J Endod. 2010 Mar;36(3):442-6. doi: 10.1016/j.joen.2009.12.018.
The presence of cracks and fractures in teeth can pose difficulties in diagnosis, prognosis assessment, and treatment recommendations. When a tooth has no significant restorations or caries, whereby the pulp is nonvital in the absence of a luxation injury, it is suggested that this necrosis is likely caused by a significant longitudinal crack that extends from the occlusal surface and into the pulp. This type of presentation has been termed "fracture necrosis."
Twenty-seven teeth with nonvital pulps were evaluated that had no restorations or minimally deep restorations and no signs of caries. These teeth were extracted and evaluated as to the depth and location of any potential fracture.
All evaluated teeth were found to have cracks that extended from the occlusal surface into the pulp and progressed to an external root surface.
Pulp necrosis, in the absence of restorations, caries, or luxation injuries, is likely caused by a longitudinal fracture extending from the occlusal surface and into the pulp. Based on the available literature, these types of teeth may have a poor prognosis after endodontic treatment, with the potential ramification of extensive periodontal and/or periapical bone loss. Extraction may be considered as the primary treatment option.
牙齿的裂缝和断裂会给诊断、预后评估和治疗建议带来困难。当牙齿没有明显的修复体或龋齿，牙髓在没有脱位损伤的情况下失活时，建议这种坏死很可能是由从咬合面延伸到牙髓的明显纵向裂缝引起的。这种表现形式被称为“骨折性坏死”。
评估了 27 颗无修复体或仅有少量深修复体且无龋齿迹象的无活力牙髓牙齿。这些牙齿被拔出并评估任何潜在裂缝的深度和位置。
所有评估的牙齿都发现有从咬合面延伸到牙髓并进展到外部牙根表面的裂缝。
在没有修复体、龋齿或脱位损伤的情况下，牙髓坏死可能是由从咬合面延伸到牙髓的纵向裂缝引起的。根据现有文献，这些类型的牙齿在根管治疗后预后可能较差，可能会导致广泛的牙周和/或根尖周骨丢失。拔牙可能被认为是主要的治疗选择。
