上颌磨牙近颊根根管类型及其临床意义

A vitro study on the type of the mesiobuccal root canal of the maxillary molars and its clinical significance

目的:运用透明标本法观察离体上颌第一、二磨牙近颊根根管形态,并进行分类和讨论其临床意义。方法:收集离体上颌第一、二磨牙共275颗,制成透明标本。根管显微镜下观察、记录近颊根的根管数目、走向、融合和分支情况,并进行分类。结果:①上颌磨牙近颊根管形态各异,可概括为八种类型,双根管中以2-1型和2-2型多见;双根管率在第一磨牙和第二磨牙分别为81.48%和49.7%。②近颊根主根管(MB)和近颊根第二根管(MB2)的尖1/3多弯向远中,MB2在近根管口1mm～3mm处有一斜向近中的弯曲点。结论:掌握上颌磨牙近颊根1-2型、2-1-2型和1-2-1型根管形态,是提高上颌磨牙根管治疗技巧和成功率的关键;有效去除根管近中壁部分突起的牙本质,以减小冠1/3处的弯曲度,可望提高MB2根管的探通率。

Objective: To investigate the type of the mesiobuccal root canal of the first and second maxillary molars inChinese population using the clearing technique. Methods: 275 extracted human first and second maxillary molars wereselected and hyatinized. Under Dental operating microscope(DOM), the number of root canals and their different typeswere determined. Results: ① 81.48% of the mesiobuccal roots in the first and 49.7% in the second molars had two canalsin the transparent specimens. ② Variable canal configurations were found in the mesiobuccal root and classified into 8types. Most of the specimens with presence of two canals in the mesiobuccal roots were 2-1 type and 2-2 type matched toVertucci type II and IV configurations. Conclusions: The anatomical data obtained from the study may provide experimentalevidence for clinical management of mesiobuccal canal and increase the success rate of root canal therapy in maxillarymolars.