【作者】 薛立秋； 郑立娟； 曲晓复；

【Author】 Xue Li-qiu;ZHENG Li Juan;QU Xiao Fu;The Stomatology Hospital of Dalian;

【机构】 大连市口腔医院；

【摘要】 目的:运用锥形束CT(CBCT)观察老年人下颌第一、第二磨牙牙根和根管系统的解剖形态,对复杂变异的牙根和根管系统做出诊断,为临床根管治疗提供依据。方法:选择102例老年人患者双侧下颌第一、第二磨牙(下颌第一磨牙204颗,下颌第二磨牙184颗),CBCT进行扫描,通过数据分析下颌第一、第二磨牙变异牙根数、根管数、根管分型(按皮昕分类法)及变异牙根、根管对称性等。结果:1.在204颗下颌第一磨牙中变异牙根独立远舌根和四根管发生率分别为28.4%和54.9%。在双根牙中94.5%近中根管是双管型,61.0%的远中根管是单管型;在三根牙中96.6%近中根管是双管型,远颊根管和远舌根管均为单管型,发生率为100%。2.在184颗下颌第二磨牙中变异牙根C形融合根和C形根管发生率分别为38.6%和33.7%;单根牙和单根管发生率均为1.6%。在双根牙中67.2%近中根管是双管型,93.6%远中根管是单管型。3.下颌第一磨牙变异牙根独立远舌根左右侧对称的发生率为68.9%,下颌第二磨牙变异牙根C形融合根和C形根管的左右侧对称发生率分别为77.7%和75.0%。结论:锥形束CT可评价老年人下颌磨牙变异牙根和根管系统的解剖形态特征。下颌第一磨牙独立远舌根及四根管发生率较高;下颌第二磨牙C形融合根及C形根管发生率较高。变异牙根下颌第一磨牙独立远舌根、下颌第二磨牙C形融合根和C形根管左右侧具有较高的对称性。更多还原

【Abstract】 objective: To investigate in root canal configuration of the mandibular first and second molar teeth using cone-beam computed tomography, in order to make a diagnosis on the complicated variant root and canal morphology. Methods: A total of 102 elderly patients with healthy, untreated, well-developed mandibular first and second molars were enrolled. Radiographic examined by cone-beam computed tomography was conducted as part of their routine examination. Over all, 204 mandibular first and 184 mandibular second molar teeth were examined in vivo by one-beam computed tomography. The number of roots, the number of canals per root, the canal configuration(according to Pi Xin’s criteria), the varied roots and symmetry of bilateral canal classification were recorded. Results: 1. 54.9% of the 204 mandibular first molars examined had four canals. 28.4% had three varied roots, and all the third root was a separate distolingual root. In the two-rooted samples, 94.5% of the mesial root canals were of double tubular type, and 61.0% of the distal root canals were of single tubular type. In the three-rooted samples, 96.6% of the mesial root canals were of double tubular type, both of the distobuccal and distolingual root canals were of single tubular type, the occurrence rate of which is 100%. 2. 38.6% of the 184 mandibular second molars examined had varied C-shaped fused roots. 33.7% had C-shaped roots. The occurrence rate of single-rooted teeth and single canal is 1.6%. In the two-rooted samples, 67.2% of the mesial root canals were of double tubular type, and 93.6% of the distal root canals were of single tubular type. 3. In the separate distolingual root of mandibular first molars, 68.9% had symmetry of bilateral canal. In the C-shaped fused roots and C-shaped canals of mandibular second molars, 77.7% and 75.0% had symmetry of bilateral canal, respectively. Conclusion: Cone-beam computed tomography scans allow the identification of anatomic features of the mandibular molar in the elderly. Mandibular first molars have a higher prevalence of a separated distolingual canal and four canals. Mandibular second molars have a higher prevalence of C-shaped fused roots and C-shaped canals. The varied separate distolingual root of mandibular first molars, C-shaped fused roots of mandibular second molars and C-shaped canals had higher symmetry.更多还原