华东地区汉族人下颌第一前磨牙根管弯曲度的测量
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摘要
目的采用显微CT精确测量下颌第一前磨牙根管的弯曲度,为临床根管治疗提供依据。方法收集华东地区汉族人154颗离体下颌第一前磨牙并进行显微CT扫描,采用Mimics 10.01(Materialise,Leuven,比利时)对牙齿及根管系统进行三维重建,在平行投照模式下,采集根管系统颊面观及邻面观的影像并测量根管的弯曲度。结果下颌第一前磨牙单根管在颊面观上初次弯曲的平均角度仅为11.1°(Schneider法),二次弯曲出现率较低,在颊面观出现6例,邻面观出现4例。下颌第一磨牙双根管时,重度弯曲(>20°)主要位于邻面观,颊、舌根管初次弯曲的平均角度分别为17.5°和28.7°,二次弯曲的发生率分别为19.1%(9/47)和85.1%(40/47)。舌侧副根管的弯曲半径和圆心角均值分别为6.6 mm和54.2°;舌侧根管的根管口离根尖的平均距离为6.6 mm。结论下颌第一前磨牙舌侧根管多出现在根中及根尖1/3,在邻面观常有重度弯曲。
Objective To accurately measure the root canal curvatures in the mandibular first premolars by using micro-CT scans.Methods A total of 154 extracted mandibular first premolars were collected from a Han-Chinese population in East China and were scanned by a micro-CT scanner.The specimens and root canal systems were reconstructed three-dimensionally by software Mimics 10.01(Schneider method).The canal curvatures were analyzed in the clinical(CV) and proximal views(PV).Results The average angle of first root canal curvatures in the first mandibular premolar was only 11.1° in the buccal view(Schneider method).The incidence of secondary root canal curvatures was low.There were 6 cases in the buccal view and 4 cases in the adjacent view.In the first mandibular premolars with double canals,severe curvature(>20°) was mostly detected in the PV.The mean degrees of the primary angle of the buccal and lingual canals were 17.5 and 28.7 degrees,respectively;and the occurrence rate of the secondary curvature was 19.1%(9/47) and 85.1%(40/47),respectively.The mean radii and center angle of the accessory lingual canals were 6.4 mm and 54.2°,respectively,and the orifice of the accessory canal was located at a mean level of 6.6 mm from the apex.Conclusion The lingual root canal in the mandibular first premolars was mostly located at the middle or apical third of the root with severe curvature in the adjacent view.
Objective To accurately measure the root canal curvatures in the mandibular first premolars by using micro-CT scans.Methods A total of 154 extracted mandibular first premolars were collected from a Han-Chinese population in East China and were scanned by a micro-CT scanner.The specimens and root canal systems were reconstructed three-dimensionally by software Mimics 10.01(Schneider method).The canal curvatures were analyzed in the clinical(CV) and proximal views(PV).Results The average angle of first root canal curvatures in the first mandibular premolar was only 11.1° in the buccal view(Schneider method).The incidence of secondary root canal curvatures was low.There were 6 cases in the buccal view and 4 cases in the adjacent view.In the first mandibular premolars with double canals,severe curvature(>20°) was mostly detected in the PV.The mean degrees of the primary angle of the buccal and lingual canals were 17.5 and 28.7 degrees,respectively;and the occurrence rate of the secondary curvature was 19.1%(9/47) and 85.1%(40/47),respectively.The mean radii and center angle of the accessory lingual canals were 6.4 mm and 54.2°,respectively,and the orifice of the accessory canal was located at a mean level of 6.6 mm from the apex.Conclusion The lingual root canal in the mandibular first premolars was mostly located at the middle or apical third of the root with severe curvature in the adjacent view.
引文
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2 Scott RG,Turner CG II.The anthropology of modern human teeth.Cambridge:Cambridge University Press,1997.
3 Slowey RR.Root canal anatomy.Road map to successful endodontics.Dent Clin North Am,1979,23(4):555-573.
4 Peters OA.Current challenges and concepts in the preparation of root canals ystems:a review.J Endod,2004,30(8):559-567.
5 罗剑,童庆春.Protaper Universal镍钛根管预备器械临床使用寿命分析.口腔材料器械杂志,2016,25(1):18-21.
6 刘叶飞.4种新式机用镍钛锉的研究进展.口腔材料器械杂志,2017,26(1):44-48.
7 Pruett JP,Clement DJ,Carnes DL Jr.Cyclic fatigue testing of nickel-titanium endodontic instruments.J Endod,1997,23(2):77-85.
8 Li X,Liu N,Liu N,et al.A micro–momputed tomography study of the location and curvature of the lingual canal in the mandibular first premolar with two canals originating from a single canal.J Endod,2013,38(3):309-312.
