486例汉族青少年上颌第一恒磨牙解剖学特征分析

Analysis of root canal morphology of the first maxillary molars by cone-beam computed tomography in 486 cases of Chinese Han adolescents

目的:通过回顾性分析一定数量的泸州地区汉族青少年的锥形束CT(Cone-beam computed tomography,CBCT)影像,分析上颌第一磨牙根管系统的解剖特点,为临床治疗提供理论依据,完善中国汉族人群上颌第一磨牙根管系统的解剖数据。方法:在西南医科大学附属口腔医院收集符合纳入标准的影像资料486例,采用CBCT分析根管数目及根管构型。根管数目和根管构型的记录采用Vertucci分类法。结果:1上颌第一磨牙近中颊根根管构型复杂,按发生率大小依次排列为Ⅳ型(32.51%)、Ⅰ型(30.86%)、Ⅱ型(17.44%)、Ⅴ型、Ⅲ型、Ⅵ型、2-1-2型、2-3-2型,近中颊根第二根管(Second mesiobuccal canal,MB2)的发生率为67.91%。远中颊根根管构型以Ⅰ型(95.46%)为主。腭根根管构型以Ⅰ型为主,偶见双根管的情况。男性、女性与左侧、右侧各牙根根管构型分布差异无统计学意义(P>0.05);2近颊根根管构型左右对称性发生率为71.07%,远颊根根管构型对称性发生率为97.73%,腭根根管构型对称性发生率为99.79%。男性与女性对称性发生率差异均无统计学意义(P>0.05)。结论:CBCT可评价磨牙根管系统解剖形态,上颌第一磨牙近颊根MB2发生率高,根管构型左右对称性发生率高。

Objective： To study the root canal morphology of the first maxillary molars in Chinese Han adolescents in Luzhou through retrospective analysis of a large number of cone-beam computed tomography （CBCT） images. Methods： A total of 486 subjects with healthy first maxillary molar teeth who required CBCT examination in Dental Hospital of Southwest Medical University were enrolled in the present study. The number of root canals and the root canal configuration based on Vertucci＇s classification were determined. Results：① The root canal configuration of mesiobuccal root of the first maxillary molar was complex with more variations. The incidence rate of root types from high to low were： type Ⅳ （32.51%）, Ⅰ （30.86%）, Ⅱ （17.44%）, Ⅴ, Ⅲ, Ⅵ,2-1- 2, 2-3-2. Overall, the incidence of the second mesiobuccal canal （MB2） was 67.91%.Most distobuccal root of the first maxillary molar showed type Ⅰ and almost all palatal root canals were type Ⅰ , occasionally were type Ⅳ. There was no statistical difference between male and female and between left and right sides. ② The mesiobuccal roots of the first maxillary molars were found to be symmetrical in 71.07%, while the distobuccal and the palatal root showed symmetry in 97.73% and 99. 79% respectively. Conclusions： CBCT can be used to evaluate the anatomic features of the root canal systems .The incidence of a second canal in the mesiobuccal root of the first maxillary molars is high, and the first maxillary molars are highly symmetrical.