根管治疗术后的牙根纵折

Vertical root fractures in endodontically treated teeth

在根管治疗过程中,为了彻底清除根管内感染源和大锥度根管预备器械的使用,常使根管预备过度,导致根管壁变薄而使牙根易发生折裂。通常情况下,完全的牙根横折和斜折,通过常规的X线根尖片即可明确诊断,但当牙根纵折时,则由于其临床症状和X线根尖片表现多与根管治疗失败和某些类型的牙周病类似,而使诊断困难,常导致患牙或病变牙根的拔除。本文通过相关文献回顾,就根管治疗术后牙根纵折的发生率、病因、临床表现、诊断和治疗作一综述。

Owing to both the effort of completely removing infectious source in root canal and the applica- tion of root canal shaping instruments with a big taper in root canal therapy procedure, root canal preparations are prone to be excessive and overzealous, which may weaken the root and lead to the development of root fracture. Complete hor- izontal and oblique root fractures can be easily detected by conventional periapical radiographs. However, it may be dif- ficult to diagnose vertical root fracture （ VRF）, because the clinical signs and symptoms associated with VRF as well as radiographic presentations are often similar to those associated with unsuccessful endodontic treatment and with certain forms of periodontal disease. VRF in endodontieally treated teeth is one of the most frustrating complications of root canal therapy, which results in tooth or root extraction. The present article systematically summarizes the prevalence, etiological factors, clinical presentations, diagnosis and treatment methods of VRF in endodontically treated teeth by reviewing related literatures.