Radiographic features of vertically fractured, endodontically treated maxillary premolars

Objective. The purpose of this study was to evaluate the most frequent radiographic appearance of bony lesions associated with vertically fractured roots of endodontically treated maxillary premolars. Study design. The radiographic features of 102 endodontically treated teeth and their periradicular areas (51 with and 51 without vertically fractured roots) were evaluated and compared. Results. The predominant appearance of the periradicular area in the teeth with vertically fractured roots was the "halo" lesion (57%); by contrast, in the non-vertically fractured roots group, a "periapical" radiolucent lesion was most frequently found (55%). Angular bone loss (14%) and periodontal radiolucency (14%) were also typical radiolucent lesions in the vertically fractured teeth. Conclusions. "Halo" lesion, perilateral radiolucency, and angular resorption of the crestal bone, combined with diffuse or defined but not corticated borders, indicated a high probability of vertical root fracture in maxillary premolars.