锥体束CT结合显微超声处理上颌第一磨牙近中颊根第2根管钙化的疗效评价

Evaluation of cone beam computed tomography combined with dental operating microscopy and ultrasonic instruments in treatment of calcified MB2 canals in maxillary first molars

目的评价锥体束CT检测结合显微超声技术疏通上颌第一磨牙钙化近中颊根第2根管的疗效。方法选取临床常规治疗中132个上颌第一磨牙钙化的近颊第2根管,共161个钙化段,随机分为两组。试验组66个根管79个钙化段:根管上1/3钙化20个,中1/3钙化25个,中下1/3钙化34个;采用锥体束CT扫描,获得牙体及根管的三维数据,配合显微镜用超声器械疏通。对照组66个根管82个钙化段:根管上1/3钙化21个,中1/3钙化29个,中下1/3钙化32个;在普通X线片检测下,用显微超声器械疏通。比较两组间钙化段疏通的成功率。结果上1/3段钙化的近颊第2根管疏通成功率组间差异无统计学意义,而中1/3和中下1/3段钙化的近颊第2根管,组间差异有统计学意义(P<0.05)。试验组和对照组钙化段疏通的总成功率分别为81.01%和60.98%,组间差异有统计学意义(P<0.05)。结论锥体束CT技术结合显微超声能为临床疏通上颌第一磨牙近颊第2根管钙化治疗提供更有效的方法。

Objective To evaluate the therapeutic effects of cone beam computed tomography combined with dental operating microscope and ultrasonic instruments on negotiation of calcified MB2 canals in the maxillary first molars. Methods A total of 161 calcified segments in 132 maxillary first molar MB2 canals were collected and randomly divided into the experimental and control group in clinical treatment. Experimental group had 79 calcified segments in 66 root canals. There were 20 calcified segments in upper 1 /3 of canal and 25 in middle 1 /3 of canal and 34 in 1 /3 apex. All canals in experimental group were treated by CBCT to obtain 3-D data of teeth and root canals and negotiated by dental operating microscope and ultrasonic instruments. Control group had 82 calcified segments in 66 root canals. There were 21 calcified segments in upper 1 /3 of canal and 29 in middle 1 /3 of canal and 32 in 1 /3 apex. All canals in control group were treated by ordinary X-ray and negotiated by microscope and ultrasonic instruments. The success rate of negotiated calcified segments was compared between the two groups.Results There was no difference in the success rate of negotiated calcified segments in upper 1 /3 of canal between the two groups. The success rate showed significant differences in middle 1 /3 of canal and 1 /3 apex between the two groups. The total success rate of experiment group and control group was 81. 01% and 60. 98%,respectively,and the difference between two groups was statistically significant. Conclusion Combining CBCT with dental operating microscope and ultrasonic instruments could be an effective method in negotiation of calcified MB2 canals in the maxillary first molars.