Department of Endodontics, College of Stomatology, Nanjing Medical University, Nanjing, PR China.
J Endod. 2010 Apr;36(4):609-17. doi: 10.1016/j.joen.2009.12.002.
Although long-term functional survival rates can be high for initial endodontically treated permanent teeth, they are generally more susceptible to fracture than teeth with vital pulps. Tooth extraction is often the consequence of an unfavorable prognosis after coronal and root fractures, but their occurrence in endodontically treated teeth might be reduced by identifying the risks for fracture associated with various operative procedures.
This article presents an overview of the risk factors for potential tooth fractures in endodontically treated teeth on the basis of literature retrieved from PubMed and selected journal searches.
Postendodontic tooth fractures might occur because of the loss of tooth structure and induced stresses caused by endodontic and restorative procedures such as access cavity preparation, instrumentation and irrigation of the root canal, obturation of the instrumented root canal, post-space preparation, post selection, and coronal restoration and from inappropriate selection of tooth abutments for prostheses.
Potential tooth fractures might be reduced by practitioners being aware during dental treatments of controllable and noncontrollable risks.
尽管初始根管治疗后的恒牙长期功能存活率可能较高,但与活髓牙相比,它们更容易发生骨折。冠根折后预后不佳,往往会导致拔牙,但通过识别与各种手术操作相关的骨折风险,可以降低根管治疗牙发生骨折的几率。
本文根据从 PubMed 和选定的期刊搜索中检索到的文献,概述了根管治疗牙潜在牙折的危险因素。
根管治疗后牙折可能是由于牙体结构的丧失和根管治疗和修复程序(如开髓、根管预备和冲洗、根管器械的填充、桩腔预备、桩选择、牙冠修复)引起的内应力,以及对修复体基牙选择不当所致。
在进行牙科治疗时,临床医生了解可控和不可控风险,有助于降低潜在牙折的风险。