应用锥形束CT对成人上颌前磨牙牙根和根管系统形态的研究

目的：运用锥形束CT（CBCT）观察中国人群上颌前磨牙的牙根和根管系统的解剖形态,为临床根管治疗提供影像学依据。方法：选择200名患者的双侧上颌前磨牙（上颌第一前磨牙、上颌第二前磨牙各358颗）的CBCT扫描数据,使用NNT软件分析上颌第一、第二前磨牙的牙根数、根管数、根管分型以及双侧对称情况。结果：上颌第一前磨牙主要为单根（65.92%）和双根（33.80%）。上颌第二前磨牙主要为单根（93.85%）。上颌第一前磨牙的根管系统主要为双根管（84.36%）。上颌第二前磨牙的根管系统单、双根管比例接近（分别为52.79%和46.08%）。上颌第一前磨牙主要根管分型为：Ⅳ型（48.32%）、Ⅱ型（24.30%）和Ⅰ型（12.56%）。上颌第二前磨牙主要根管分型为：Ⅰ型（51.68%）、Ⅱ型（21.51%）和Ⅳ型（14.25%）。上颌第一、第二前磨牙的根管分型左右对称（对称率分别为74.57%和81.29%）。上颌前磨牙根管系统的主要变异为：管间交通支、颊根C形根管和多根管（树形根管或神经根样根管）。结论：上颌第一、第二前磨牙的根管系统主要为单根管和双根管。术前了解根管形态的变异是治疗成功的关键因素。     

陕西人群上颌第二磨牙根管系统的CBCT分析研究

目的 运用CBCT分析陕西地区人群上颌第二磨牙牙根和根管形态及变异情况。方法 筛选在我院进行CBCT检查的1007名陕西籍患者共2014颗上颌第二磨牙，对其影像资料进行回顾性分析，记录患者的性别、年龄、牙位、牙根和根管数目和形态，并对其进行分类和描述。结果 (1)上颌第二磨牙中，3根的发生率最高（84.31%），其次为单根（8.69%），双根和4根的发生率较少；(2)上颌第二磨牙根管系统变异在近颊根、远颊根及腭根中均可发生。26.96%的近中颊根存在第二根管（MB2），男性的检出率高于女性，44岁及以下年龄组检出率高于44岁以上人群；(3)上颌第二磨牙融合根的检出率为24.08%；(4)上颌第二磨牙左右两侧牙根及根管形态一致的比例为84.31%。结论 陕西地区人群上颌第二磨牙牙根和根管变异较大，临床工作中要注意此变异在性别、年龄和牙位（左右两侧）中的差异。     

乳磨牙根管复杂性的CBCT研究

目的 利用CBCT研究上海地区儿童乳磨牙牙根数目及根管系统解剖形态,为临床诊断提供影像学依据.方法 选取167例患者(4～7岁)CBCT扫描图像,测量乳磨牙牙根数目、牙齿长度,分析根管数目和类型,并对相应结果做统计学分析.结果 ①上颌第一乳磨牙牙根中三根占50.30％,双根占47.59％.上颌第二乳磨牙牙根三根检出率99.37％.下颌第一、二乳磨牙牙根以双根居多,分别为91.48％、72.95％.②上颌乳磨牙腭根的牙齿长度较颊根长;下颌第一乳磨牙近、远中根的牙齿长度未见明显差异,下颌第二乳磨牙近中根的牙齿长度较远中根长.③上颌第一乳磨牙根管数目以三根管居多,为97.59％.上颌第二乳磨牙三根管占87.13％,四根管占12.27％.上颌乳磨牙的根管类型为Ⅰ型、Ⅱ型、Ⅲ型和Ⅳ型,以Ⅰ型居多.④下颌第一乳磨牙中三根管占41.96％(近中根管为双根管的占39.10％,远中根管为双根管的占60.90％),四根管为39.75％,双根管18.30％.下颌第二乳磨牙中多为四根管,占83.28％.下颌乳磨牙的根管类型主要是Ⅰ型和Ⅳ型.结论 乳磨牙牙根及根管解剖结构复杂多变、变异率高.上颌第二乳磨牙和下颌第一乳磨牙根管结构变异率较其他牙位高,结合CBCT有利于明确诊断和治疗.     

