Journal of dentistry · 2026
Occlusal and behavioral factors associated with vertical root fractures in endodontically treated teeth: A retrospective matched case-control study.
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Sricharat Piraya, Nalamliang Napat, Jearanaiphaisarn Thanomsuk
Аннотация
OBJECTIVES: This study investigated clinical factors and oral functional behaviors associated with vertical root fractures (VRFs) in endodontically treated teeth (ETT).
METHODS: Forty-nine matched pairs of patients who attended the Graduate Endodontic Clinic between 2017 and 2024 were included. Each pair consisted of one patient with a VRF in an ETT and one matched control without a VRF. Matching was based on sex, age, tooth type, and duration since root canal treatment. Retrospective clinical and radiographic data were collected to assess tooth-related factors, including root canal filling length, type of restoration, type of post, adjacent teeth, and opposing dentition. At the recall visit, occlusal characteristics, tooth wear, bony exostosis, and mandibular plane angle were examined and patients completed structured interviews regarding oral functional behaviors at the time of VRF detection. Univariable logistic regression was performed, and variables with p < 0.05 were entered into a multivariable model. Mandibular angles were compared using independent t-tests.
RESULTS: Metal posts, protrusive occlusal interference, unilateral chewing, and frequent intake of hard or sticky foods were significantly associated with VRF. Multivariate analysis confirmed all of these factors, except sticky food intake, as independent predictors, whereas the remaining variables were not significant.
CONCLUSIONS: Unilateral chewing and consumption of hard foods were strongly associated with VRFs, along with the presence of metal posts and protrusive occlusal interference.
CLINICAL SIGNIFICANCE: Assessing occlusal patterns, masticatory behaviors, and post type in endodontically treated teeth is important. Early identification and management of these factors may help reduce VRF occurrence and improve long-term prognosis.
METHODS: Forty-nine matched pairs of patients who attended the Graduate Endodontic Clinic between 2017 and 2024 were included. Each pair consisted of one patient with a VRF in an ETT and one matched control without a VRF. Matching was based on sex, age, tooth type, and duration since root canal treatment. Retrospective clinical and radiographic data were collected to assess tooth-related factors, including root canal filling length, type of restoration, type of post, adjacent teeth, and opposing dentition. At the recall visit, occlusal characteristics, tooth wear, bony exostosis, and mandibular plane angle were examined and patients completed structured interviews regarding oral functional behaviors at the time of VRF detection. Univariable logistic regression was performed, and variables with p < 0.05 were entered into a multivariable model. Mandibular angles were compared using independent t-tests.
RESULTS: Metal posts, protrusive occlusal interference, unilateral chewing, and frequent intake of hard or sticky foods were significantly associated with VRF. Multivariate analysis confirmed all of these factors, except sticky food intake, as independent predictors, whereas the remaining variables were not significant.
CONCLUSIONS: Unilateral chewing and consumption of hard foods were strongly associated with VRFs, along with the presence of metal posts and protrusive occlusal interference.
CLINICAL SIGNIFICANCE: Assessing occlusal patterns, masticatory behaviors, and post type in endodontically treated teeth is important. Early identification and management of these factors may help reduce VRF occurrence and improve long-term prognosis.