Micro-CT三维重建技术在根管治疗研究中的应用

The application of three-dimensional reconstruction-based Micro-CT in the research of root canal treatment

熟悉根管系统的解剖形态特征、彻底的根管预备和严密的根管充填是根管治疗成功的重要保障。随着医学影像学技术的发展,三维影像重建技术已广泛应用于根管形态学、根管预备效果、根管充填质量、根管再治疗效率、三维有限元力学等相关研究。通过不同角度和层面观察和定性定量地分析三维重建后的根管三维图像,了解根管解剖形态,评价根管治疗各个环节的操作效果,对于临床操作具有重要的指导意义。本文就基于Mirco-CT的三维重建技术在根管解剖形态、根管预备、根管充填、根管再治疗效率以及三维有限元力学等研究中的应用作一综述。文献综述结果表明,Micro-CT分辨率高,Micro-CT扫描三维重建后的立体影像能精确地显示根管的细微解剖形态;准确测算根管预备前后的根管体积和形态变化、根管充填后的空隙发生率和空隙体积;准确计算根管再治疗前后根管充填材料的体积变化,是目前根管系统形态学研究和评价根管预备和充填质量的金标准。Micro-CT扫描三维重建后,可建立三维有限元模型,模拟根管治疗的过程并进行应力分析,分析根管治疗器械应力分布和根管预备对牙体组织应力的影响、根管充填过程中根管壁的应力分布等,从而筛选合适的操作方法、预防器械折断及牙根的折裂。Micro-CT三维重建技术在根管形态及根管治疗评价中具有重要价值。

Important guarantees of the success of root canal therapy include being familiar with the anatomical features of root canal system,good root canal preparation and complete root canal filling.With the development of medical imaging technology,three-dimensional reconstruction technology has been widely applied in root canal morphology,root canal preparation,root canal filling quality,root canal retreatment efficiency,three-dimensional finite elements and other related research.The reconstructed 3D images can be observed qualitatively and quantitatively from different angles and levels,which aid in the understanding of root canal anatomy and evaluation of the operation effect on all aspects of root canal therapy,providing important guiding significance for clinical operation.The application of 3D reconstruction technology based on micro-CT in the research of root canal anatomy,root canal preparation,root canal filling,root canal retreatment efficiency and three-dimensional finite element analysis are reviewed.The results of a literature review showed that the resolution of micro-CT is high.Furthermore,three-dimensional reconstruction can accurately display the fine anatomical morphology of a root canal,accurately measure the volume and morphological changes of root canal before and after root canal preparation,accurately measure the incidence and volume of the void after root canal filling and accurately calculate the volume changes of the root canal filling materials before and after root canal retreatment.Micro-CT is the gold standard for the morphological study of the root canal system and quality analysis of root canal preparation and filling.After three-dimensional reconstruction with micro-CT scans,a three-dimensional finite element model can be established to simulate the process of root canal therapy and stress analysis.This method can be used to analyze the stress distribution of root canal preparation instruments and the influence of root canal preparation on the stress distribution of tooth tissue and the root canal wall in the process of root canal filling.Then,suitable operation methods can be selected to prevent instrument breakage and root fracture.The application of three-dimensional reconstruction-based micro-CT is of great value in the evaluation of root canal morphology and treatment.