不同年龄段双根管下颌侧切牙舌根管开口位置及分叉角度的锥形束CT研究

目的    通过锥形束CT（cone beam CT,CBCT）对下颌侧切牙双根管发生率及双根管牙的舌根管开口位置和双根管间分叉角度进行研究,为临床中对双根管下颌侧切牙的治疗提供理论依据。方法    于2019年10月至2020年5月在西部战区总医院口腔科因种植、正畸、牙髓病等原因拍摄的CBCT影像学资料中随机抽取300例符合纳入标准的患者CBCT资料,对其中符合纳入标准的586颗下颌侧切牙的影像进行分析,筛选出其中的双根管牙,将它们按患者年龄分组,记录舌根管开口处的位置及根管分叉角度,并进行分析。结果    纳入研究的586颗下颌侧切牙中有95颗为双根管,双根管发生率为16.2%;在低年龄组（≤ 30岁）、中年龄组（> 30 ~ 60岁）及高年龄组（> 60岁）,双根管下颌侧切牙的舌根管开口处距切端距离分别为（12.48 ± 1.43）、（11.18 ± 1.21）、（9.81 ± 0.86）mm,组间差异有统计学意义（P < 0.05）;而根管分叉角度在各年龄段的差异无统计学意义（P > 0.05）。下颌侧切牙舌根管开口处至切端距离和根管分叉角度在左右侧之间均具有对称性（r值分别为0.626和0.603,均P < 0.001）。结论    下颌侧切牙双根管发生率较高,并且随着年龄的增加,舌根管开口处至切端的距离在逐渐减小;同时两侧的双根管发生率、舌根管开口处至切端距离以及根管分叉角度均有较高的对称性。     

Root Canal Morphology Evaluation of Central and Lateral Mandibular Incisors Using Cone-beam Computed Tomography in an Israeli Population

Introduction

Central and lateral mandibular incisors usually have 1 root canal. The purpose of this study was to investigate the prevalence of additional root canals in central and lateral mandibular incisors and to investigate the prevalence of oval and long oval canals in the cervical, middle, and apical thirds of cases with 1 root canal.

下颌切牙根管解剖特点的锥形束CT影像学研究

目的采用锥形束CT研究下颌切牙根管解剖特点,及其与性别、年龄、牙位的关系。方法使用锥形束CT观察316例共1148颗下颌切牙,获得其断层图像后进行三维重建,通过计算机图像观察其根管数目及根管类型。记录被检查者的性别、年龄和牙位。计算下颌切牙双根管检出率,统计根管类型,分析根管解剖特点与性别、年龄、牙位的关系。结果下颌切牙双根管检出率为27．5％,其双根管类型以Vertucci分类的Ⅲ型最多,占14．1％。双根管在各年龄段间的分布差异有统计学意义（P〈0．05）,20～29岁和30～39岁两个年龄段的双根管检出率较高,分别为36．8％和36．5％。下颌切牙双根管的检出率女性高于男性。侧切牙双根管的检出率高于中切牙,结论下颌切牙双根管检出率较高,锥形束CT在诊断双根管方面具有重要作用。     

150例患者下颌中切牙根管系统的锥形束CT分析

目的：运用锥形束CT分析下颌中切牙的根管数目和形态特征,为临床治疗提供参考。方法 筛选就诊于上海交通大学医学院附属第九人民医院的150例患者的CBCT图像。其中,男79例,女71例,共295颗下颌恒中切牙,对根管的数目以及形态进行分析。结果 61%的下颌中切牙具有1个根管。具有双根管的下颌中切牙占39%,其中8.8%的牙有独立的2个根尖孔。结论 本组下颌中切牙具有双根管的比例为39%,与其他有关不同人种下颌中切牙双根管的研究结果一致。     

Root canal morphology of mandibular incisors in a Jordanian population

AIM: To investigate the root canal morphology of mandibular incisors in a Jordanian population using a canal staining and tooth-clearing technique. METHODOLOGY: Four hundred and fifty extracted mandibular incisors were collected from dental clinics within north Jordan. Following pulp tissue removal and staining of the canal systems, the teeth were decalcified with 5% nitric acid, dehydrated with ascending concentrations of alcohol and rendered clear by immersion in methyl salicylate. Cleared teeth were examined by eye and the following features were evaluated: (i) number and type of root canals; (ii) presence and location of lateral canals and intercanal communications; (iii) location of apical foramina; and (iv) frequency of apical deltas. RESULTS: The majority of mandibular incisors had a single canal (73.8% of teeth possessed a Type I canal system). Although 26.2% of the roots possessed two canals, only 8.7% had two separate apical foramina. CONCLUSIONS: The prevalence of two canals in this group of mandibular incisors was 26.2% and is within the range of previous studies performed on populations of different racial origin.     