乳磨牙根管复杂性的CBCT研究

目的 利用CBCT研究上海地区儿童乳磨牙牙根数目及根管系统解剖形态,为临床诊断提供影像学依据.方法 选取167例患者(4～7岁)CBCT扫描图像,测量乳磨牙牙根数目、牙齿长度,分析根管数目和类型,并对相应结果做统计学分析.结果 ①上颌第一乳磨牙牙根中三根占50.30％,双根占47.59％.上颌第二乳磨牙牙根三根检出率99.37％.下颌第一、二乳磨牙牙根以双根居多,分别为91.48％、72.95％.②上颌乳磨牙腭根的牙齿长度较颊根长;下颌第一乳磨牙近、远中根的牙齿长度未见明显差异,下颌第二乳磨牙近中根的牙齿长度较远中根长.③上颌第一乳磨牙根管数目以三根管居多,为97.59％.上颌第二乳磨牙三根管占87.13％,四根管占12.27％.上颌乳磨牙的根管类型为Ⅰ型、Ⅱ型、Ⅲ型和Ⅳ型,以Ⅰ型居多.④下颌第一乳磨牙中三根管占41.96％(近中根管为双根管的占39.10％,远中根管为双根管的占60.90％),四根管为39.75％,双根管18.30％.下颌第二乳磨牙中多为四根管,占83.28％.下颌乳磨牙的根管类型主要是Ⅰ型和Ⅳ型.结论 乳磨牙牙根及根管解剖结构复杂多变、变异率高.上颌第二乳磨牙和下颌第一乳磨牙根管结构变异率较其他牙位高,结合CBCT有利于明确诊断和治疗.     

乳磨牙根管复杂性的CBCT研究

目的 利用CBCT研究上海地区儿童乳磨牙牙根数目及根管系统解剖形态,为临床诊断提供影像学依据.方法 选取167例患者(4～7岁)CBCT扫描图像,测量乳磨牙牙根数目、牙齿长度,分析根管数目和类型,并对相应结果做统计学分析.结果 ①上颌第一乳磨牙牙根中三根占50.30％,双根占47.59％.上颌第二乳磨牙牙根三根检出率99.37％.下颌第一、二乳磨牙牙根以双根居多,分别为91.48％、72.95％.②上颌乳磨牙腭根的牙齿长度较颊根长;下颌第一乳磨牙近、远中根的牙齿长度未见明显差异,下颌第二乳磨牙近中根的牙齿长度较远中根长.③上颌第一乳磨牙根管数目以三根管居多,为97.59％.上颌第二乳磨牙三根管占87.13％,四根管占12.27％.上颌乳磨牙的根管类型为Ⅰ型、Ⅱ型、Ⅲ型和Ⅳ型,以Ⅰ型居多.④下颌第一乳磨牙中三根管占41.96％(近中根管为双根管的占39.10％,远中根管为双根管的占60.90％),四根管为39.75％,双根管18.30％.下颌第二乳磨牙中多为四根管,占83.28％.下颌乳磨牙的根管类型主要是Ⅰ型和Ⅳ型.结论 乳磨牙牙根及根管解剖结构复杂多变、变异率高.上颌第二乳磨牙和下颌第一乳磨牙根管结构变异率较其他牙位高,结合CBCT有利于明确诊断和治疗.     

