title: Detection of vertical root fracture using cone beam computed tomography: report of two cases.
abstract: 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.
authors.affiliation: State Key Laboratory of Oral Diseases, West China College of Stomatology, Sichan University, Chengdu, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Tang
authors.forename: Xue-dong
authors.initials: XD
authors.lastname: Zhou
authors.forename: Yao
authors.initials: Y
authors.lastname: Wang
authors.forename: Lan
authors.initials: L
authors.lastname: Zhang
authors.forename: Qing-hua
authors.initials: QH
authors.lastname: Zheng
authors.forename: Ding-ming
authors.initials: DM
authors.lastname: Huang
mesh_terms: D001641:Bicuspid / Q000000981:diagnostic imaging / Q000293:injuries; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003731:Dental Caries / Q000000981:diagnostic imaging; D003790:Dental Pulp Necrosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008875:Middle Aged; D008963:Molar / Q000000981:diagnostic imaging / Q000293:injuries; D010347:Patient Care Planning; D016300:Radiography, Bitewing; D019227:Tooth Apex / Q000293:injuries; D014081:Tooth Extraction; D014082:Tooth Fractures / Q000145:classification / Q000000981:diagnostic imaging*; D014092:Tooth Root / Q000000981:diagnostic imaging / Q000293:injuries*; D019553:Tooth, Nonvital / Q000000981:diagnostic imaging