An unusual presentation of all the mandibular anterior teeth with two root canals--a case report

A rare case of two root canals in all mandibular anterior teeth is presented. The patient initially reported for the treatment of mandibular right central and lateral incisors. However, radiographic evaluation revealed variant root canal and apical foramen patterns.     

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。     

Clinical management of 3 mandibular incisors with 2 separate canals and foramina: case report

This case report describes the root canal treatment of 3 mandibular incisors, each with 2 separate canals and foramina, in 1 patient. The case demonstrates an unusual morphological configuration of the root canal system and supplements previous reports of the existence of such configurations in mandibular incisors.     

下颌切牙双根管的显微根管治疗

目的评价显微根管治疗术处理下颌切牙双根管的临床疗效。方法选取143颗需进行根管治疗的下颌切牙（下颌中切牙68颗,下颌侧切牙75颗）,拍摄术前X线正位投照片和偏位投照片。对单根管患牙采用常规根管治疗;对疑为双根管的患牙先常规探查根管,再在牙科手术显微镜下探查并疏通根管,机用镍钛器械预备根管,垂直加压充填技术充填根管。记录根管类型,不同X线投照角度、使用和未使用牙科手术显微镜时多根管的发现率,根据术前、术中及术后X线片评价根管预备和充填效果。结果采用显微根管治疗,下颌中切牙、侧切牙双根管的发现率分别为26.47%、29.33%,X线偏位投照片双根管的发现率高于正位投照片;使用牙科手术显微镜后,多根管的发现率高于未使用时;在牙科手术显微镜下进行根管预备,无根管堵塞、偏移、台阶、器械分离等并发症发生;134颗患牙适充,9颗有糊剂或牙胶超充,无欠充。结论显微根管治疗是处理双根管下颌切牙的有效方法,在牙科手术显微镜下以机用镍钛器械预备根管,垂直加压充填技术充填根管可取得良好的治疗效果。     

CBCT检查发现儿童多颗下颌切牙双根管2例

下颌切牙萌出早于上颌,易受外力撞击而发生牙外伤。下颌切牙多为单根单管型,本文报道2例儿童牙外伤后应用CBCT检查分别发现4颗和2颗下颌切牙存在根管变异。     

中国人下颌恒切牙根管弯曲的解剖学研究

目的 探讨下颌恒切牙根管弯曲情况。方法 选择299颗离体下颌恒切牙,将15号K锉插入根管,唇舌向和近远中向采集数字化X线牙片图像,测量根管的弯曲角度、弯曲半径以及弯曲长度,并根据弯曲角度和弯曲形状进行分类。对测量结果进行统计分析。结果 下颌恒切牙根管的弯曲角度、弯曲半径以及弯曲长度,唇舌向分别为5.28°±5.52°、16.19 mm±12.38 mm、4.10 mm±2.01 mm,近远中向分别为9.99°±5.84°、18.86 mm±9.71 mm、3.27 mm±2.39 mm。下颌恒切牙根管中直根管、轻度、中度、重度弯曲根管分别为15.7%、66.9%、16.7%和0.7%（P<0.05）;直根管、单弯根管、双弯根管分别为7.7%、50.5%和41.8%（P<0.05）。结论 下颌恒切牙以弯曲根管为主,唇舌向弯曲程度大于近远中向弯曲程度。     

母女二人下颌前牙双根管病例报告

下颌前牙多为单根单管,但有资料表明下颌切牙的根管解剖形态可有较大的变异,因此在根管治疗中应高度重视,以免造成根管遗漏.作者就母女二位患者的下颌前牙均为对称型双根管做一报道.     

基于锥形束CT对下颌前牙根管系统构型的初步研究分析

目的:应用锥形束CT研究海口地区下颌前牙的根管形态,为牙体牙髓病治疗提供参考依据。方法:选取海南口腔医院影像科CBCT影像资料库中男性、女性各300例,按年龄分6组:12~20、21~30、31~40、41~50、51~60、61~70岁,每组男、女各50例。采用配套软件处理,根据Vertucci分类法观察下颌前牙根管系统的构型。结果:下颌中切牙、侧切牙和尖牙的多根管率分别为11.75%、23.5%和10.41%,下前牙的多根管发生率有统计学差异(P<0.05)。不同年龄组,下颌中切牙,侧切牙多根管发生率,有显著性统计学差异(P<0.001),下颌尖牙多根管发生率无统计学差异(P>0.05)。下前牙多根管时,其根管分叉至解剖性根尖的距离,下颌中切牙为(8.56±2.08)mm,下颌侧切牙为(9.43±1.93)mm,下颌尖牙为(10.60±2.01)mm。不同牙位之间比较,该距离均有统计学差异(P<0.05)。性别间比较,仅下颌中切牙根管分叉至解剖性根尖的距离有统计学差异(P=0.020,P<0.05)。不同年龄组间比较,下颌侧切牙和下颌尖牙的根管分叉至解剖性根尖的距离有统计学差异(P=0.004,P=0.04,P<0.05)。结论:下颌前牙单根多管发生率在10.41%~23.5%区间、多根管发生率和年龄相关性密切。     

