下颌第二磨牙C形根管的临床诊断和治疗

Clinical diagnosis and treatment of C-shaped root canals in mandibular second molars

目的:探讨下颌第二磨牙C形根管的临床诊断和治疗。方法:选择需进行治疗的下颌第二磨牙104个,通过术前拍摄X线片和术中根管显微镜下髓腔探查,按照AL-Fouzan术前X线诊断标准和Melton分类标准分别诊断是否为C形根管。采用手用Protaper进行根管预备,热牙胶垂直加压技术充填根管。记录C形根管口的类型,统计两种方法诊断的成功率。根据治疗前、中、后的X线评价根管预备和充填的效果,3～6个月后复查。结果:下颌第二磨牙C形根管术前X线片和根管显微镜的诊断率分别为72.1%和90.7%,所有患牙均无根管内并发症发生,治疗效果好。结论:术前X线片和根管显微镜相结合大大提高了下颌第二磨牙C形根的诊断率,镍钛器械预备根管和热牙胶垂直加压技术充填根管可获得良好的治疗效果。

Objective：To discuss the diagnosis and treatment of C-shaped root canals in mandibular second molars.Method：The C-shaped root canals in 104 mandibular second molars were diagnosed by X-ray films and microscopy using Melton＇s method and AL-Fouzank＇s method respectively.The root canals were shaped by using Ni-Ti rotary instrument protaper.The type of C-shaped root canal、the success rate of diagosis and the in-operative complications were record.The efficiency of preparation and obturation was analyzed with radiographs before,during and after operation.Result：The frequency of C-shaped root canal in mandibular second molars was 41.3 %.The success rate of diagnosis of X-ray films and microscopy was 72.1 % and 90.7 % separately.There was no complication in all cases.The result of treatment was good.Conclusion：Preoperative X-ray film and microscopy improve the diagnosis of C-shaped root canal obviously.The C-shaped mandibular second molars can be treated very well with Ni-Ti rotary instrument and warm vertical compation technique.