X线结合锥束CT检测上颌磨牙遗漏根管的研究

Clinical Appliance of X Ray and Cone-beam Computed Tomography in Finding Missing Canals in Maxillary Retreated Molars

目的:评价X线结合锥束CT应用于根管再治疗中寻找上颌磨牙遗漏根管的临床效果,探讨上颌磨牙最容易遗漏根管的类型。方法:123例X线怀疑有根管遗漏需行根管再治疗的上颌磨牙,拍摄CBCT,记录上颌磨牙最容易遗漏的根管类型。按照随机化分组的原则分为2组,第1组61例,第2组62例。第1组根据X线检查结果,手术显微镜下探寻遗漏根管。第2组根据X线及CBCT检查结果,判断根管遗漏的数目及位置,手术显微镜下探寻遗漏根管。分别记录第1组和第2组上颌磨牙遗漏根管的检出率,比较其有无差异。结果:第1组61例患牙中53例通过CBCT确诊为遗漏根管,其中43例显微镜下寻找到遗漏根管,第2组62例患牙中51例通过CBCT确诊为遗漏根管,其中48例显微镜下寻找到遗漏根管。第2组对于遗漏根管的发现率(48/51)高于第1组(43/53),两者之间有统计学差异。上颌第一磨牙和上颌第二磨牙最容易遗漏根管均为MB2。结论:X线结合锥束CT,有助于帮助发现遗漏根管,提高根管再治疗的成功率。

Objective：To evaluate the effect of X ray and cone-beam computed tomography in finding missing canals in maxillary retreated molars,and investigate the most possible missing canal type in maxillary molars.Methods：123maxillary molars which were suspected missing canals through X rays were collected and then were taken CBCT.We recorded the most possible missing canals through CBCT.All teeth were divided into 2groups by principle of randomization.The first group included 61 molars and the second group 62 molars.The condition of missing canals in first group was judged from the X ray and the detection of missing canals were taken under microscope,while the condition of missing canals in second group was judged by the combination of X ray and CBCT.We recorded the finding rate of missing canals in two groups.Results：53of 61 maxillary molars in first group was judged as missing canals through CBCT,in which 43 could be found the missing canals,while 51 of 62 maxillary molars in second group was judged as missing canals through CBCT,in which 48 could be found the missing canals.There was statisticly difference between two groups in the finding rate of missing canal.The most possible missing canals in maxillary and second molars were both MB2.Conclusion：The combination use of X ray and CBCT can enhance the detection of missing canals in maxillary retreated molars and improve the quality of root canal retreatment.