4.2 Article

Development and validation of a method for creating incomplete vertical root fracture in extracted teeth

Journal

ODONTOLOGY
Volume 111, Issue 3, Pages 750-758

Publisher

SPRINGER
DOI: 10.1007/s10266-023-00787-z

Keywords

Cone-beam computed tomography; Diagnosis; Endodontics; Fracture width; Vertical root fracture

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The present study developed a method to induce incomplete root fracture in human extracted teeth for evaluating different diagnostic imaging techniques. The method involved removing tooth crowns, preparing root canals, and applying a customized conical wedge with a specific force to induce fractures. The method was successful in producing fractures that resembled clinical presentation. It is a reproducible and reliable method for laboratory studies on vertical root fractures.
The present study reported a method for inducing incomplete root fracture in human extracted teeth for the purpose of evaluating the merits of different diagnostic imaging techniques. Thirty-five single-rooted teeth were inspected under magnification and transillumination to exclude previously fractured teeth. Tooth crowns were removed, and the root canals were prepared up to the ProTaper Next X4 (40.06) file. Each root was lined with wax and embedded in a polystyrene resin block. The setup was attached to a universal testing machine for pressing a customized conical wedge (diameter at tip: 0.6 mm; taper: 0.2 mm/mm) into the instrumented canal with a 2 kN load at 5 mm/min. The machine was programmed to stop after a sudden 10% drop in loading force. Each specimen was removed from the resin block and inspected under x 20 magnification and transillumination to identify the fracture characteristics (pattern, surfaces and root-third affected). The gap width of each specimen was measured at different locations along the fracture line. The protocol induced incomplete vertical root fractures in all specimens. Fracture widths were < 100 mu m in all specimens (mean gap width: 34.9 mu m). The proposed methodology was successful in inducing incomplete vertical root fractures with characteristics that resemble the clinical presentation of these conditions. The method is easy to execute, highly reproducible and helps to minimize bias in laboratory studies that aims to mimic vertical root fractures.

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