【作者】 喻刚； 黄定明； 周智；

【机构】 重庆医科大学口腔医学院牙体牙髓科； 四川大学华西口腔牙体牙髓科；

【摘要】 目的:收集临床病例调查三牙根下颌第一恒磨牙在本土中国人中的发生率,以提高对中国人下颌第一磨牙根管系统解剖的认识,为提高临床根管治疗成功率提供参考。材料及方法:通过临床实地随机收集四川大学华西口腔医院牙体牙髓科2007年6月至2008年4月中国人下颌第一恒磨牙根管治疗完整病例378例,其中男性患者144位,女性患者206位。以X线片上能清楚看见远中两个牙根的牙周膜影像连续,根管影像清晰为诊断远舌根(第三牙根)的金标准。对X线片阅读产生的分歧,通过病例收集者与临床医师的讨论和临床检查以及通过加照侧位X线片来加以证实,直至意见达成一致。结果:三牙根下颌第一恒磨牙的发生率为26.98%(102/378)。46.03%(174/378)的下颌第一磨牙为4个根管,其中60.34%(105/174)的第四根管来自于远舌根。男性患者远舌根发生率(27.08%,39/144)与女性(27.18%,56/206)无统计学差异(P>0.05)。左侧下颌第一磨牙远舌根发生率(22.63%,43/190)与右侧(31.38%,59/188)无统计学差异(P>0.05)。在女性患者中,左侧下颌第一磨牙远舌根发生率(26.13%,29/113)与右侧(27.69%,31/112)无统计学差异(P>0.05)。而在男性患者中,左侧下颌第一磨牙远舌根发生率(17.72%,14/79)与右侧(36.84%,28/76)有统计学差异(P<0.05),右侧高于左侧。结论:三牙根下颌第一恒磨牙在中国人中发生率为26.98%,46.03%的下颌第一磨牙为4个根管,其中60.34%的第四根管来自于远舌根。其中,男性患者右侧下颌第一磨牙远舌根发生率高于左侧。临床医生在对下颌第一磨牙进行根管治疗时,应注意中国人三牙根下颌第一磨牙高发生率的种族特异性,防止根管遗漏和治疗意外的发生,提高根管治疗的成功率。更多还原

【Abstract】 OBJECTIVE:The purpose of this study was to investigate the prevalence of three-rooted mandibular first molars among a native Chinese population,and to improve the recognition of the anatomy of Chinese mandibular first molars and the possibility of successful root canal treatment.SUBJECTS and METHODS:A total of 378 cases’ clinical records and periapical radiographs(144 men,206 women),which were randomly acquired in the dental offices of Department of Operative Dentisty and Endodontics,West China Hospital of Stomotology,Si Chuan University in Chengdu,China,from June 2006 to April 2008.The radiographic criteria for the indication of an extra root(radix entomolaris RE,the 3rd root) were justified by the crossing of the translucent lines defining the pulp space and the periodontal ligaments in the mandibular first molars.Disagreement in the interpretation of radiographs was discussed between the investigator and the endodontist of that patient until a consensus was reached though clinical oral examination with root canal scouting and confirmed by radiographs from other angles.RESULTS:The prevalence of three-rooted mandibular first molars with was 26.98%(102/378).46.03%(174/378) of the mandibular first molars were found 4 root canals.46.03%(105/174) of the fourth canal was came from the RE.Both gender and bilateral occurrence did not show a significantly difference with this three-rooted mandibular first molars(P>0.05),but there was a significantly greater incidence of this anatomical variant on the right side of the mandible(36.84%,28/76)than on the left(17.72%,14/79) in male Chinese individuals(P<0.05).CONCLUSION:The prevalence of three-rooted mandibular first molars with was 26.98%.46.03%of the mandibular first molars were found 4 root canals.46.03%of the fourth canal was came from the RE.And there was a significantly greater incidence of this anatomical variant on the right side of the mandible than on the left in male Chinese individuals.Clinicians should be aware of the high racial prevalence of the three-rooted mandibular first molars among the Chinese population before initiating endodontic treatment.更多还原