上颌第三磨牙根管形态的CBCT研究

目的：应用锥形束CT（cone?beam computed tomography ,CBCT）技术研究上颌第三磨牙的根管形态,为临床治疗提供解剖学依据。方法随机调取397颗上颌第三磨牙的CBCT资料,分析上颌第三磨牙的牙根数目、根管数目、根管分类等。结果397颗上颌第三磨牙中,三根牙最多,占43.07%;融合根牙次之,占40.30%。分析根管数目显示,三根管最多,占47.86%;单根管次之,占28.21%。根据Vertucci根管分类,89.6%的牙根以Ⅰ型根管为主,但仍会出现根管治疗时较难操作的Ⅱ型、Ⅲ型、Ⅴ型、其他型等根管。结论上颌第三磨牙根管解剖形态多样,根管系统复杂、变异大。     

上颌第三磨牙根管治疗的疗效观察

上颌第三磨牙由于萌出晚且位于牙弓的末端,根管系统复杂,进行根管治疗时难度较大。有关这方面的研究报道甚少,笔者对患有牙髓炎或根尖周炎的上颌第三磨牙进行常规的根管治疗,取得了满意疗效,现报道如下:1临床资料1.1一般资料2003年起对我科门诊接诊的上颌第三磨牙患者54例54颗,     

上颌第三磨牙根形态与根管形态的研究

目的：寻找上颌第三磨牙根形态及根管形态的规律。方法：使用传统的牙透明技术,充分显露该牙髓腔外形,在体式显微镜下读取根管系统的形态,并统计分类。结果：103颗上颌第三磨牙,融合根占72%,分叉根占28%;完全融合型牙根单根管（1-1型）多见,不完全融合牙根中双根管（2-2）和三根管（3-2;3-3）为主;分叉根型中近中颊根分为双管型常见;根尖分歧和根管侧枝在各型根管中均可见到。结论：上颌第三磨牙融合根常见,但根管形态多样。     

CBCT结合Mimics软件重建体内上颌第三磨牙根管系统的准确性研究

目的：运用CBCT结合Mimics Medical软件三维重建提取体内上颌第三磨牙根管系统解剖形态,并评估CBCT数据三维重建根管系统的准确性。方法：选取在我院口外门诊就诊需拔除上颌第三磨牙的患者100例,拔牙前行CBCT扫描,导出数据后用Mimics Medical 21.0软件三维重建活体牙根管系统并测量重建牙体数据(共113颗);拔牙后离体牙进行编号并与CBCT扫描数据一一对应,测量离体牙数据后再制作透明牙观察根管类型,以离体牙、透明牙为标准,评估CBCT三维重建活体牙根管系统的准确性。结果：CBCT结合Mimics Medical软件三维重建体内上颌第三磨牙共发现Ⅰ、Ⅱ、Ⅲ、Ⅴ、Ⅵ型根管,三维重建牙体数据与离体牙实测相近(P>0.05);在主根管类型分型上与透明牙一致性较好(kappa=0.798>0.75,P<0.001);但对侧副根管检出率,一致性较差(Kappa=0.309<0.4,P<0.001),三维重建检出率(7.1%),明显低于透明牙检出率(22.1%)且差别具有统计学意义。结论：CBCT结合Mimics Medical三维重建技术能...     

下颌第三磨牙根管治疗的临床疗效观察

目的 观察下颌第三磨牙根管治疗的临床疗效。方法 对22例下颌第三磨牙采用改良双敞技术预备、侧方加压方法充填根管，一年后复查观察其临床疗效。结果 22例根管治疗的下颌第三磨牙，一年复查成功19例，成功率为86．36％。结论 尽管下颌第三磨牙根管形态复杂，操作难度大，掌握了不同类型患牙的特点，根管治疗仍可获得较高的成功率。     

显微CT法研究上颌第一磨牙根管系统解剖形态

目的 使用显微CT研究上颌第一磨牙根管系统解剖形态.方法 随机收集33颗上颌第一磨牙,使用显微CT扫描后重建根管系统.观察并记录各牙根根管形态和分支根管的发生数目、位置.记录各根管口位置并测量根管口间的距离和所成角度.在距离根尖1、2和3mm处进行虚拟切割,记录断面上分支根管暴露情况.结果 上颌第一磨牙近颊根第二根管发生率为75.76%.近颊根发生分支根管为71.64%;近颊根分支根管发生率为72.73%.91.04%的分支根管发生于根尖1/3段,近颊根距根尖3mm处截面分支根管暴露率为12.12%.近颊根第一、第二根管口间的距离为(1.60±0.41)mm.结论 上颌第一磨牙根管系统解剖形态复杂,近颊根根管形态存在较大解剖变异.     

