多根管下颌前磨牙显微根管治疗的效果观察

目的观察下颌前磨牙多根管的发现率以及显微根管治疗方法处理多根管下颌前磨牙的临床疗效。方法选取152颗需进行根管治疗的下颌前磨牙，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，对怀疑多根管的患牙先常规探查根管，再在显微镜下探查并疏通根管，镍钛机动器械预备根管，垂直加压充填技术充填根管。记录根管类型，使用和未使用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。结果下颌第一前磨牙、第二前磨牙多根管的发现率分别为32．9％、7．5％；使用显微镜多根管的发现率高于未使用显微镜者；治疗中无根管堵塞、偏移、台阶、器械折断等并发症发生，完成治疗的31颗多根管下颌前磨牙30颗适充，1颗超充。结论显微根管治疗是处理多根管下颌前磨牙的有效方法。     

3个根管的下颌第一前磨牙的根管治疗1例

3个根管的下颌第一前磨牙极其罕见,本文报道1例3个根管的下颌第一前磨牙的根管治疗,并着重探讨了根管探查和预备的要点。     

下颌第一前磨牙根管的形态分析

目的:采用锥形束CT(CBCT)探讨双侧下颌第一前磨牙根管的解剖形态。方法:选取97例双侧下颌第一前磨牙的CBCT扫描数据,使用NNT软件分析下颌第一前磨牙的根管数目、形态、根面沟、根管分叉和双侧根管对称性。结果:下颌第一前磨牙根管Vertucci分类,发生率分别为Ⅰ型83.5%,Ⅲ型3.6%,Ⅴ型8.8%,C形4.1%。多根管类型的根面沟发生率为75%,明显高于单根管的3.7%,并且56.3%、31.3%的多根管类型分别在根中1/3、根尖1/3分叉。93.8%的下颌第一前磨牙根管双侧对称,其中,单根管对称率为95.2%,高于多根管的66.7%。结论:下颌第一前磨牙根管解剖结构复杂,CBCT可为根管系统提供准确的依据。     

下颌第一前磨牙三根管的临床治疗六例

根管治疗的成功依赖于对根管形态和解剖知识的了解,通过对根管正常解剖形态的了解,识别变异根管[1].下颌第一前磨牙的根管形态存在广泛变异,特别是近几年,大多数研究表明下颌第一前磨牙多根管发生率在25%左右.三根管的病例也时有报道[1-3].在临床治疗中,常规术前X线片检查很难发现根管的变异情况,临床治疗的过程也具有很大难度.本研究通过对下颌第一前磨牙三根管的6例临床病例的诊断和治疗过程进行分析,旨在对下颌第一前磨牙根管变异的临床治疗提供帮助.     

下颌第一前磨牙的临床根管漏治

目的：提高临床医生对下颌第一前磨牙存在双根管的认识。方法：报道4例典型的下颌第一前磨牙根管漏治的病例，结合69个离体的下颌第一前磨牙的根管类型研究。结果：由于临床医生的疏忽和下颌第一前磨牙自身解剖特点，易发生下颌第一前磨牙根管漏治。结论：下颌第一前磨牙根管漏治是根管治疗术失败原因之一。     

下颌第一前磨牙根管形态与根外形的研究

目的:探索下颌第一前磨牙根管形态分布规律。方法:收集形态完整的下颌第一前磨牙105个,先将根外形分类,再使用透明法显示根管系统形貌,经统计学处理探索其根管形态分布规律。结果:①下颌第一前磨牙的根外形有"单一形"和"异根形"两类,其中异根形占24.8%、单根形占66.7%;②根管类型按Vertucci分类有8型之多,异形根的根管通常复杂,约占92.3%。结论:下颌第一前磨牙根外形和根管形态并非形貌单一,故在临床根管治疗操作中应谨慎。     

下颌切牙及下颌第一前磨牙根管形态的体外研究

目的:采用透明标本法观察下颌切牙、下颌第一前磨牙根管系统的类型和特点.方法:选取根尖发育完全,牙根完整,未进行过牙髓治疗的离体下颌切牙120个、下颌第一前磨牙156个,开髓、去髓,注入墨水,制成透明标本.观察根管数目,按Vertucci分类法对根管系统进行分类,测量多根管牙根管分叉处至釉牙骨质界的距离.结果:下颌切牙、下颌第一前磨牙多根管的发生率分别为28.2%、30.9%,多根管以1-2型为主,多数在根管中段出现分叉.结论:下颌切牙、下颌第一前磨牙根管系统复杂,了解其形态特征有利于避免遗漏根管.     