CBCT法研究上颌第一磨牙根管形态

目的：探讨应用锥形束CT研究上颌第一磨牙牙根及根管形态的价值。方法选取70例患者83颗上颌第一磨牙的锥形束CT（cone beam computed tomogaphy,CBCT）影像,分析其牙根数目、根管数目及根管系统的解剖结构。参照Vertucci分类法对根管形态进行分类,统计近中颊根第二根管（the seconal mesiobuual canal, MB2）率。结果83颗上颌第一磨牙均为3个独立牙根,其中MB2的发生率为38.6%,近中颊根根管VertucciⅠ型（1?1）、Ⅳ型（2?2型）、Ⅱ型（2?1）、Ⅲ型（1?2?1）所占百分比分别为61.4%、18.1%、15.7%和4.8%。结论上颌第一磨牙根管系统复杂,CBCT影像可反映真实根管形态,为根管治疗提供参考。     

青少年下颌第一恒磨牙牙根及根管的锥形束 CT 研究

目的:应用锥形束CT(CBCT)分析青少年下颌第一恒磨牙牙根及根管形态。方法:收集2012-07~12拍摄CBCT的183例12~16岁青少年患者的366颗下颌第一恒磨牙的锥形束CT影像资料,记录患者年龄、性别、观察牙位及牙根数目、根管数目及根管形态,利用SPSS 19.0软件统计分析下颌第一恒磨牙牙根及根管数目的性别差异和左右侧差异。结果:纳入研究的366颗下颌第一恒磨牙中,近中单根者365颗,远中单根者282颗(77.05%),双根者83颗(22.68%),1颗牙为C形根。近中单根双根管者356颗(97.27%),单根一根管者9颗(2.46%);远中单根一根管者229颗(62.57%),单根双根管者53颗(14.48%),双根各一根管者83颗(22.68%);C形根3根管者1颗(0.27%)。牙根及根管数目在男女之间与左右侧之间差异均无统计学意义。结论:下颌第一恒磨牙以双根居多,牙根变异主要发生在远中根,远中舌根的发生率较高;性别间与左右侧牙之间无明显差异。     

上颌第二磨牙4根4根管1例

上颌第二磨牙的解剖形态与上颌第一磨牙相似,但变异较多,通常为2～3个根管。有研究报道上颌第二磨牙4个根管的发生率约为8.1%,多为近颊单根双根管[1]。笔者临床发现1例腭侧双根双根管的上颌第二磨牙,经螺旋     

辽宁地区汉族人下颌第二恒磨牙牙根和根管数目的锥形束CT研究

目的：利用锥形束CT（CBCT）扫描评估辽宁地区汉族人下颌第二恒磨牙牙根和根管数目的情况。方法：调取于我院口腔科行CBCT扫描患者的图像资料,统计分析下颌第二恒磨牙牙根和根管数目的情况。结果：在900例下颌第二恒磨牙中,双根的发生率为51．22％,其中82％的近中根内为双根管,100％的远中根内为单根管;三根的发生率为2．18％;融合根的发生率为46．6％,其中完全融合的锥形根占5．71％,不完全融合的C形根（C型根管）占40．89％,C型根管发生率在男女性别间差异无统计学意义（p〉0．05）,以双侧对称性分布较多,单侧发生率以右侧为多。结论：在辽宁地区汉族人中,下颌第二恒磨牙以双根或融合根居多,c形根（C型根管）的发生率较高。     

上颌第一恒磨牙80颗牙体解剖的离体研究

目的 :了解上颌第一恒磨牙牙体解剖基础知识。方法 :肉眼观察近颊根外形 ,牙合面磨耗程度 ,髓室底形态 ,根尖孔数目及类型 ;游标卡尺测量各项长度指标及根尖孔到牙根顶点的距离 ;透明牙标本法观察根管系统。结果 :上颌第一恒磨牙近颊根Ⅲ型根尖孔 2 6.9% ;双根管率为 5 6.2 5 % ,三根管率为 7.5 %。结论 :上颌第一恒磨牙近颊根存在着较高的多根管率 ( 63 .75 % ) ,应该引起临床医生的高度重视     

Evaluation of Root Canal Configuration of Maxillary Molars in a Brazilian Population Using Cone-beam Computed Tomographic Imaging: An In Vivo Study

Introduction

The aim of this study was to analyze and characterize root canal morphology of maxillary molars of the Brazilian population using cone-beam computed tomographic (CBCT) imaging.

