%）	χ²值	P值	腭根/n（%）	近中颊根/n（%）	χ²值	P值
折裂类型			22.00	<0.001			8.48	0.014
横折	21（18.2）	23（31.1）			4（11.8）	10（20.4）
斜折	47（40.9）	7（9.4）			10（29.4）	3（6.1）
纵折	47（40.9）	44（59.5）			20（58.8）	36（73.5）
总数	115（100.0）	74（100.0）			34（100.0）	49（100.0）
横折部位			9.13	0.01			0.72	0.699
根尖1/3	1（4.8）	1（4.3）			0（0.0）	1（10.0）
根中1/3	10（47.6）	2（8.7）			1（25.0）	2（20.0）
颈1/3	10（47.6）	20（87.0）			3（75.0）	7（70.0）
总数	21（100.0）	23（100.0）			4（100.0）	10（100.0）
纵折方向			68.72	<0.001			36.59	<0.001
颊腭向	4（8.5）	42（95.5）			2（10.0）	33（91.7）
近远中	43（91.5）	2（4.5）			18（90.0）	3（8.3）
总数	47（100.0）	44（100.0）			20（100.0）	36（100.0）

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