Identifying and Reducing Risks for Potential Fractures in Endodontically Treated Teeth

Introduction: Although long-term functional survival rates can be high for initial endodontically treated permanent teeth, they are generally more susceptible to fracture than teeth with vital pulps. Tooth extraction is often the consequence of an unfavorable prognosis after coronal and root fractures, but their occurrence in endodontically treated teeth might be reduced by identifying the risks for fracture associated with various operative procedures. Methods: This article presents an overview of the risk factors for potential tooth fractures in endodontically treated teeth on the basis of literature retrieved from PubMed and selected journal searches. Results: Postendodontic tooth fractures might occur because of the loss of tooth structure and induced stresses caused by endodontic and restorative procedures such as access cavity preparation, instrumentation and irrigation of the root canal, obturation of the instrumented root canal, post-space preparation, post selection, and coronal restoration and from inappropriate selection of tooth abutments for prostheses. Conclusions: Potential tooth fractures might be reduced by practitioners being aware during dental treatments of controllable and noncontrollable risks. (J Endod 2010;36:609-617)