Methods

Patients referred for a CBCT radiographic examination for accurate diagnosis and treatment planning were enrolled in the study. A total of 620 healthy, untreated, fully developed maxillary first and second molars were included (314 first molars and 306 second molars). The following observations were recorded: (1) number of roots and their morphology, (2) number of canals per root, (3) fused roots, and (4) primary variations in the morphology of the root canal systems.

Results

First and second molars showed a higher prevalence of 3 separate roots, mesiobuccal, distobuccal, and palatal, with 1 canal in each root (52.87% and 45.09%, respectively). Two canals in the mesiobuccal roots represented 42.63% of teeth, whereas mesiobuccal roots of second molars presented 2 canals in 34.32%. The most common anatomic variation in the maxillary first molar was related to the root canal configuration of the mesiobuccal root, whereas the root canal system of the maxillary second molar teeth showed more anatomic variables.

Conclusions

Mesiobuccal roots of maxillary molar teeth had more variation in their canal system than the distobuccal or palatal roots. The root canal configuration of the maxillary second molars was more variable than the first molars in a Brazilian population. CBCT imaging is a clinically useful tool for endodontic diagnosis and treatment planning.     

上颌第一磨牙根管系统的研究

目的 观察上颌第一磨牙的根管系统。方法 制备50个上颌第一磨牙透明牙标本,显露根管系统的空间构型,在体视显微镜下观察并记录根管系统的形态,结合应用加以统计。结果 ①上颌第一磨牙近中颊根单根管率为66%,其中Ⅰ型占38%,双根管率为34%,远中颊根Ⅰ型占74%,腭根Ⅰ型占94%。②根管侧支、根尖分歧、根尖分叉多见于近颊根,在近颊根的发生率为40%, 远颊根的发生率为24%,腭根的发生率为6%,发生部位多见于根尖1/3。结论 上颌第一磨牙近颊根的根管系统最为复杂,根管变异较远颊根多,腭根变异最少。     

Analisi della morfologia radicolare e canalare di molari superiori ed inferiori in una popolazione Caucasica: studio in vivo alla CBCT

AimTo investigate the root and canal morphology of maxillary and mandibular permanent molar teeth in a Caucasian population by using Cone Beam Computed Tomography (CBCT).MethodsA total of 596 permanent molars were included. The number of roots, the number of canals per root and the root canal configurations according to the method of Vertucci were recorded.ResultsAlmost all of maxillary first molars (95.7%) had three separate roots; however, 40.3% of mesiobuccal roots had two canals (MB2). Of 157 maxillary second molars, 88.5% had three roots. Among the mesiobuccal roots, 15.1% had two canals. The majority of mandibular molars (100% of first molars, 89.4% of second molars) had two separate roots. Most distal roots had a simple type I configuration, whereas mesial roots had more complex canal systems, with more than one canal.ConclusionsCBCT is an efficient method of studying root canal systems.     

Root and canal morphology of maxillary first and second permanent molar teeth in a Ugandan population

AIM: To investigate the root and canal morphology of permanent maxillary molar teeth from a Ugandan population. METHODOLOGY: Maxillary first (n = 221) and second molar (n = 221) teeth were collected from patients attending dental clinics in Kampala. Teeth were prepared using a clearing technique: the pulp chambers were accessed and the teeth placed consecutively into 5% sodium hypochlorite, 10% nitric acid, then methyl salicylate. Indian ink was injected into the pulp chambers to demonstrate the canal system. RESULTS: In the first molars, 95.9% of the teeth had separate roots. The mesiobuccal root was fused with the palatal root in 3% of specimens and with the distobuccal root in 0.5% of teeth. In the second molars, 86% of the teeth had separate roots. The mesiobuccal root was fused with the palatal root in 6.3% of specimens and with the distobuccal root in 6.8% of teeth. Apical deltas were more frequent in the mesiobuccal root when compared with distobuccal and palatal roots of both the first and second molars. A type I canal configuration (>75%) was the most frequent in all the roots of both the first and second molars. Canal intercommunications and lateral canals were more frequent in the mesiobuccal root when compared with other roots. CONCLUSIONS: The mesiobuccal root tended to have more variations in the canal system followed by the distobuccal root, whereas the palatal root had the least. The findings in root and canal morphology of this Ugandan population were different from previous studies, which may partly be attributed to racial differences.     