显微CT法研究中国人上颌第一前磨牙分支根管形态

目的:使用显微CT扫描法研究中国人离体上颌第一前磨牙分支根管解剖形态。方法:收集63颗中国人上颌第一前磨牙,使用显微CT扫描并构建根管系统三维可视化模型。观察并记录分支根管、根尖三角区发生情况,分析分支根管发生率、分布和开口特征。结果:共有50颗上颌第一前磨牙含有分支根管,发生率为79.37%。共记录到124个分支根管,其中95.16%发生于根尖1/3。分支根管开口于近中和远中方向的分别为33.06%和23.39%。根尖三角区的发生率为7.94%。结论:上颌第一前磨牙分支根管发生率高,根管系统形态复杂,了解其分支根管发生规律对于提高根管治疗成功率具有重要意义。     

上颌第三磨牙的形态观察

目的 探讨上颌第三磨牙牙尖数目与牙根型、牙根型与根管数目间的关系,为上颌第三磨牙的保留和再利用提供参考。方法 利用电子数显游标卡尺对上颌第三磨牙进行测量分析,观察牙尖数目和牙根的关系,并通过透明标本的制作观察其髓腔形态。结果 上颌第三磨牙根长大于冠长,颊舌径大于近远中径。其（牙合）面以三尖型居多,其次是四尖型。二尖型和三尖型融合根比例大,四尖型和五尖型者,则二根比例较大。根管系统虽较为复杂,但主要是双根管和三根管型。结论 上颌第三磨牙牙尖与牙根、牙根与根管间的关系有一定的规律性。?     

显微CT法研究中国人下颌切牙根管系统解剖形态

目的:使用显微CT扫描技术研究中国人离体下颌切牙根管系统解剖形态。方法:收集108颗中国人下颌切牙,使用显微CT进行扫描后构建根管系统三维可视化模型。对主根管形态进行分型,记录第二根管分出位置,分支根管的发生率和位置。结果:下颌切牙根管最常见的形态为VertucciⅠ型和Ⅲ型,发生率分别为78.70%和14.81%,分支根管发生率为24.07%。第二根管发出位置在釉质牙骨质界根方(6.07±3.42) mm。结论:下颌切牙根管系统解剖形态复杂,了解其主根管及分支根管的发生规律对于提高根管治疗成功率具有重要意义。     

上颌第三磨牙的根管治疗

目的：评估上颌第三磨牙根管治疗的临床技术特点及近期临床效果。方法：32例患牙髓炎症的上颌第三磨牙进行常规根管预备，标准牙胶尖侧向加压充填。术后x线评估根管充填质量。结果：32个病例中，适充25例，适充比例为78．12％，欠充7例，欠充比例为21．88％，没有超充病例。结论：常规根管治疗技术治疗上颌第三磨牙可以取得较好的临床效果。     