下颌第二前磨牙双根3根管治疗1例

下颌前磨牙根管形态较为复杂,可能存在多根管,给根管治疗带来难度.插诊断丝的X线片,和多角度投射有助于发现其他根管.CBCT可更加直观的看到根管形态,从而有利于分析根管的分布.报告1例CBCT在下颌第二前磨牙双根3根管治疗中的诊断作用.     

4 3根管1例

下颌第一前磨牙多为单根管,约25%有双根管.多根管者极为少见,国外有文献报道,约0.5%下颌第一前磨牙有3根管.日前,我们在临床上发现1例4 3根管的病案,现报告如下.     

下颌第一前磨牙复杂根管治疗2例报告

下颌第一前磨牙根管系统复杂多变,双根管、多根管都有一定的发生率,临床医师应熟悉掌握其根管系统的正常解剖及其可能出现的变异。本文报告2例左下颌第一前磨牙双根管(2-2型,Verlucci分类)及多根管(1-3型,Verlucci分类)变异,可分为颊根、舌根及位于两者之间的正中根管,并结合相关文献,对下颌第一前磨牙双根、多根的诊断及探查进行分析,以期减少根管遗漏,确保完善的根管治疗。     

Mandibular first premolar with four canals

A case of endodontic treatment of a mandibular first premolar exhibiting a total of four distinct root canals and four apical foramina is described. This occurrence in mandibular first premolar has rarely been reported in the endodontic literature. Endodontic treatment that considers the anatomic variation of root canal morphology is important to ensure a favorable healing outcome, and its identification could be enhanced by careful examination using a dental operating microscope. Obturation of root canals using a warm vertical compaction technique with a highly‐radiopaque root canal sealer, such as AH Plus, after careful ultrasonic activated irrigation with ethylenediaminetetraacetic acid might allow the flow of sealer into the narrowed but unprepared part of the canal. This offers valuable adjuncts for the successful negotiation of calcified main canals, thereby facilitating optimum chemo‐mechanical debridement of the root canal system.     

The microscopic diagnosis and treatment of a mandibular second premolar with four canals

AIM: The purpose of this article is to report the case of a mandibular second premolar with four distinct canals. SUMMARY: It is generally recognized that incomplete instrumentation and cleaning of root canals will lead to failure in root-treated teeth. Before root canal treatment is performed, the clinician should be aware of the configuration of the pulp space of the tooth that is to be treated. Frequently, root canals are left untreated because the clinician fails to identify their presence, particularly in teeth that have anatomical variations or additional root canals. Traditionally, additional canals have been detected by clinical examination of the floor of the pulp chamber, and sometimes found radiographically. More recently microscopic examination of the pulp chamber using endodontic microscopy has assisted the identification of extra canals. A case report is presented that deals with the successful treatment of a mandibular second premolar with four canals. KEY LEARNING POINTS: Even in teeth with a low frequency of abnormal root canal anatomy, the possibility of additional root canals has to be considered in the clinical and radiographic examination of the patient. The ability to recognize and locate unsuspected canals is enhanced by microscopic investigation of the pulp chamber.     

Four root canals in a mandibular second premolar

A case report is presented involving the successful endodontic treatment of a mandibular second premolar with four canals in a single root. Statistics of morphological variations are irrelevant when the involved tooth is an anomaly.     

