State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichan University, Chengdu, China.
Dent Traumatol. 2011 Dec;27(6):484-8. doi: 10.1111/j.1600-9657.2011.01030.x. Epub 2011 Jul 14.
Vertical root fractures (VRFs) often occur in endodontically treated teeth and in patients older than 40 years of age. However, VRFs in teeth without endodontic treatment are relatively uncommon. VRFs are difficult to diagnose as the symptoms are non-specific or often delayed. The most common radiographic findings are thickening of the periodontal ligament, deep, localized, vertical bone loss, and localized periradicular bone loss. The explicit feature for detecting VRFs is direct visualization of a radiolucent fracture line on radiographs. However, the fracture line can be difficult to directly visualize in conventional diagnostic methods such as periapical radiographs. If unrecognized, VRFs can lead to frustration and inappropriate endodontic treatment. The two cases reported here demonstrate that the use of cone beam computed tomography (CBCT) successfully diagnoses VRFs on teeth without representative clinical and periapical radiographic findings. The clear fracture line can be discerned from the images of CBCT. Thus, CBCT imaging is useful in rapid diagnosis of VRFs and designing of further treatment.
垂直根折（VRF）常发生于牙髓治疗后的牙齿和 40 岁以上的患者。然而，未经牙髓治疗的牙齿发生 VRF 则相对少见。由于症状不典型或常出现延迟，VRF 较难诊断。最常见的放射影像学表现为牙周膜增宽、深而局限的垂直骨丧失以及局限性根尖周骨丧失。检测 VRF 的明确特征是放射影像学上直接观察到透亮性骨折线。然而，骨折线在常规诊断方法（如根尖片）中可能难以直接观察到。如果未能识别，VRF 可能导致沮丧和不适当的牙髓治疗。本文报道的两例病例表明，锥形束 CT（CBCT）的使用成功诊断了无代表性临床和根尖片放射影像学表现的牙齿 VRF。从 CBCT 的图像中可以清楚地分辨出骨折线。因此，CBCT 成像有助于 VRF 的快速诊断和进一步治疗方案的设计。