Root and canal morphology of Burmese maxillary molars

AIM: To investigate the root and canal morphology of Burmese maxillary molars using a canal staining and tooth clearing technique. METHODOLOGY: Maxillary molars (239) were collected from indigenous Burmese patients and designated; first (90), second (77), third (72) molars. Following pulp tissue removal and canal system staining with Indian ink, the teeth were decalcified with 10% nitric acid, dehydrated and cleared with methyl salicylate. The following features were evaluated: (i) number of roots and morphology; (ii) number of canals per root: (iii) root canal configuration (Vertucci's classification); (iv) number of apical foramina per root; (v) number and location of lateral canals; and (vi) the presence of intercanal communications. RESULTS: All first and second molars had three separate roots, whilst third molars had one of five different root forms, of which three separate (25%) or fused (31%) roots were most prevalent. The majority of palatal (100%) and disto-buccal (96%) roots possessed one canal (type I). The prevalence of mesio-buccal roots with two canals decreased from first to third molars (68%, 49%, 39%, respectively); type II (two orifices, one apical foramen) and IV (two orifices, two apical foramina) configurations were the most common. Single/fused rooted third molars had a range of number and type of canals. Most roots in all molars had one apical foramen, those with four apical foramina were confined to third molars. Intercanal communications were most prevalent in mesio-buccal roots and two/three fused rooted third molars. Lateral canals were most prevalent in the apical third of the roots of all molars. CONCLUSIONS: The mesio-buccal roots of Burmese maxillary molars possessed a variety of canal system types. Over 50% of the first and second molars had a second mesio-buccal canal, of which over 20% had intercanal communications. The palatal and disto-buccal canals mainly had type I canals. Lateral canals were equally prevalent in all tooth types but were most common in the apical third.     

上颌第二磨牙近颊根根管形态的研究

目的:运用透明牙技术研究上颌第二磨牙近颊根根管形态。方法:收集离体上颌第二磨牙70颗,先去除牙髓,根管内注入印度墨水,经10%硝酸脱钙,酒精梯度脱水,于99%水杨酸甲酯中透明,在放大镜下观察根管形态,按Vertucci标准对根管分类。结果:70颗上颌第二磨牙中67颗为三根牙,占95.71%。67颗三根牙的腭根和远颊根均为单根管,近颊根单根管率为55.22%。70颗上颌第二磨牙中,近颊第二根管(MB2)的发生率为42.86%,其根管类型以Ⅱ型(2-1)和Ⅳ型(2-2)为主。结论:上颌第二磨牙近颊根根管形态复杂,对其解剖形态熟练掌握,能够提高该牙根管治疗的成功率。     

Unusual palatal root canal morphology in maxillary molars

Abstract Three clinical cases are presented in which the palatal root(s) of human maxillary molars exhibited root canal morphology characterized by multiple canals/roots.     

Root canal morphology of the mesiobuccal root of maxillary first molars: a micro-computed tomographic analysis

Aim  To investigate ex vivo , the root canal morphology of the MB root of maxillary first molar teeth by means of micro-computed tomography.
Methodology  Thirty extracted intact human maxillary first molar teeth were selected for micro-tomographic analysis (SkyScan 1072, Aartselaar, Belgium) with a slice thickness of 38.0 μm. The following data regarding the MB root were analysed and recorded: number and type of root canals, prevalence of isthmuses, prevalence of intercanal connections, presence of accessory canals, presence of loops and number of apical foramina.
Results  The MB2 canal was present in 80% of specimens and was independent in 42% of these cases. When present, the MB2 canal merged with the MB1 canal in 58% of cases. Communications between the two canals were found in all specimens, with isthmuses in 71% of the cases. These communications and isthmuses were respectively in 42% and 54% of the cases in the coronal third, in 59% and 79% of the cases in the middle third and in 24% and 50% of the cases in the apical third. A single apical foramen was found in 37% of specimens, two apical foramina were present in 23% of the cases, with three or more separate apical foramina occurring in 40% of the specimens.
Conclusions  The MB root canal anatomy was complex: a high incidence of MB2 root canals, isthmuses, accessory canals, apical delta and loops was found.     

C-shaped root canal configuration in maxillary first molars

AIM: This clinical report presents the endodontic treatment of two maxillary first molars and the anatomical study of two additional maxillary first molars with a C-shaped distally located root canal system. This configuration is not a common finding. SUMMARY: According to the endodontic literature, the C-shaped root canal is most frequently seen in the mandibular second molar. The occurrence of C-shapes in maxillary first molars, however, has only been described in a limited number of case reports. We observed this configuration in two out of 2175 root-filled maxillary first molars treated at the Department of Endodontology, Ghent University Hospital, during the last 10 years. In order to study and visualize this particular aberration, cross-sections in two additional two-rooted maxillary first molars were made. From these cross sections it can be concluded that the C-shaped canal configuration is the result of a fusion of the distobuccal and the palatal roots.     

