基于锥形束CT的老年人下颌前磨牙根面沟及根管构型研究

Cone-beam computed tomographic analysis of radicular grooves and canal configurations of mandibular premolars in the elderly

目的本研究利用锥形束CT(Cone-beam CT,CBCT)分析对下颌第一、第二前磨牙根面沟的发生率、分布特点、长度及深度进行定量分析,并对其根管构型进行统计学评估,以期为临床治疗决策提供依据。方法收集678颗下颌第一前磨牙、482颗下颌第二前磨牙的CBCT图像,对其根管构型进行详尽分析,测量并记录根面沟的位置、长度及深度。结果下颌第一、第二前磨牙的根管构型主要为TypeⅠ(分别为87.76%、97.93%),其次是TypeⅤ(分别为6.93%、1.03%)和TypeⅢ(分别为3.09%、0.83%),以及其他少见类型。根面沟在下颌第一前磨牙中的检出率为15.63%,在下颌第二前磨牙中为3.11%,二者比较差异有统计学意义(P<0.05)。在伴有根面沟的前磨牙中,复杂根管构型的检出率(如Ⅲa型、Ⅲb型、Ⅴa型、Ⅴb型等)显著高于无根面沟的前磨牙(P<0.05)。结论根面沟的存在与复杂根管构型高度相关,特别是在下颌第一前磨牙中。根面沟的出现可能会引起根管系统变异,从而增加临床治疗的难度与风险。

Objective To analyze the incidence,distribution characteristics,length and depth of the root canal groove of the mandibular first and second premolar teeth,and statistically evaluate the root canal configuration,in order to provide a basis for clinical treatment decisions by using cone beam computed tomography(CBCT).Methods The CBCT images of 678 mandibular first premolar teeth and 482 mandibular second premolar teeth were collected,and the root canal configuration was analyzed in detail.The position,length and depth of the root canal were measured and recorded.Results First and second premolars were classified as follows:Type I,(87.76%,97.93%);Type V,(6.93%,1.03%);Type III,(3.09%,0.83%);and other types.RGs were exhibited by 15.63%of first and 3.11%of second premolars(P<0.05).Incidence of complex canals(types III,V and other types)in first premolars with RGs was significantly higher versus without RGs(P<0.05).Conclusion The presence of root canals is highly correlated with complex root canal configurations,especially in mandibular first premolars.The appearance of the root canal groove may cause the variation of the root canal system,which increases the difficulty and risk of clinical treatment.