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目的应用锥形束CT(cone beam computed tomography,CBCT)观察下颌第1磨牙的根管解剖形态,为临床根管治疗提供参考依据。方法由两名牙体牙髓专业医生筛选我院口腔科自2014年12月至2015年12月进行CBCT检查的500名患者,共计924颗下颌第1磨牙的影像资料,分别记录患者的基本信息、牙位、根管构型及钙化情况,并进行统计学分析。结果 424名存在双侧下颌第1磨牙的患者中,76.2%(323)根管构型完全对称。924颗下颌第1磨牙中,双根率为76.7%(709),3根率即远舌根发生率为23.3%(215);近中根最常见根管类型为Vertucci Ⅳ型,占71.97%(665),其次为Ⅱ型,占23.70%(219);远中根最常见根管类型为Ⅰ型,占49.35%(458),其次为Ⅳ型占31.82%(292)。存在远舌根时,远舌根管口与远颊根管口距离为(2.94±0.27)mm。下颌第1磨牙根管钙化率与年龄有关,老年人钙化率高,中年人次之。结论华南地区人群下颌第1磨牙根管形态多样,变异性较大;CBCT是观察根管形态的有效工具,可以为根管治疗提供辅助诊断。
Objective To observe the root canal anatomy of mandibular first molar with cone beam computed tomography (CBCT), and provide a reference for clinical root canal therapy. Methods Two dental pulp specialists screened 500 patients undergoing CBCT from December 2014 to December 2015 in our department. A total of 924 mandibular first molar images were recorded and the basic information of the patients were recorded , Tooth position, root canal configuration and calcification, and statistical analysis. Results Of 424 patients with bilateral mandibular first molars, 76.2% (323) of the root canal configurations were completely symmetrical. In the 924 mandibular first molars, the rate of double root was 76.7% (709) and the rate of three roots was 23.3% (215). The most common type of root canal was Vertucci Ⅳ, which accounted for 71.97% (665) ), Followed by type Ⅱ, accounting for 23.70% (219). The most common type of distal root was type Ⅰ, accounting for 49.35% (458), followed by type Ⅳ (31.82%, 292). In the presence of distal root, the distance between distal root canal and distal buccal canal was (2.94 ± 0.27) mm. Mandibular first molar root canal calcification rate and age-related, high rate of calcification in the elderly, followed by middle-aged. Conclusions The root canal morphology of mandibular first molar in South China is diverse and has a great variability. CBCT is an effective tool to observe the morphology of root canal and can provide auxiliary diagnosis for root canal therapy.