华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

人下颌恒切牙管间峡区解剖的显微CT研究

刘成霞1 李文2 郑庆华1 耿宁1 孙拓祺1 黄定明2   

  1. 1.口腔疾病研究国家重点实验室, 四川大学; 2.四川大学华西口腔医院牙体牙髓病科, 四川成都610041
  • 收稿日期:2010-04-25 修回日期:2010-04-25 出版日期:2010-04-20 发布日期:2010-04-20
  • 通讯作者: 黄定明,Tel:028-85501439
  • 作者简介:刘成霞(1981—),女,山东人,硕士
  • 基金资助:

    国家“十五”科技攻关计划资助项目(2004BA720A23)

Anatomic study of canal isthmuses of mandibular permanent incisors by Micro -CT

LIU Cheng -xia1, LI Wen2, ZHENG Qing-hua1, GENG Ning1, SUN Tuo-qi1, HUANG Ding-ming2   

  1. 1. State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610041, China; 2. Dept. of Conservative Dentistry and Endodontics, West China College of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2010-04-25 Revised:2010-04-25 Online:2010-04-20 Published:2010-04-20
  • Contact: HUANG Ding-ming,Tel:028-85501439

摘要:

目的研究人离体下颌恒切牙管间峡区的解剖学特点。方法选择离体下颌恒切牙拍摄近远中向X线片,选出双根管牙33颗,对距根尖6 mm以内的牙根组织进行显微CT扫描。扫描层厚20 μm,每颗牙齿获得扫描截面300个。通过三维重建观察牙根管间峡区的解剖形态。记录距根尖1、2、3、4、5、6 mm处各截面根管数目及管间峡区的出现情况,并测量根管壁的最小厚度。结果所有双根管下颌恒切牙都存在管间峡区,完全峡区占49.7%,部分峡区占4.5%。距根尖6 mm内各截面管间峡区的出现率为10.0%~85.5%,卡方检验显示距根尖1~6 mm处管间峡区出现率的差异有统计学意义(P=0.001)。距根尖3~6 mm处管间峡区出现率较高,以5 mm处最高,为85.5%。距根尖6 mm以内的根管壁最小厚度均小于0.5 mm。结论下颌恒切牙管间峡区的出现率较高,根管壁最小厚度位于峡部,在临床进行根管治疗和牙髓外科手术时应引起重视。

关键词: 根管解剖, 下颌切牙, 管间峡区, 根管壁厚度

Abstract:

Objective To investigate the anatomic feature of the canal isthmus of mandibular permanent incisors by Micro-CT. Methods Thirty-three mandibular permanent incisors with two canals were selected through the radiograph in proximal view. These teeth were then scanned using Micro-CT and reconstructed. The scanning layer thickness was 20 μm. We observed the apical 6 mm of the 33 roots, and 300 sections were gained each tooth, giving a total of 9 900 sections. The numbers of canals at each level in the apical 6 mm were recorded. The num - bers of sections showing isthmuses at each level of the root canals were recorded too. Data were analyzed using the Chi-square statistic to test the null hypothesis that location of the sections in each of the apical 6 mm and presence of the isthmus were independent. The minimum root canal wall thickness was measured in each of the apical 6 mm of the roots. Results Isthmuses were found to be present at all levels with prevalence from 10.0% to 85.5%. The Chi-square test indicated a significant difference in the distribution of isthmuses with section(P=0.001). The incidence of isthmuses was higher at the apical 3-6 mm level, and the highest incidence(85.5%) was at 5 mm level. There were many more sections containing complete isthmuses(49.7%) than those containing partial isthmuses(4.5%). The thickness of the minimum root canal was less than 0.5 mm. Conclusion The mandibular incisors have a high incidence of isthmus and are narrow in proximal direction. Debridement of the isthmus is a major challenge during surgical and nonsurgical root canal treatment.

Key words: canal anatomy, mandibular incisor, canal isthmus, root canal wall thickness