锥形束CT与透明牙染色法对下颌恒切牙根管形态的比较研究

Comparative study of root canal morphology of mandibular incisors by cone-beam CT and canal staining and clearing technique

目的:采用锥形束CT(cone-beam CT,CBCT)与透明牙染色法观察下颌恒切牙根管形态,比较2种方法对根管形态研究结果的一致性。方法:选取根尖发育完全、牙根完整、未进行过牙髓治疗的离体下颌恒切牙61颗,进行CBCT扫描,并用透明牙染色法对根管系统进行染色,比较2种方法对下颌恒切牙根管数目、根管Vertucci分型的一致性,分析2种方法对根管分支结构检出率之间的差异。采用SPSS 17.0软件包对数据进行统计学分析。结果:CBCT法和透明牙法对单、双根管的一致性检验的Kappa值为0.847(P<0.001),2种方法对Vertucci根管分型一致性检验的Kappa值为0.861(P<0.001);2种方法根管分支结构的检出率分别为8.19%、22.95%,差异具有显著性(P=0.025),透明牙染色法的根管分支结构检出率显著高于CBCT。结论:CBCT能准确反映离体下颌恒切牙的根管类型,但对根管分支结构的诊断不如透明牙染色法,CBCT是一种较准确的诊断根管形态的方法。

PURPOSE： To compare the root canal morphology of mandibular incisors by using cone-beam CT （CBCT） and canal staining and clearing technique. METHODS： Sixty-one extracted mandibular incisors with complete dental root and apex which received no endodontic treatment and no post crown restoration were selected. Each tooth was radiographed with CBCT, and the root canal system was stained by canal staining and clearing technique. The consistency of the number of root canal, root canal Vertucci type of mandibular permanent incisors between the two methods were compared, and the differences of the detection rate on root canal branch structure between the two methods were analyzed. The results were statistically analyzed with SPSS 17.0 software package. RESULTS： The Kappa value of single and double root canal types between CBCT and canal staining and clearing technique was 0.847 （P〈0.001） .The Kappa value of Vertucci root canal types between CBCT and canal staining and clearing technique was 0.861 （P〈0.001）. The detection rates of root canal branch structure were 8.19% and 22.95%, respectively, with significant difference between the two methods （P=-0.025）. The canal staining and clearing technique was significantly better than CBCT in detection of root canal branch structure. CONCLUSIONS： CBCT can reflect the root canal types nearly perfectly, but inferior to canal staining and clearing technique in detection of root canal branch structure, CBCT is a relatively accurate clinical diagnosis tool of root canal morphology.