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歯内治療歯と非歯内治療歯における垂直性歯根破折の臨床的およびX線学的特徴
Clinical and Radiographic Characteristics of Vertical Root Fractures in Endodontically and Nonendodontically Treated Teeth.
PMID: 28292598
抄録
はじめに:
垂直性歯根破折(VRF)とは、歯根の長手方向に伸びる歯根破折であり、歯内療法を行った歯でしばしば認められる。しかし、VRFの臨床的およびX線学的特徴は完全にはわかっていない。
INTRODUCTION: A vertical root fracture (VRF) is a root fracture extending along the longitudinal axis of roots and is often noted in endodontically treated teeth. However, the clinical and radiographic characteristics of VRFs are not completely known.
方法:
中国人患者58人、計65歯、68本の垂直破折歯根を調査した。臨床検査記録とX線写真を詳細に検討した。
METHODS: A total of 65 teeth with 68 vertical fractured roots in 58 Chinese patients were investigated. The clinical examination records and radiographic images were reviewed in detail.
結果:
25~90歳(平均57歳)の男性患者24名(41.38%)、女性患者34名(58.62%)を対象とし、51名(87.93%)が1歯、7名(12.07%)が2歯の歯列でVRFを認めた。VRFは主に下顎大臼歯(29歯、44.62%)の中根(20歯、57.14%)に発生した。臨床的には、VRFを有する歯は通常、歯周プロービングデプス5mm以上(44歯、91.67%、P<.001)、補綴物あり(55歯、84.62%、P<.001)、比較的無傷な歯列(42歯、77.78%、P<.001)であった。歯内療法を受けていないVRFのほとんどは、咬合面は咬耗していた。VRFを有する歯のX線写真の特徴は、一般的に、根管治療の既往(56歯、86.15%、P<.001)、歯周骨喪失(62歯、95.38%、P<.001)、歯根端骨喪失(52歯、80.00%、P<.001)、歯根膜拡大(61歯、93.85%、P<.001)と関連していた。下顎大臼歯の中根は、歯内療法を行った歯および歯内療法を行っていない歯のいずれにおいても、VRFの影響を最も受けやすかった。
RESULTS: A total of 24 male (41.38%) and 34 female (58.62%) patients aged 25-90 years (average = 57 years) were included; 51 (87.93%) and 7 (12.07%) patients exhibited 1 tooth and 2 teeth with VRFs, respectively, in the dentition. VRFs occurred mainly in the mesial root (20 roots, 57.14%) of the mandibular molars (29 teeth, 44.62%). Clinically, teeth with VRFs usually presented a periodontal probing depth >5 mm (44 teeth, 91.67%, P < .001) with a prosthesis (55 teeth, 84.62%, P < .001) and a relatively intact dentition (42 patients exhibited <4 missing teeth in the dentition, 77.78%, P < .001). Most of the nonendodontically treated VRFs exhibited attrited occlusal surfaces. Radiographic characteristics of the teeth with VRFs were typically associated with prior root canal treatment (56 teeth, 86.15%, P < .001), periodontal bone loss (62 teeth, 95.38%, P < .001), apical bone loss (52 teeth, 80.00%, P < .001), and periodontal ligament widening (61 teeth, 93.85%, P < .001). The mesial roots of the mandibular molars were most susceptible to VRFs in both endodontically and nonendodontically treated teeth.
結論:
以上の結果から、VRFの同定を容易にする臨床的、X線的、診断的特徴が明らかになった。
CONCLUSIONS: These results elucidated some clinical and radiographic and diagnostic features that facilitate VRF identification.