锥形束CT应用于恒前牙复杂根管系统的研究
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摘要
目的:运用锥形束CT(cone-beam computed tomography,CBCT)研究上下颌前牙根管构型等特征。方法:纳入1103例患者12858颗前牙,以40岁为界分A组(≤40岁)和B组(>40岁),上前牙6404颗,下前牙6454颗,分析其牙根及根管数目、冠根长度、根管构型、左右同名牙双根管的对称性及与年龄、性别的关系,比较下前牙间双根管检出的两两相关性。结果:上前牙及下切牙均为单根,下尖牙双根检出率为1.66%。上、下前牙双根管检出率分别为0.03%和11.25%,其中下侧切牙检出率最高(17.40%)。上下前牙根管构型以Ⅰ型为主,下前牙双根管构型以Ⅲ型为主(7.07%)。下前牙左右同名牙双根管检出呈对称性。上下前牙冠根长度无年龄差异(P>0.05)。18~50岁下前牙双根管检出率逐渐增加,50岁之后逐渐降低。男性下前牙双根管检出率(13.12%)高于女性(9.93%)(P<0.05)。下中切牙、下侧切牙及下尖牙两两间的双根管检出均呈正相关关系(P<0.05)。结论:下前牙根管形态复杂多变。双根管具有左右对称性、年龄及性别差异。
Objective: To study the root canal system in permanent anterior teeth by cone-beam computer tomography( CBCT). Methods: 12858 anterior teeth in 1103 patients were divided into group A( ≤40 years) and group B( > 40 years). The CBCT images of 6404 maxillary anterior teeth and 6454 mandibular anterior teeth were collected. The number of roots and root canals,crown-root length,the types of root canal configurations,symmetry,age-related changes and gender differences were analyzed statistically. The correlation of double root canals system in mandibular anterior teeth were compared. Results: All of the maxillary anterior teeth and mandibular incisors had only one root while 1. 66% double roots were found in canines. The prevalence of double root canals in maxillary and mandibular anterior teeth were 0. 03% and 11. 25% respectively,that of the lateral incisors was the highest( 17. 40%). Type Ⅰwas the most frequent type( 88. 75%) in permanent anterior teeth followed by Type Ⅲ( 7. 07%). There was symmetrical distribution of the bilateral root canals of anterior teeth. There was no statistical significance of crown-root length among different age groups in permanent teeth( P > 0. 05). The variation of the root canal rate increased gradually at the age of 18-50 years,decreased gradually after the age of 50. The incidence of double root canals was higher in males( 13. 12%) than in females( 9. 93%) in mandibular anterior teeth. The incidence of double root canals of mandibular central incisors was positively correlated with lateral incisors and canines respectively( P <0. 05). Conclusion: The root canal morphology of mandibular anterior teeth is complicated. The prevalence of double root canals is symmetic,age-related and gender difference.
Objective: To study the root canal system in permanent anterior teeth by cone-beam computer tomography( CBCT). Methods: 12858 anterior teeth in 1103 patients were divided into group A( ≤40 years) and group B( > 40 years). The CBCT images of 6404 maxillary anterior teeth and 6454 mandibular anterior teeth were collected. The number of roots and root canals,crown-root length,the types of root canal configurations,symmetry,age-related changes and gender differences were analyzed statistically. The correlation of double root canals system in mandibular anterior teeth were compared. Results: All of the maxillary anterior teeth and mandibular incisors had only one root while 1. 66% double roots were found in canines. The prevalence of double root canals in maxillary and mandibular anterior teeth were 0. 03% and 11. 25% respectively,that of the lateral incisors was the highest( 17. 40%). Type Ⅰwas the most frequent type( 88. 75%) in permanent anterior teeth followed by Type Ⅲ( 7. 07%). There was symmetrical distribution of the bilateral root canals of anterior teeth. There was no statistical significance of crown-root length among different age groups in permanent teeth( P > 0. 05). The variation of the root canal rate increased gradually at the age of 18-50 years,decreased gradually after the age of 50. The incidence of double root canals was higher in males( 13. 12%) than in females( 9. 93%) in mandibular anterior teeth. The incidence of double root canals of mandibular central incisors was positively correlated with lateral incisors and canines respectively( P <0. 05). Conclusion: The root canal morphology of mandibular anterior teeth is complicated. The prevalence of double root canals is symmetic,age-related and gender difference.