运用锥束CT对恒前牙根管变异的分析

目的采用锥束CT扫描所得图像数据,统计和分析前牙根管的变异。方法收集600例患者7200颗前牙图像数据,运用NNT软件,在冠状面、矢状面和横断面进行观察,统计和分析根管的数目、形态变异,根管类型,牙根数及两侧根管变异的对称性。结果 1根管数目：上颌前牙均为单根管,未见到根管变异;下颌前牙中330颗牙出现变异根管,为9.16%;2根管类型：上颌前牙均为Ⅰ型,下颌前牙Ⅰ型90.84%,Ⅱ型0.83%,Ⅲ型6.67%,Ⅳ型1.33%,Ⅴ型0.33%;3根管变异的对称性：上颌前牙不存在变异根管对称;下颌前牙两侧变异根管对称率：中切牙69.2%;侧切牙86.1%;尖牙66.7%;4牙根数：前牙除2例下颌尖牙为双根外,余均为单根。结论上颌前牙未见根管和牙根的变异;下颌前牙根管形态较复杂,根管变异率为9.16%,CBCT可准确发现根管变异。     

不同投照角度X线根尖片诊断下颌前牙、前磨牙多根管的临床评价

目的 探讨不同角度X线投照技术对发现下颌前牙、前磨牙多根管及提高其临床治疗率的作用。方法 选取临床上需要进行下颌前牙、前磨牙根管治疗的患者214例，共247颗患牙。每颗患牙均需拍摄术前X线正、偏位投照片及诊断丝X线正、偏位投照片。依据两种X线影像特点（根管位置和走向不在牙根中心、较粗大的根管在根管上1／3、中1／3突然消失或模糊）判断是否为可疑多根管。采用冠向下法预备，冷侧压法根管充填后将根管分为Ⅰ～Ⅴ型并与X线结果对应。结果 在87颗X线诊断的多根管患牙中，临床证实多根管为60．92％；26．44％为扁根管。诊断丝X线偏位投照片的多根管X线诊断灵敏度为93．0％，4例术后发现有遗漏根管。247颗下颌前牙、前磨牙临床治疗多根管57颗，多根管临床治疗率分别为：中切牙9．43％、侧切牙38．33％、尖牙15．90％、第一前磨牙加．38％、第二前磨牙2．63％。结论 不同角度的术前及诊断丝X线根尖片有助于临床医师发现下颌前牙、前磨牙多根管，其中以诊断丝X线偏位投照发现的多根管最多。     

A Study of the Root Canal Morphology of Mandibular Anterior Teeth Using Cone-beam Computed Tomography in a Chinese Subpopulation

IntroductionThe purpose of this study was to investigate the root canal configuration of the mandibular anterior teeth using cone-beam computed tomographic (CBCT) imaging in a Chinese subpopulation.MethodsA total of 3,871 CBCT images of mandibular anterior teeth were collected from 648 patients who accepted CBCT projection as a preoperative assessment for implants or orthodontic treatment. The following items were recorded and evaluated: tooth position, root number, canal number, root canal type, the distance between the anatomic apex and the point at which the canal divided into 2 for mandibular anterior teeth with 2 root canals (excluding canines with 2 roots), and the distance between the 2 root canal orifices. The Fisher exact test was used to analyze the correlation between the number of root canals and tooth position.ResultsAll of the incisors in this study had 1 root, and 1.32% of the canines had 2 roots. The prevalence of 2 root canals in the lateral incisors (354, 27.36%) was higher than that in the central incisors (202, 15.71%) (P < .05) and the canines (81, 6.27%) (P < .05).ConclusionsThere is a high prevalence of 2 root canals in the mandibular anterior teeth of the studied Chinese subpopulation. This study provides detailed information about the root canal morphology of mandibular anterior teeth in a Chinese subpopulation.     

