Pattern of bone resorption in vertically fractured, endodontically treated teeth

By Lustig J, Tamse A, Fuss Z

Date: 01/2000
Journal: OSOMOP

Purpose:

Evaluate the pattern of alveolar bone loss on vertical root fractures and correlate it with signs and symptoms before extraction

Materials/Methods:

N=110 endodontically teeth (66 maxillary premolars, 13 mandibular premolars, 31 mandibular molar M root) with diagnosis of Vertical root fracture referred for extraction. Excluded if records did not supply accurate info(previous symptoms), or apical surgery. Signs/symptoms recorded by oral surgeon before extraction:

  • Chronic pain that is mild and intermittent when biting with the tooth, or purulent suppuration from a sinus tract or from an osseous defect
  • Acute or persistent pain, swelling, or both
  • Exacerbation of chronic symptoms: patient’s tooth history showed previous chronic symptoms, becoming acute before extraction
  • Asymptomatic: a suspicious radiographic feature or vertical root fracture was detected on routine examination with no symptoms

Teeth were then extracted, socket inspected for type of alveolar bone loss B-P/L and interproximal walls

Results:

  1. Patients with chronic symptoms had signifcantly more bone resorption
  2. 2 types of bone resorption of buccal plate
  3. dehiscence-V shaped-tip at apical point of fx/resorption, base-most coronal points of bone loss(91%)
  4. fenestration-oval shaped with bridge of coronal bone (9%) –only clinical sign was abscess
  5. Lingual dehiscence showed less resorption and tip of triangle was more rounded-U shaped

Clinical Significance:

The type of bone loss described in this article may be seen with exploratory surgery and will help confirm the diagnosis of Vertical root fracture, and early diagnosis of Vertical root fracture and extraction can prevent more severe bone loss