Vertical root fracture in nonendodontically treated teeth--a clinical report of 64 cases in Chinese patients

Vertical root fractures (VRFs) in teeth without endodontic treatment are uncommon. A clinical study was done on 64 cases of VRFs in 61 Chinese patients to define better the clinical characteristics, diagnostic signs, and possible causes. Results showed that fractures occurred most often in first molars of patients between 40 and 69 yr of age, and the incidence was two times higher in males than in females. Flat roots with smaller mesiodistal diameters were more prone to fracture. The majority (79%) of patients had intact dentition with less than four teeth missing. Fractured teeth were frequently attrited with no restorations. VRFs may result from excessive or repetitive masticatory force due to damaging chewing habits exerted on flat roots of smaller mesiodistal diameter. Nonendodontic VRFs seem to occur more frequently than earlier believed and may represent an underdiagnosed clinical entity deserving of our attention.