Cone-beam computed tomographic evaluation of root canal morphology of mandibular anterior teeth in a Saudi subpopulation,retrospective In-Vivo study

BackgroundThere is variability in the results of dental morphological studies between different ethnic populations. This study aimed to investigate the root canal morphology of mandibular anterior teeth in a Saudi subpopulation in the Riyadh region.MethodsWe examined a total of 1,769 cone-beam computed tomography (CBCT) images of the mandibular anterior teeth, including the central incisors (n = 587), lateral incisors (n = 590), and canines (n = 592). The number and configuration of the root canals were determined. Fisher's exact and Pearson’s chi-square tests were used to assess the differences between sexes and age groups, with a level of statistical significance was set at p < 0.05.ResultsOverall, Type I canal was the most frequent configuration among the mandibular anterior teeth (76.1%). However, the prevalence of Type III canal configuration in the central and lateral incisors was 36.5% and 31%, respectively. Additionally, the mandibular canines were mainly Type I canals (98.4%). The prevalence of canal configuration was predominantly Type I (95.7%), followed by Type III (2.7%), Type IV (0.4%), and Type V (1.2%). There was a statistically significant difference in the canal configurations between men and women (p = 0.02). Females more often had Type I root canals (60.6%), while Type III was more frequent in males (57.2%). However, there were no statistically significant differences between the age groups in canal configuration.ConclusionThe mandibular anterior teeth of the Saudi subpopulation had mainly one root canal. However, almost one-third of the central and lateral incisors had two canals. CBCT is a useful tool that can be used, if available, to investigate root canal morphology before root canal treatment.     

不同开髓方向对探查下领切牙双根管的影响

目的：观察不同开髓方向对探查下切牙双根管的影响。方法：选取150颗临床拔除的下颌切牙，随机分为两组，一组进行传统舌侧开髓不损伤切缘；另一组按照近远中垂直向X光片根管影所划直线进行开髓，不考虑对切缘的影响。结果：传统方法发现1．33％双根管；另一组发现12．0％双根管。结论：传统方法进行开髓遗漏了大部分舌侧根管，临床应改进这一传统方法。     

Radiographic prevalence of root canal ramifications in a sample of root canal treatments in a Brazilian Dental School

The aim of this study was to radiographically investigate the presence of root canal ramifications found after endodontic treatment, and to determine any relationship between their presence and the type of the auxiliary chemical substance used. The study evaluated 1,470 endodontic treatments performed by final year undergraduate students at the Dental School of Piracicaba, State University of Campinas (UNICAMP), SP, Brazil, during the period from 1998 to 2000. The X-rays taken during treatment were evaluated in order to establish the presence of ramifications of the root canal system. The initial X-ray did not show the presence of any canal ramifications. After filling, X-rays showed only 3 ramification types: 3.06% of lateral canals, 2.99% of apical deltas, and 0.1% of interradicular canals. The maxillary premolars showed the highest number of lateral canals (n = 13), followed by mandibular premolars (n = 10) and maxillary incisors (n = 10). Apical deltas were mostly found in mandibular molars (n = 14), followed by maxillary incisors (n = 9). Only mandibular molars had interradicular canals. The detection of ramifications increased with the use of EDTA. However, no statistically significant relationship was found between the type of auxiliary chemical substance used and the number of root canal ramifications detected after root canal filling. It was concluded that the frequency of root canal ramifications found radiographically was low in treatments performed by undergraduate students.     

Investigation of the root canal configurations of mandibular permanent teeth in the Turkish population

AIM: To investigate the root and canal morphology of mandibular permanent teeth collected from an indigenous Turkish population. METHODOLOGY: A total of 1400 extracted mandibular permanent teeth were evaluated. The teeth were divided into seven groups as central incisors, lateral incisors, canines, first premolars, second premolars, first molars and second molars in order to evaluate their root canal configurations. Access cavities were prepared and pulp tissue removed using 5.25% sodium hypochlorite solution. The teeth were stored in 5% nitric acid solution for 5 days, then rinsed under running water for 4 h and placed in increasing concentrations of ethyl alcohol. The teeth were rendered transparent by immersion in xylene solution for 3 days until complete transparency was achieved. Following this procedure, India ink was injected in the root canal systems and their configurations were examined and compared with the classification of Vertucci. The following observations were made: (i) root canal classification of mandibular teeth; (ii) morphology of the mandibular permanent teeth. The classification of Vertucci was taken as a reference during the evaluation; however additional canal morphological types were evaluated as separate groups. RESULTS: The presence of a second canal was detected in 68% of mandibular central incisors and 63% of lateral incisors. Lateral canals were found in 6.5% of mandibular central incisors and in 13% of lateral incisors. Overall, 62% of mandibular first premolar teeth had a single canal whereas 71% of second premolars had a single canal. The mandibular first and second molar teeth exhibited similar root canal configurations except for a group of second molar teeth that had a single root and canal. CONCLUSIONS: The morphological characteristics of teeth in this Turkish population were consistent with those of other studies performed on different populations using similar methodology.