Abstract
When a vertical root fracture reaches the outer surface of the root, it communicates with the periodontal ligament, and an inflammatory process begins in this area. On communication with the oral cavity through the gingival sulcus, foreign material and bacteria obtain access to the fracture area. The inflammatory process increases with a slow separation of the fractured parts of the root and a breakdown in the periodontal ligament and the alveolar bone. Consequently, granulomatous tissue is formed, and bone subsequently resorbs with typical features such that most are clinically manifested. This chapter will describe the histopathological features of the hard and soft tissues associated with vertical root fractured teeth, including the various tissues and elements involved.
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References
Karygianni L, Krengel M, Winter M, Stampf S, Wrbas KT. Comparative assessment of the incidence of vertical root fractures between conventional versus surgical endodontic retreatment. Clin Oral Investig. 2014;18(8):2015–21.
Tamse A. Vertical root fractures in endodontically treated teeth. In: Ingle JI, Backland LK, Baumgartner JC, editors. Ingle’s endodontics. 6th ed. Hamilton: BC Decker, Inc.; 2008. p. 676–89.
Lustig J, Tamse A, Fuss Z. Pattern of bone resorption in vertically fractured, endodontically treated teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:224–7.
Tamse A, Kaffe I, Lustig J, et al. Radiographic features of vertically fractured endodontically treated mesial roots of mandibular molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;101:797–802.
Rivera E, Walton R. Longitudinal tooth fractures. In: Torabinejad M, Walton R, Fouad A, editors. Endodontics: principles and practice. 5th ed. St Louis: Elsevier; 2015. p. 121–41.
Newman M, Takei H, Klokkevold P, Carranza F, editors. Carranza’ clinical periodontology. 11th ed. St Louis: Elsevier; 2012. p. 509.e14–E16 (epub report 2014).
Tsesis I, Rosen E, Tamse A, Taschieri S, Kfir A. Diagnosis of vertical root fractures in endodontically treated teeth based on clinical and radiographic indices: a systematic review. J Endod. 2010;36(9):1455–8.
Tamse A. Vertical root fractures in endodontically treated teeth: diagnostic signs and clinical management. Endod Top. 2006;13:84–94.
Walton R, Michelich R, Smith G. The histopathogenesis of vertical root fractures. J Endod. 1984;10:48–56.
Torabinejad M, Shabahang S. Pulp and periapical pathosis. In: Torabinejad M, Walton R, Fouad A, editors. Endodontics: principles and practice. 5th ed. St Louis: Elsevier; 2015. p. 58–62.
Sundquist G, Figdor D, Persson S, et al. Microbiologic analysis of teeth with failed root canal treatment and the outcome of conservative retreatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85:86–93.
Siquiera J, Rocas I. Polymerase chain reaction-based analysis of microorganisms associated with failed endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97:85–94.
Donlon R, Costeron J. Biofilms: survival mechanisms of clinically relevant microorganisms. Clin Microbiol Rev. 2002;15:167–93.
Siquiera J, Rocas I. Community as the unit of pathogenicity: an emerging concept as to microbial pathogenesis of apical periodontitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:870–8.
Theilade E. Microbiology, Chapter 8. In: Bergenholtz G, Horsted-Bindslev P, Reit C, editors. Textbook of endodontology. Oxford, UK: Blackwell; 2003. p. 112–4.
Kerns D. Acute periodontal conditions, Chapter 12. In: Rose L, Mealey B, Genco R, editors. Periodontics: medicine, surgery and implants. St Louis: Elsevier; 2004. p. 204.
Chavez de Paz L, Molander A, Dahlen G. Gram-positive rods prevailing in teeth with apical periodontitis undergoing root canal treatment. Int Endod J. 2004;37:579–87.
Chu F, Leung W, Tsang P, et al. Identification of cultivable microorganisms from root canals with apical periodontitis following two-visit endodontic treatment with antibiotic/steroids or calcium hydroxide dressings. J Endod. 2006;32:17–23.
Pitts D, Matheny H, Nicholls J. An in vitro study of spreader loads required to cause vertical root fracture during lateral condensation. J Endod. 1983;9:544–50.
Holcomb J, Pitts D, Nicholls J. Further investigation of spreader loads required to cause vertical root fracture during lateral condensation. J Endod. 1987;13:277–84.
Preshaw P, Taylor J. Periodontal pathogenesis, Chapter 21. In: Newman M, Takei H, Klokkevold P, Carranza F, editors. Carranza’s clinical periodontology. 11th ed. St Louis: Elsevier; 2012. p. 195.
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Walton, R.E., Rivera, E. (2015). Pathogenesis of the Vertical Root Fracture. In: Tamse, A., Tsesis, I., Rosen, E. (eds) Vertical Root Fractures in Dentistry. Springer, Cham. https://doi.org/10.1007/978-3-319-16847-0_6
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DOI: https://doi.org/10.1007/978-3-319-16847-0_6
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-16846-3
Online ISBN: 978-3-319-16847-0
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