Relationships between pain-related mediators and both synovitis and joint pain in patients with internal derangements and osteoarthritis of the temporomandibular joint

OBJECTIVES: Routine dental CT scans were used to describe mandibular first premolar root configurations and canal variations. STUDY DESIGN: One hundred twenty dental CT examinations were evaluated for mandibular first premolar root configurations and canal variations regarding shape of root and root canal, incidence of multiple canals, and level of bifurcation. RESULTS: A total of 17 teeth in 12 patients showed mesial invagination of the root of the mandibular first premolar. One root displayed 3 canals with 3 apical foramina. In 2 teeth, a single canal divided into 2 canals, but merged into 1 apical foramen. One root showing 2 root canals finally divided into 2 roots near the apex. Thirteen roots had 2 canals and 2 apical foramina. The distance from the cementoenamel junction to the level of bifurcation was between 4 and 13 mm (mean, 7.4 mm). CONCLUSION: The occurrence of incidentally found mandibular first premolar root variations should be an important component of dental CT reports.     

Root canal treatment of mandibular second premolar with four root canals: a case report

The importance of an accurate diagnosis of the morphology of the root canal system is a prerequisite for successful root canal treatment and has been emphasized throughout the literature. Root canal morphology of premolar teeth, either maxillary or mandibular, and the discrepancies between first and second premolars, have been investigated and reported. A case report is presented of the root canal treatment of a mandibular second premolar with four root canals. As far as the reviewed literature revealed, up to three root canals in mandibular premolars have been reported. No previous report of a similar case of four root canals in a mandibular premolar was found.     

Mandibular first premolar with three root canals

Abstract This report presents a case of endodontic treatment of a mandibular first premolar with 3 root canals and a review of the literature concerning root canal anatomy of lower premolars. It is stressed that, even in teeth with a low frequency of abnormal root canal anatomy, the possibility of additional root canals has to be considered in the clinical and radiographic examination of the patient.     

Mandibular first premolar with three root canals

This report presents a case of endodontic treatment of a mandibular first premolar with 3 root canals and a review of the literature concerning root canal anatomy of lower premolars. It is stressed that, even in teeth with a low frequency of abnormal root canal anatomy, the possibility of additional root canals has to be considered in the clinical and radiographic examination of the patient.     

Multiple canals in a mandibular first premolar. Case report

It has been recorded that the occurrence rate of more than one canal in the mandibular first premolar varies between different races. This report presents the diagnosis and treatment of a mandibular first premolar with multiple root canals in a young male Asian. It is noted that knowledge of canal morphology, careful interpretation of the radiograph, and tactile sense during treatment constitute the major factors in achieving success with endodontic therapy in cases of complex root canal morphology.     

Endodontic treatment of three-rooted maxillary first premolar: A case report

A meticulous knowledge of the tooth morphology, careful interpretation of angled radiographs, proper access preparation and a detailed exploration of the interior of the tooth are prerequisites for a successful treatment outcome. False assumption about root canal morphology may lead to incomplete debridement and obturation of root canal space eventually leading to endodontic failures.Maxillary first premolar is known for the greatest variations in root anatomy and root canal morphology, while presence of two roots with two canals is quite common and is considered normal. The incidence of first maxillary premolar with three roots & three canals is quite rare and has been reported to 0–6% by Carns and Skid.This case report discusses the diagnosis and treatment of a maxillary first premolar with three canals and three separate roots. The presence of three roots with three canals was detected by radiographic interpretation, access refinements and confirmed by using spiral computed tomography.     

Diagnosis and root canal treatment of a mandibular second premolar with three root canals

AIM: To present a case of a mandibular second premolar with three root canals. SUMMARY: An accurate diagnosis of the morphology of the root canal system is a prerequisite for successful root canal treatment. A review of the literature reveals a low incidence of all types of premolars with three root canals. Diagnostic means such as preoperative radiographs and examination of the pulp chamber floor aid the location of root canal orifices. The diagnostic and therapeutic problems concerning premolars with unusual anatomy are described on the basis of a clinical example. A case report describes the successful treatment of a mandibular second premolar with three root canals. KEY LEARNING POINTS: Clinicians should be aware of unusual root canal anatomy in mandibular premolars. Radiographs exposed at two different horizontal angles and their careful interpretation facilitate the search of additional root canals. The use of magnification and additional lighting are recommended for the clinical examination of the pulpal floor.