上颌第二恒磨牙根管治疗中根管口定位及根管数目变异的研究

Study on root canal orifice localization and root canal number in the root canal treatment of maxillary second permanent molar

目的研究上颌第二恒磨牙在根管治疗中根管口定位及根管数目的变异情况。方法收集2015年1月至2017年1月就诊于内蒙古包头医学院第三附属医院口腔科的97例患者,选择上颌第二恒磨牙100颗。在根管显微镜定位下,结合使用超声器械,乙二胺四乙酸(Ethylene Diamine Tetraacetic Acid,EDTA),MTWO机用镍钛锉行根管预备,热压胶垂直加压充填,并记录根管变异类型统计结果。结果根管定位中髓底形态类型统计:"Y"形沟44例(44. 0%),近中颊舌沟13例(13. 0%),远中颊舌沟17例(17. 0%),"7"形沟8例(8. 0%),正中沟18例(18. 0%)。根管数目变异有4种类型:单根管2例(2. 0%),双根管18例(18. 0%),三根管72例(72. 0%),四根管8例(8. 0%),其中四根管均为近中颊根第二根管(MB2),未发现远中颊侧(DB2)及腭侧两根管,MB2包含2-2型5例(6. 0%),2-1型3例(2. 0%),未发现1-2型。结论上颌第二恒磨牙髓底形态多样,根管数目变异较多,术中结合根管显微镜探查定位根管口,可避免遗漏根管,并减少并发症的发生。

Objective To study the root canal orifice localization and the number of root canals in treatment of maxillary second permanent molar.Methods 97 patients were enrolled in the department of stomatology,the third affiliated hospital of Baotou medical college,Inner Mongolia during January 2015 to January 2017,100 maxillary second molar teeth which needed to prtform root canal therapy.The teeth were examined by endodontic microscopy.Ultrasonic apparatus,EDTA and MTWO Ni-Ti file were completing the root canal preparation.By using lateral and vertical compaction technique to fill the root canal.During the process,results of root canal variation types were documented and analysed by statistical results.Results Maxillary second permanent molar pulp bottom type had recorded:Y groove 44 cases(44.0%),mesial buccal tongue channel 13 cases(13.0%),far in the buccal tongue groove of 17 cases(17.0%),7 shaped groove 8 cases(8.0%),in the middle of ditch 18 cases(18.0%).There are four types of root canal number variation:single root canal had 2 cases(2.0%);double root canals had 18 cases(18.0%);three root canals had 72 cases(72.0%);four root canals had 8 cases(8.0%),of which were all MB2.DB2 and second palatal canals were not found.MB2 contained 2-2 types 5 cases(6.0%),2-1type 3 cases(2.0%),and no 1-2 type was found.Conclusion The pulp bottom of maxillary second permanent molar was diverse,and the number of root canals was more variable.In the operation,the root canal can be detected by endodontic microscopy to reduce the complications and missed canals.