Yoshino Koichi, Ito Koji, Kuroda Masahiko, Sugihara Naoki
Department of Epidemiology and Public Health, Tokyo Dental College.
Kyushikai, Kuroda Dental Clinic.
Bull Tokyo Dent Coll. 2018;59(1):59-61. doi: 10.2209/tdcpublication.2016-0049.
Diagnosing vertical root fracture (VRF) is difficult. Here, we retrospectively investigated the duration from initial symptoms to a definite diagnosis of VRF in dental offices. Data were collected on patients with VRF between July 2013 and June 2015. Initial symptoms were ascertained from clinical records. The focus was on the maxillary second premolars and mesial roots of the mandibular first molars, where VRF is most frequent. All VRF in the bilateral dentition was analyzed. Only cases in which the buccal-lingual plane of the root was fractured were included. Data from 31 dental offices revealed a total of 39 VRFs in the maxillary second premolars and 43 in the mandibular mesial roots of the first molars. The patients comprised 42 males and 40 females, and the average age was 59.7±11.6 years at initial onset of symptoms. The mean duration from initial symptoms to a definite diagnosis in the maxillary second premolars was 18.3±22.5 months, while that in the mandibular first molars was 16.1±17.8 months. The cumulative diagnostic rate was 48.7% at 12 months and 79.5% at 24 months in the maxillary second premolars, and 38.1% at 12 months and 86.0% at 24 months in the mandibular first molars. No significant difference was observed between tooth type. If VRF is suspected, doctors should explain the risks of tooth extraction and begin considering treatment options. The present results revealed that 80% of VRFs were diagnosed within 2 years of initial onset of symptoms.
诊断垂直根折(VRF)很困难。在此,我们回顾性调查了牙科诊所中从初始症状出现到确诊VRF的时间。收集了2013年7月至2015年6月期间VRF患者的数据。初始症状从临床记录中确定。重点关注上颌第二前磨牙和下颌第一磨牙的近中根,这是VRF最常发生的部位。分析了双侧牙列中的所有VRF。仅纳入牙根颊舌向平面发生骨折的病例。来自31家牙科诊所的数据显示,上颌第二前磨牙共有39例VRF,下颌第一磨牙近中根有43例。患者包括42名男性和40名女性,症状初始发作时的平均年龄为59.7±11.6岁。上颌第二前磨牙从初始症状到确诊的平均时间为18.3±22.5个月,而下颌第一磨牙为16.1±17.8个月。上颌第二前磨牙在12个月时的累积诊断率为48.7%,在24个月时为79.5%;下颌第一磨牙在12个月时为38.1%,在24个月时为86.0%。不同牙位之间未观察到显著差异。如果怀疑有VRF,医生应解释拔牙风险并开始考虑治疗方案。目前的结果显示,80%的VRF在症状初始发作后的2年内得到诊断。