Journal of Failure Analysis and Prevention

, Volume 4, Issue 1, pp 41–46 | Cite as

Failure analysis of a broken tooth

  • J. B. Quinn
  • G. E. Schumacher
  • L. W. Schultheis
Peer Reviewed Articles


Several days after heart surgery, a patient discovered his upper right canine tooth had broken at the root. Such tooth damage, recognized post-operatively, is usually assumed to be caused by blunt mechanical force from an instrument used by the anesthesiologist during placement of a breathing tube at the start of surgery.

In this case, the patient had saved the crown portion of the broken tooth, and it was possible to examine the root fracture characteristics. The curvature and direction of the crack path and natural tooth situation suggested that failure could be described through a cantilever beam model. This was confirmed when a whole extracted sample tooth was embedded and broken by a measured force in a manner consistent with the model. The resulting fracture surface matched that of the patient’s broken canine tooth. However, the high load and force direction necessary to fracture the root was inconsistent with forces applied during the anesthesia procedure. The failure analysis and further investigation indicated tooth clenching on the breathing tube during recovery was the likely cause of fracture.

This paper presents an alternate explanation for intubation-related dental injury, demonstrates the practicality of fractographic analysis of biological materials, and introduces a methodology for simulating in vitro tooth settings for mechanical testing.


broken tooth failure analysis of biological materials fractography laryngoscopy 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    M.E. Warner, S.M. Benenfield, M.A. Warner, D.R. Schroeder, and P.M. Maxson: “Perianesthetic Dental Injuries: Frequency, Outcomes, & Risk Factors,” Anesthesiology, 1999, 90, pp. 1302–05.CrossRefGoogle Scholar
  2. 2.
    H. Owen and I. Wadell-Smith: “Dental Trauma Associated with Anaesthesia,” Anaesth. Intens. Care, 2000, 28(2), pp. 133–145.Google Scholar
  3. 3.
    P.B. Lockhart, E.V. Feldbau, R.A. Gabel, S.F. Connolly, and J.B. Silversin: “Dental Complications During and After Tracheal Intubation,” JADA, 1986, 112, pp. 480–83.Google Scholar
  4. 4.
    R. Ravi, D.V. Subhedar, and C. Gevirtz: “Dental Injury with a Cuffed Oropharyngeal Airway,” Am. J. Anesthes., 1999, 26(3), p. 129.Google Scholar
  5. 5.
    V. Frechette: “Failure Analysis of Brittle Materials,” Advances in Ceramics, American Ceramics Society, Westerville, OH, 1990, Chapter 28.Google Scholar
  6. 6.
    R. Morrell, W.P. Byrne, and M. Murray: “Fractography of Ceramic Femoral Heads,” Ceramic Trans., 2001, 122, p. 253.Google Scholar
  7. 7.
    J.R. Kelly: “Fractography of Dental Ceramics,” Ceram. Trans., 2001, 122, p. 241.Google Scholar
  8. 8.
    J.R. Kelly, R. Giordanno, R. Pober, and M.J. Cima: “Fracture Surface Analysis of Dental Ceramics: Clinically Failed Restorations, Int. J. Prosthodont., 1990, 3, pp. 430–40.Google Scholar
  9. 9.
    J.Y. Thompson, K.J. Anusavice, A. Naman, and H.F. Morris: “Fracture Surface Characterization of Clinically Failed All-Ceramic Crowns,” J. Dent. Res., 1994, 73, pp. 1824–32.Google Scholar
  10. 10.
    T.G. Oberholzer and R.J. Rossouw: “Unusual Fracture of a Mandibular Second Premolar: A Case Report,” Quintessence Int., 2001, 32(4), pp. 299–302.Google Scholar
  11. 11.
    H.H.W. Ho, F.C.S. Chu, and A.N. Stokes: “Fracture Behavior of Human Mandibular Incisors Following Endodontic Treatment and Porcelain Veneer Restoration,” Int. J. Prosthodont., 2001, 14(3), pp. 260–64.Google Scholar
  12. 12.
    D. Vollmer, C. Bourauel, K. Maier, and A. Jager: “Determination of Resistance in an Upper Human Canine and Idealized Tooth Model,” Eur. J. Orthodont., 1999, 21, pp. 633–48.CrossRefGoogle Scholar
  13. 13.
    S.R. Ahmed, M.R. Khan, K.M.S. Islam, and Md.W. Uddin: “Investigation of Stresses at the Fixed End of Deep Cantilever Beams,” Compos. Struct., 1998, 69, pp. 329–38.CrossRefGoogle Scholar
  14. 14.
    H. Vaughan: “Crack Propagation and the Principal-Tensile-Stress Criterion for Mixed-Mode Loading,” Eng. Fract. Mech., 1998, 59(3), pp. 393–97.CrossRefGoogle Scholar
  15. 15.
    “Standard Practice for Fractography and Characterization of Fracture Origins in Advanced Ceramics,” C 1145-01, ASTM, West Conshohocken, PA.Google Scholar
  16. 16.
    J.S. Rees: “An Investigation into the Importance of the Periodontal Ligament and Aveolar Bone as Supporting Structures in Finite Element Studies,” J. Oral Rehabil., 2001, 28(5), pp. 425–32.CrossRefGoogle Scholar
  17. 17.
    F. Miura and H. Oyama: “Mechanical Properties of Periodontal Tissues Affected with Orthodontic Forces,” J. Dent. Res., 1975, 54, p. C103.Google Scholar
  18. 18.
    K. Nishigawa, E. Bando, and M. Nakano: “Quantitative Study of Bite Force during Sleep Associated Bruxism,” J. Oral Rehabil., 2001, 28(5), pp. 485–91.CrossRefGoogle Scholar
  19. 19.
    C. Misch: Implant Dentistry, Mosby-Year Book, Inc., St. Louis, 1999.Google Scholar
  20. 20.
    M.M. Ohayon, K.K. Li, and C. Guilleminault: “Risk Factors for Sleep Bruxism in the General Population,” Chest, 2001, 119(1), pp. 53–61.CrossRefGoogle Scholar
  21. 21.
    G. Pingitore, V. Chrobak, and J. Petrie: “The Social and Psychological Factors of Bruxism,” J. Prosthet. Dent., 1991, 65(3), pp. 443–46.CrossRefGoogle Scholar
  22. 22.
    F. Romanelli, D.A. Adler, and K.M. Bungay: “Possible Paroxetine-Induced Bruxism,” An. Pharm., 1996, 30(11), pp. 1246–48.Google Scholar

Copyright information

© ASM International 2004

Authors and Affiliations

  • J. B. Quinn
    • 1
  • G. E. Schumacher
    • 1
  • L. W. Schultheis
    • 2
  1. 1.Paffenbarger Research CenterNational Institute of Standards and TechnologyGaithersburg
  2. 2.FDA CDERRockville

Personalised recommendations