Horizontal root fractures in posterior teeth without dental trauma: tooth/root distribution and clinical characteristics.
OBJECTIVE
To describe the clinical characteristics and radiographic findings of horizontal root fractures (HRF) in posterior teeth without a history of dental trauma.


METHODS
A total 24 patients and 31 HRF cases in 28 posterior teeth were collected from 2006 to 2015. Clinical examinations and radiographic imaging were evaluated. Value of confidence intervals of the proportions was calculated for data presentation.


RESULTS
The number of males (54%) was similar to females (46%). The patients were predominantly between 50 and 70 years of age (75%). Most HRF cases were found in nonendodontically treated teeth (79%), without crown and bridge restorations (82%), and maxillary molars (54%). Many roots of maxillary molars had developed HRF, and the probability was nearly equal. Fractured teeth usually presented with periodontal and apical bone loss, and most patients (92%) were diagnosed with full mouth chronic periodontitis. Tooth wear was another common clinical feature amongst these patients.


CONCLUSIONS
HRF in posterior teeth without dental trauma occurred mainly in patients aged between 50 and 70, in nonendodontically treated teeth, teeth with attrition but without crown and bridge restorations, maxillary molars and with periodontal and periapical bony destruction. Periodontal condition, occlusal wear and patients' age at diagnosis were the possible related factors. HRF in posterior teeth without dental trauma is a diagnostic challenge and even misdiagnosed. A thorough clinical examination, radiographic analysis and recognition of the clinical characteristics are helpful in the early diagnosis and treatment of HRF.
Graduate Institute of Clinical Dentistry, National Taiwan University Medical College, Taipei, Taiwan.|Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
Y-L
YL
Tsai
Graduate Institute of Clinical Dentistry, National Taiwan University Medical College, Taipei, Taiwan.|Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
W-C
WC
Liao
Graduate Institute of Clinical Dentistry, National Taiwan University Medical College, Taipei, Taiwan.|Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
C-Y
CY
Wang
Biomedical Science Team, Chang Gung University of Science and Technology, Taoyuan, Taiwan.|Department of Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan.
M-C
MC
Chang
Biostatistics Laboratory, College of Public Health, National Taiwan University, Taipei, Taiwan.
S-H
SH
Chang
Department of Dentistry, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
S-F
SF
Chang
Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan.
C-W
CW
Chang
Graduate Institute of Clinical Dentistry, National Taiwan University Medical College, Taipei, Taiwan.|Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
Y-D
YD
Huang
Department of Dentistry, Chang Gung Memorial Hospital, Taipei, Taiwan.
C-P
CP
Chan
Graduate Institute of Clinical Dentistry, National Taiwan University Medical College, Taipei, Taiwan.|Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.
J-H
JH
Jeng
D017677:Age Distribution; D000368:Aged; D001641:Bicuspid / Q000000981:diagnostic imaging / Q000293:injuries; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008963:Molar / Q000000981:diagnostic imaging / Q000293:injuries; D011861:Radiography, Dental; D017678:Sex Distribution; D014082:Tooth Fractures / Q000000981:diagnostic imaging; D014092:Tooth Root / Q000000981:diagnostic imaging / Q000293:injuries*
horizontal root fracture; occlusal trauma; posterior teeth; predisposing factor; root canal treatment; traumatic dental injury