山东地区人离体上颌第二恒磨牙牙根及根管形态观察

目的:观察山东地区人上颌第二恒磨牙牙根及根管形态的解剖特点。方法:于山东地区收集离体上颌第二恒磨牙118个,观察牙根形态及类型;应用透明牙标本法观察根管形态并按Vertucci八分类法对其进行分类。结果:118个上颌第二恒磨牙中以3根分离者为主,占91.52%,牙根融合者共10例,占8.47%,其中融合成2根者为5.08%,主要为近中颊根与远中颊根融合;融合成单根者为3.39%。透明牙标本法下观察根管系统,上颌第二恒磨牙远中颊根及腭根根管以Ⅰ型为主;近颊根根管仅44.95%为Ⅰ型,近颊根第二根管(the second mesiobuccal canal,MB2)的发生率达51.38%。结论:山东地区上颌第二恒磨牙的牙根具有多样性,以3根分离根形态为主,同时可发生各种融合根;其根管形态复杂,MB2的发现率较高。     

Root canal morphology of maxillary permanent first molar teeth at various ages

The root canal anatomy and pulp chamber morphology of 216 maxillary permanent first molar teeth of known age was examined using a radiographic technique after infusion of the root canal system with a radiopaque sodium iothalontate gel. This technique proved to be a rapid and effective method for the examination of root canal morphology and is recommended when root canal anatomy needs to be examined before further investigations are carried out. Over 95% of palatal and disto-buccal roots contained a single root canal. The mesio-buccal root was more complex. All types of configurations were seen. Only 26% of mesio-buccal roots showed a single canal. The pulp canal in all roots appeared to narrow at an early age. In the mesio-buccal root, a definite two-directional calcification pattern was apparent in most teeth by the age of 10. The rate of progress of root formation was very variable. There was no apparent relationship between the type of canal system in the mesio-buccal root and the type of canal orifice present. The transverse cross-sectional shape of the pulp chamber was trapezoidal in 81% of teeth.     

上颌第一磨牙根管弯曲度的实验研究

目的:分析上颌第一磨牙根管弯曲位置、方向及弯曲度。方法:收集80个上颌第一磨牙,在根管中分别插入15#-20#扩大针,拍摄近远中向和颊舌向X线片,用Photoshop6.0软件测量根管弯曲位置、方向和弯曲度。结果:上颌第一磨牙腭侧根管通畅、较直。远中颊侧根管80%在近远中方向、45%在颊舌方向有>5°的明显弯曲,弯曲位置多位于根中1/3,且近远中向弯曲度明显大于颊舌向(P<0.05)。近中颊根颊侧根管在近远中方向、颊舌方向分别有82.5%、77.5%出现>5°的明显弯曲。两个方向上的弯曲度无明显差异(P>0.05)。35%的标本探通了近颊根舌侧根管,其在近远中向、颊舌向出现明显弯曲的比例达91%和83%。结论:上颌第一磨牙四个根管在近远中向、颊舌方向均有不同程度的弯曲,其第二弯曲出现的情况也各不相同。     

上颌第二磨牙的形态学研究

上颌第二磨牙的形态比较复杂且存在变异,临床的解剖位置又比较靠后,给牙髓和牙周病的治疗带来了很大困难。所以,掌握上颌第二磨牙的形态对临床治疗具有指导性的意义。本文系统地回顾了上颌第二磨牙的研究方法和进展,并结合临床对上颌第二磨牙的牙冠和牙根等外部形态以及髓腔和根管形态等内部结构进行了较全面的综述。根管治疗成功的关键是对髓腔解剖的理解和掌握,所以,充分掌握牙根和根管形态并了解可能存在的变异,才能更好地进行治疗。     

显微CT在评价根管预备效果中的应用

显微CT作为一种非侵入性技术,能精确测量牙齿解剖间的细微差异,三维重现根管原始形态,通过比较根管预备前后数据,使得定性、定量研究根管预备成为可能。该文对显微CT在评价根管预备效果的指标方法进行综述。