The root and root canal anatomy of maxillary molars in a Chinese population

Abstract The purpose of this investigation was to study the prevalence of fused roots, C-shaped roots, C-shaped root canal orifices and C-shaped root canals in the maxillary molars of a Chinese population. A total of 305 first molars and 309 second molars were collected in Taiwan. The teeth were demineralized and placed in methyl salicylate to make them transparent. Root fusion was examined and the pulp chamber floor was checked for C-shaped orifices. Chinese ink was then injected into the root canal system to demonstrate possible C-shaped canals. The maxillary first molars had the palatal root fused with the mesiobuccal root in 0.3% of the cases, and with the distobuccal root in 2.0%. Teeth with C-shaped roots existed in only 0.3% of maxillary first molars, while 6.2% of the maxillary first molars and 40.1% of the maxillary second molars had fused roots. The maxillary second molars had the palatal root fused with the mesiobuccal root in 18.1% and with the distobuccal root in 2.6%; the palatal root was fused with the mesiobuccal and distobuccal root in 8.1% of the material. The maxillary second molars had a C-shaped root in 4.5% and C-shaped root canal orifices with C-shaped root canals in 4.9% of the cases. Fused roots or incompletely separated roots are common in the maxillary second molars amongst Chinese people, while C-shaped roots and root canals in maxillary molars are not frequently seen.     

Root and canal morphology of Thai maxillary molars

AIM: To investigate the root and canal morphology of 268 maxillary permanent molars collected from an indigenous Thai population. METHODOLOGY: The cleaned teeth were accessed, the pulp dissolved by sodium hypochlorite under ultrasonication, and the pulp system injected with Indian ink. The teeth were rendered clear by demineralization and immersion in methyl salicylate. The following observations were made: (i) number of roots and their morphology; (ii) number of root canals per root; (iii) root-canal configuration in each root using Vertucci's classification with additional modifications; and (iv) presence and location of lateral canals and intercanal communications. RESULTS: All the maxillary first and second molars had three separate roots. Only, half (51%) of the maxillary third molars had three separate roots; the other half had fused or conical roots. The majority of the distobuccal (98.1-100%) and palatal (100%) roots had type I canals. Over half of the mesiobuccal roots of first (65%) and second (55%) molars had two canals. The most common (44.2%) canal configuration in mesiobuccal roots of first molars was type IV (two canals, two foramina). A variety of canal types were found in the mesiobuccal roots of second molars. Maxillary third molars showed the greatest diversity of canal morphology. There was an increase in the prevalence of lateral canals towards the apical part of the roots and intercanal communications were present in 16% of each of first, second and third Thai maxillary molars. CONCLUSIONS: The mesiobuccal roots of Thai maxillary molars possessed a variety of canal system types. Over 50% of the first molars had a second mesiobuccal canal. The palatal and distobuccal canals mainly had type I canals. Only, a small proportion (7.3-13.3%) of the roots exhibited lateral canals which were the most common in the apical third     

Root and canal morphology of the mesiobuccal and distal roots of permanent first molars in a Kuwait population--a clinical study

