摘要
目的利用锥形束CT(CBCT)扫描并研究下颌第一磨牙近中第三根管发现率及其根管弯曲度。方法对我院口腔科就诊的1600名患者的下颌第一磨牙进行CBCT扫描,将发现近中第三根管的患者分为5组(A组:18~29岁;B组:30~39岁;C组:40~49岁;D组:50~59岁;E组:60~80岁)。对纳入的所有图像均采用Planmeca Romexis CBCT机的图像重建系统进行三维重建并测量,并采用改良的Schneider法对根管弯曲度、弯曲部位进行测量,进一步研究根管形态并对其根管系统进行分析。结果1600个患者的2856颗下颌第一恒磨牙,有168例存在近中第三根管(5.88%),发现率分别为:A组37.50%、B组17.80%、C组14.88%、D组19.64%、E组10.12%;A组近远中向根管弯曲度中度大于其他各组,差异有统计学意义(P<0.05);5组根管近远中向根管弯曲度差异有统计学意义(P<0.05),且A组近远中向根管弯曲度>C、D、E组,差异有统计学意义(P<0.05);5组根管颊舌向弯曲度相比较,差异无统计学意义(P>0.05);近远中向和颊舌向弯曲部位在根中1/3处的发现率显著高于根冠1/3处与根尖1/3处,差异有统计学意义(P<0.01)。结论下颌第一磨牙近中第三根管发现率会随年龄增大而降低,根管弯曲度会随年龄增长而增加,特别是在30岁之后出现较为明显的下降趋势;下颌第一磨牙近中第三根管系统复杂且多变,大多数都会出现近远中向及颊舌向明显的弯曲且弯曲多发生在根中1/3处;CBCT能为临床治疗提供有效的指导,减少临床实际操作的失败率。
Objective To investigate mesial root canal curvatures of human mandibular first molars using cone-beam computed tomography（CBCT）. Methods CBCT was performed for scanning the mandibular first molars of 1600 Chinese subjects, among whom the subjects identified to have middle mesial canals were divided into 5 age groups, namely group A（18-29 years）, group B（30-39 years）, group C（40-49 years）, group D（50-59 years）, and group E（60-80 years） for further analysis. All the CBCT images were reconstructed using Planmeca Romexis CBCT image reconstruction system, and the curvature of the mesial root was measured using the Schneider method. Results A total of 2856 CBCT images were obtained from the 1600 subjects, among whom 168（5.88%） were found to have middle mesial canals in the mandibular first molars. The prevalence of middle mesial canals was 37.50% in group A, 17.80% in group B, 14.88% in group C, 19.64% in group D, and10.12% in group E. The moderate of the curvature in the mesiodistal direction was significantly higher in group A than in the other groups（P〈0.05）; the curvature in mesiodistal direction differed significantly among the 5 groups（P〈0.05）, and was the greatest in group A followed by group C and group D, and was the smallest in group E. The curvature in the buccolingual direction was similar among the 5 groups. The incidence of mesiodistal and buccolingual curvature of the middle mesial canals was significantly higher in the middle 1/3 of the root canal than in the upper 1/3 and apical 1/3 of the root canal. Conclusions The incidence of middle mesial canals in the mesial root of the mandibular first molars decreases with age. The middle mesial canal system of the mandibular first molar is complex and variable, and most of the first molars have obvious curvature in the mesiodistal and buccolingual directions. CBCT can provide reference for clinical treatment to reduce the treatment failure rate.
作者
许骏杨
陈明
杨叶青
吴补领
XU Junyang;CHEN Ming;YANG Yeqing;WU Buling(Department of Stomatology,Nanfang hospital,Southern Medical University,Guangzhou 510515,China)
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2018年第7期824-829,共6页
Journal of Southern Medical University
基金
国家自然科学基金(81670986)
南方医科大学南方医院院长基金(2017Z004)
南方医科大学南方医院院长基金(2016C023)
广东省医学科学技术研究基金项目(B2018012)
南方医院"科研启动计划"基础研究前期启动项目(QD2017N013)~~
关键词
锥束CT
近中第三根管
下颌第一磨牙
cone beam computed tomography
middle mesial canals
mandibular first molars
