中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (27): 4265-4268.doi: 10.3969/j.issn.2095-4344.1370

• 口腔组织构建 oral tissue construction •    下一篇

锥形束计算机断层扫描评估儿童中下颌第1乳磨牙牙根数量及根管形态变化和分布

郭冬梅1,佘  芳2,谢  奇2   

  1.  (海南省人民医院,1口腔正畸科, 2口腔特诊室,海南省海口市   510102)
  • 收稿日期:2019-04-12 出版日期:2019-09-28 发布日期:2019-09-28
  • 通讯作者: 通讯作者:谢奇,博士,主任医师,海南省人民医院口腔特诊室,海南省海口市 510102
  • 作者简介:郭冬梅,1984年生,女,海南省万宁市人,汉族,2011年中山大学毕业,硕士,主治医生,主要从事口腔正畸专业的研究。
  • 基金资助:

    海南自然科学基金(817320),项目参与者:郭冬梅;海南省医药卫生科研项目(1801320445A2001),项目参与者:谢奇,郭冬梅

Evaluation of the number of roots and root canal morphology and distribution in Chinese children's mandibular first deciduous teeth by cone-beam computed tomography

Guo Dongmei1, She Fang2, Xie Qi2   

  1.  (1Department of Orthodontics, 2Oral Consulting Room, Hainan Provincial People’s Hospital, Haikou 510102, Hainan Province, China)
  • Received:2019-04-12 Online:2019-09-28 Published:2019-09-28
  • Contact: Xie Qi, MD, Chief physician, Oral Consulting Room, Hainan Provincial People’s Hospital, Haikou 510102, Hainan Province, China
  • About author:Guo Dongmei, Master, Attending physician, Department of Orthodontics, Hainan Provincial People’s Hospital, Haikou 510102, Hainan Province, China
  • Supported by:

    the Natural Science Foundation of Hainan Province, No. 817320 (to GDM); the Medical and Health Research Project of Hainan Province, No. 1801320445A2001 (to XQ and GDM)

摘要:

文章快速阅读:

文题释义:
乳磨牙的根管系统:与恒牙相比更为复杂,侧支根管多而乱;髓底多见副根管;根管分布存在变异,形态复杂。了解乳磨牙根管系统的组成有助于指导临床医师在对乳磨牙行根管治疗时避免遗漏根管,提高根管治疗的成功率。
根管治疗(root canal therapy):是牙髓病和根尖周病的国际上最常用的有效治疗方法。根管治疗术的原理是通过机械和化学方法去除根管内的大部分感染物,并通过充填根管、封闭冠部,防止发生根尖周病变或促进已经发生的根尖周病变的愈合。
摘要
背景:
X射线成像是牙髓病诊断和治疗的重要方法,但由于根尖片的三维解剖结构被压缩成二维视图,故提供的信息有限,无法确定根管的形态及其变异性。
目的:利用锥形束计算机断层扫描技术来评估中国儿童下颌第1乳磨牙的牙根的数目、根管的形态及分布。
方法:收集海南省人民医院97名儿童下颌第1乳磨牙锥形束计算机断层扫描的图像。研究已获海南省人民医院伦理委员会批准,受试儿童的监护人对检测过程均知情同意。对97名儿童的158颗下颌第1乳磨牙的牙根和牙根管进行回顾性分析,记录性别、年龄、牙根数、根管数、根管结构,采用SPSS 19.0软件进行统计分析。
结果与结论:①纳入的受检者性别比例约为1∶1,年龄为(8.17±3.16)岁;②158颗中左侧磨牙68颗,右侧磨牙90颗;男性76颗,女性82颗;③按牙根数将其分为单根(89.24%)、双根(8.86%)和三根(1.90%);④牙根3根变异仅在男性中观察到,并且男性在右侧牙根数上与女性比较差有显著性意义(P=0.022);⑤牙根管按Vertucci分类发现,所研究的样本中Ⅰ型根管最常见(84.81%),但未发现Ⅵ、Ⅶ和Ⅷ型根管结构;根管在牙左右侧的分布差异无显著性意义(P=0.524),且与性别无关(P=0.452);⑥结果说明,对根管系统形态解剖的认识是根管治疗成功的重要因素之一。术前利用锥形束计算机断层扫描检查可明确下颌第1乳磨牙根管形态,有助于临床医生进行根管治疗。

关键词: 锥形束计算机断层扫描技术, 下颌第1乳磨牙, 牙根, 三根异形, 根管结构

Abstract:

BACKGROUND: X-ray is an important method for the diagnosis and treatment of dental pulp disease, but the three-dimensional anatomical structure of periapical film was compressed into two-dimensional image, so the morphology and variability of root canal are hard to be confirmed with the limited X-ray information.
OBJECTIVE: To evaluate the number of tooth roots, the morphology/distribution of the mandibular first deciduous molar in Chinese children by cone-beam computed tomography.
METHODS: Cone-beam CT data of 97 children mandibular first deciduous molar were collected. The study was approved by the Ethics Committee of Hainan Provincial People’s Hospital, and the children guardians were informed of the study process and signed the informed consent. The roots and the root canals of 158 mandibular first deciduous molar were analyzed retrospectively. The sex, age, root number, and root canal number/structure were recorded. SPSS 19.0 software was used for statistical analysis.
RESULTS AND CONCLUSION: (1) The sex ratio of the participants was about 1:1, and the age was (8.17±3.16) years. (2) Among 158 mandibular first deciduous molars examined, 68 were left molars, and 90 were right molars; 76 were from the male, and 82 were from the female. (3) According to the number of tooth roots, teeth were divided into single-rooted (89.24%), double-rooted (8.86%), and three-rooted (1.90%). (4) Three-rooted variations were observed only in males, and there was a significant difference in the number of right roots between males and females (P=0.022). (5) According to Vertucci classification system, type I root canal was the most common (84.81%) in the studied samples, but type VI, VII and VIII root canal structures were not observed in this study. There was no significant difference in the distribution of root canals on the left and right sides of the teeth (P=0.524), not related to gender (P=0.452). (6) In summary, the understanding of the morphology and anatomy of the root canal system is one of the essential factors in the success of root canal therapy. Preoperative cone-beam CT examination can confirm the root canal morphology of mandibular first deciduous molars, which is helpful for clinicians in root canal therapy.

Key words: cone beam computed tomography, mandibular first deciduous molars, roots, three-root anatomic variation, root canal structure

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