Aim To identify the number of roots and canal configurations in permanent first molars of the indigenous Kuwaiti sub‐population and compare them against a similar group of non‐Kuwaiti population in different age groups and gender, and to determine the frequency of a second canal in the mesiobuccal root of maxillary first molars and distal root of mandibular first molars that could be located and treated in routine practice without using magnification or special lighting conditions. Methodology A total of 220 permanent first molar teeth of patients scheduled for root canal treatment over a period of 1 year were included. Patients were identified and grouped according to their nationality as Kuwaiti and non‐Kuwaiti (which included Filipinos, Indonesian Indians, Srilankans, Egyptians, Saudi Arabians and Syrians). In both nationality groups, patients were successively distributed into four groups based on their age. The first age group included patients below 20 years, the second 21–30 years, the third 31–40 years and the fourth were over 40 years. The first three groups comprised of 15 male and 15 female patients whilst the fourth group had 10 patients of each gender. Teeth with open apices, resorptions and calcification were excluded from the study. The teeth included were both clinically and radiographically examined for number of roots, the canal configuration and the presence of the additional mesiobuccal and distal canals and recorded. The simplified classification of canal configurations proposed by Weine was utilized. Results The incidence of a second canal in the mesiobuccal (MB) root of maxillary first molars and the distal root of mandibular first molars was not influenced significantly by nationality and gender. All the 110 maxillary first molars treated had three roots; 58% of MB root had one canal and 42% had two canals. The majority of the mesial roots had Weine type II canal configuration when the second mesiobuccal canal was present. All distobuccal and palatal roots had a single or type I canal configuration. Of the 110 mandibular first molars that were treated, 96% had two roots and 4% had three roots. When present, the third root was located either buccal or lingual to the main distal root. Overall 51% of the single distal roots had one canal whilst 49% had two canals. The mesial root frequently had a Weine type II canal configuration as did the distal root when a second canal was present. Pearson’s correlation analysis of both molars revealed a significant (P < 0.05) negative correlation (r = ?0.274, r = ?0.144) between age and number of canals as well as the type of canal. Conclusions The incidence of a second canal in distal roots of permanent mandibular first molars was 49% in the Kuwaiti population and this was similar to other Asian ethnic populations. Adopting modified access and troughing procedures revealed a 42% frequency of MB2 canals in maxillary first molars. The incidence of a second canal in both mesiobuccal roots of maxillary molars and distal roots of mandibular molars decreased significantly with age; no differences were noticed amongst the nationalities and gender studied. The possibility of extra roots should be anticipated in mandibular molars.     

上颌第二磨牙牙根根管数目的CBCT影像学观察

目的：利用锥形束CT（CBCT cone beam computed tomography）三维影像对上颌第二磨牙的解剖形态进行观察分析,明确其变异性,指导临床根管治疗。方法：对来我院老年牙髓牙体病科就诊的患者进行CBCT扫描与二次重建后,对上颌第二磨牙解剖结构观察分析。结果：CBCT检查老年患者265人,上颌第二磨牙435颗。在轴位影像和3D影像上根据牙根、根管以及牙根、根管的变异性共分为8种类型。单根单根管2.30%;1根2根管7.35%;1根3根管9.20%;2根2根管3.91%;2根3根管19.54%;3根3根管38.6%;MB217.5%;4根4根管2.29%。结论：上颌第二磨牙根的数目、根管的数目以及解剖形态变异性非常大,CBCT影像为临床根管治疗等提供了可靠的依据。     

Evaluation of root canal morphology of human primary molars by using CBCT and comprehensive review of the literature

Objective Knowledge of primary tooth morphology is essential for clinical dentistry, especially for root canal treatment and dental traumatology. However, this has not been well documented to date with a large sample. This study was carried out to investigate the variation in number and morphology of the root canals of the primary molars, to study the applicability of cone beam computerized tomography (CBCT) in assessing the same and to provide a comprehensive review of the literature. Materials and methods A total of 343 primary molars, without any root resorption, were divided into four main groups including the maxillary first molars, maxillary second molars, mandibular first molars and mandibular second molars. All of them were analysed in CBCT images in the axial, sagittal and coronal planes. Various parameters such as the number of roots, number of canals, the root canal type, diameter of root and root canal and root canal curvature were studied. Results Primary molars in all four groups showed variability in the number of roots and root canals. As far as length of the roots was concerned, the palatal root of the maxillary molar was found to be longest, while the distobuccal root was shortest. In mandibular molars, the mesial root was longer than the distal root. The length of distobuccal root canal of the maxillary molars and the distolingual canal of the mandibular molars was found to be shortest. The number of roots and root canals varied from two to four and three to four, respectively. The maxillary molars exhibited more one-canal than two-canal roots. Conclusion The present study provides comprehensive information to the existing literature concerning the variation in root canal morphology of the maxillary and mandibular primary molar teeth. These data may help clinicians in the root canal treatment of these teeth.