(PO87) Predisposing Factors and Diagnostic Challenges of Vertical Root Fractures in Posterior Teeth: A Cone Beam Computed Tomography (CBCT) Analysis

Abstract: Vertical root fractures (VRFs) pose a diagnostic challenge. Most often, the presence of a VRF is inferred from the pattern of bone loss, and often, a conclusive determination of a VRF is not possible. This underscores the need to identify additional factors that clinicians could use to estimate the likelihood of a VRF. This study aims to evaluate select predisposing factors, such as the presence of proximal contact, restorations, and prefabricated posts, in posterior teeth with VRFs. Sixty-three CBCT scans of posterior teeth diagnosed with VRFs from 2021 to 2022 were retrieved from the UCLA Oral Radiology database. Descriptive statistics for RCT-treated teeth versus non-RCT-treated, tooth type, presence of proximal contacts, restoration type, and presence of a prefabricated post were performed. Among the teeth with VRFs, 27 cases (42.8%) were mandibular first molars. VRFs were most frequent in the mesial root of the lower first molar, representing 30.2% of all VRFs. Eighteen teeth (28.6%) with VRFs were observed to have at least one missing proximal contact. Fifty-nine teeth (93.7%) had undergone endodontic treatment. Prefabricated posts were found in 9 teeth (14.3%), and the majority (85.7%) had full coverage restorations.Similar to other studies, the overwhelming majority of teeth with VRFs have undergone prior endodontic treatment. The high prevalence of VRFs in mandibular first molars, particularly affecting the mesial root, suggests that root morphology and local occlusal forces may predispose to fractures. Identifying VRF risk factors offers opportunities for preventive strategies to reduce dental complications.