9 Vertucci FJ.Root canal anatomy of the human permanent teeth.Oral Surg Oral Med Oral Pathol Oral Radiol Endod,1984,58(5):589-599.
10 Schneider SW.A comparison of canal preparations in straight and curved root canals.Oral Surg Oral Med Oral Pathol,1971,32(2):271-275.
11 Cunningham CJ,Senia ES.A three-dimensional study of canal curvatures in the mesial roots of mandibular molars.J Endod,1992,18(6):294-300.
12 Gu Y,Lu Q,Wang P,et al.Root canal morphology of permanent three-rooted mandibular first molars:Part II--measurement of root canal curvatures.J Endod,2010,36(8):1341-1346.
13 Liu N,Li X,Liu N,et al.A micro-computed tomography study of the root canal morphology of the mandibular first premolar in a population from southwestern China.Clin Oral Investig,2013,17(3):999-1007.
14 Gu Y.A micro–computed tomographic analysis of maxillary lateral incisors with radicular grooves.J Endod,2011,37(6):789-792.
15 Shields ED.Mandibular premolar and second molar root morphological variations in modern humans:what root number can tell us about tooth morphogenesis.Am J Phys Anthropol,2005,128(2):299–311.
16 .England M C J r,H artw ell G R,Lance J R.D etection and treatment of multiple canals in mandibular premolars.J Endod,1991,17(4):174–178.
17 .Gu Y,Zhang Y,Liao Z,et al.A micro–computed tomographic analysis of wall thickness of C-shaped canals in mandibular first premolars.J Endod,2013,39(8):973-976.
18 Cleghorn BM,Christie WH,Dong CC.The root and the root canal morphology of human mandibular first premolar:A literature review.J Endod,2007,33(5):509-516.
19 Ingle J,Bakland I.Endodontics.5th ed.Hamilton,Ontario,Canada:BC Decker,2002.
2 Scott RG,Turner CG II.The anthropology of modern human teeth.Cambridge:Cambridge University Press,1997.
3 Slowey RR.Root canal anatomy.Road map to successful endodontics.Dent Clin North Am,1979,23(4):555-573.
4 Peters OA.Current challenges and concepts in the preparation of root canals ystems:a review.J Endod,2004,30(8):559-567.
5 罗剑,童庆春.Protaper Universal镍钛根管预备器械临床使用寿命分析.口腔材料器械杂志,2016,25(1):18-21.
6 刘叶飞.4种新式机用镍钛锉的研究进展.口腔材料器械杂志,2017,26(1):44-48.
7 Pruett JP,Clement DJ,Carnes DL Jr.Cyclic fatigue testing of nickel-titanium endodontic instruments.J Endod,1997,23(2):77-85.
8 Li X,Liu N,Liu N,et al.A micro–momputed tomography study of the location and curvature of the lingual canal in the mandibular first premolar with two canals originating from a single canal.J Endod,2013,38(3):309-312.
9 Vertucci FJ.Root canal anatomy of the human permanent teeth.Oral Surg Oral Med Oral Pathol Oral Radiol Endod,1984,58(5):589-599.
10 Schneider SW.A comparison of canal preparations in straight and curved root canals.Oral Surg Oral Med Oral Pathol,1971,32(2):271-275.
11 Cunningham CJ,Senia ES.A three-dimensional study of canal curvatures in the mesial roots of mandibular molars.J Endod,1992,18(6):294-300.
12 Gu Y,Lu Q,Wang P,et al.Root canal morphology of permanent three-rooted mandibular first molars:Part II--measurement of root canal curvatures.J Endod,2010,36(8):1341-1346.
13 Liu N,Li X,Liu N,et al.A micro-computed tomography study of the root canal morphology of the mandibular first premolar in a population from southwestern China.Clin Oral Investig,2013,17(3):999-1007.
14 Gu Y.A micro–computed tomographic analysis of maxillary lateral incisors with radicular grooves.J Endod,2011,37(6):789-792.
15 Shields ED.Mandibular premolar and second molar root morphological variations in modern humans:what root number can tell us about tooth morphogenesis.Am J Phys Anthropol,2005,128(2):299–311.
16 .England M C J r,H artw ell G R,Lance J R.D etection and treatment of multiple canals in mandibular premolars.J Endod,1991,17(4):174–178.
17 .Gu Y,Zhang Y,Liao Z,et al.A micro–computed tomographic analysis of wall thickness of C-shaped canals in mandibular first premolars.J Endod,2013,39(8):973-976.
18 Cleghorn BM,Christie WH,Dong CC.The root and the root canal morphology of human mandibular first premolar:A literature review.J Endod,2007,33(5):509-516.
19 Ingle J,Bakland I.Endodontics.5th ed.Hamilton,Ontario,Canada:BC Decker,2002.