引文
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[12]Fogel HM,Peikoff MD,Christie WH.Canal configuration in the mesiobuccal root of the maxillary first molar:A clinical study[J].J Endod,1994,20(3):135-137.
[13]朱敏,林梓桐,文珊辉,等.不同方法对下颌恒切牙根管形态的比较研究[J].南京医科大学学报,2015,35(2):258-260.
[14]Altunsoy M,Ok E,Nur BG,et al.A cone-beam computed tomography study of the root canal morphology of anterior teeth in a Turkish population[J].Eur J Dent,2014,8(3):302-306.
[15]杨正艳,李月恒,周智,等.重庆地区人群下颌前牙根管形态、牙根数目以及根面沟的锥形束研究[J].华中科技大学学报(医学版),2015,44(2):217-222.
[16]朱庆萍,陈幸.下颌前牙根管数目与年龄的关系,第七次中国老年口腔医学年会暨亚洲老年口腔医学学术研讨会论文汇编[C].北京:中华口腔医学会老年口腔医学专业委员会,2012:53-54.
[17]刘成霞,宁晖丽,管东华,等.下颌切牙根管解剖特点的锥形束CT影像学研究[J].广东牙病防治,2013,12(21):634-36.
[2]卞京有.预防口腔医学[M].5版,北京:人民卫生出版社,2008:83.
[3]Vertucci FJ.Root canal anatomy of human permanent teeth[J].Oral Surg Oral Med Oral Pathol,1984,58(5):589-599.
[4]王晓丽,徐怡,孙青,等.提高下中切牙双根管检出率的方法学研究[J].上海口腔医学,2012,21(2):157-162.
[5]Ok E,Altunsoy M,Nur BG,et al.A cone-beam computed tomography study of root canal morphology of maxillary and mandibular premolars in a Turkish population[J].Acta Odontol Scand,2014,72(8):701-706.
[6]王鑫,汪学华,吴海珍,等.离体下颌前磨牙牙根和根管形态的锥形束CT研究[J].实用口腔医学杂志,2015,31(3):397-400.
[7]蒋备战,张金凯,刘扬.下颌前牙根管变异的锥形束CT研究[J].同济大学学报(医学版),2015,36(3):59-62.
[8]白蕊,徐皑.泸州及周边地区下颌恒前牙根管系统CBCT的研究[J].西南军医,2017,19(2):122-124.
[9]吴友农,岳保利.1769个恒牙根管系统的形态学研究[J].实用口腔医学杂志,1995,11(2):98-101.
[10]Jadhav GR.Endodontic management of a two rooted,three canaled mandibular caine with a fractured instrument[J].J Conserv Dent,2014,17(2):192-195.
[11]皮昕.口腔解剖生理学[M].第7版,北京:人民卫生出版社,2013:46.
[12]Fogel HM,Peikoff MD,Christie WH.Canal configuration in the mesiobuccal root of the maxillary first molar:A clinical study[J].J Endod,1994,20(3):135-137.
[13]朱敏,林梓桐,文珊辉,等.不同方法对下颌恒切牙根管形态的比较研究[J].南京医科大学学报,2015,35(2):258-260.
[14]Altunsoy M,Ok E,Nur BG,et al.A cone-beam computed tomography study of the root canal morphology of anterior teeth in a Turkish population[J].Eur J Dent,2014,8(3):302-306.
[15]杨正艳,李月恒,周智,等.重庆地区人群下颌前牙根管形态、牙根数目以及根面沟的锥形束研究[J].华中科技大学学报(医学版),2015,44(2):217-222.
[16]朱庆萍,陈幸.下颌前牙根管数目与年龄的关系,第七次中国老年口腔医学年会暨亚洲老年口腔医学学术研讨会论文汇编[C].北京:中华口腔医学会老年口腔医学专业委员会,2012:53-54.
[17]刘成霞,宁晖丽,管东华,等.下颌切牙根管解剖特点的锥形束CT影像学研究[J].广东牙病防治,2013,12(21):634-36.