华西口腔医学杂志

• 专家论坛 •    下一篇

牙科数字成像系统、锥形束CT及透明牙对离体第一恒磨牙根管系统诊断价值的对比性研究

张治勇  孙洁   

  1. 广东省口腔医院·南方医科大学附属口腔医院放射科,广州 510280
  • 收稿日期:2013-04-20 修回日期:2013-07-20 出版日期:2013-10-01 发布日期:2013-10-01
  • 通讯作者: 张治勇,Tel:020-84405548
  • 作者简介:张治勇(1974—),男,广东人,副主任医师,硕士
  • 基金资助:
    广东省医学科研基金资助项目(A2007111)

Comparative study of the diagnostic values of radio visio graphy, cone-beam computed tomography, and transparent teeth in the in vitro diagnosis of the first molar root canal system

Zhang Zhiyong, Sun Jie   

  1. Dept. of Oral Radiology, Guangdong Provincial Stomatological Hospital, Stomatological Hospital of Southern Medical University, Guangzhou 510280, China
  • Received:2013-04-20 Revised:2013-07-20 Online:2013-10-01 Published:2013-10-01

摘要:

目的  对比分析牙科数字成像系统(RVG)、锥形束CT(CBCT)及透明牙3种检查方法在诊断离体第一磨牙根管系统的价值,分析第一磨牙根管影像解剖学与根管解剖学的对应关系,为第一磨牙根管治疗提供影像解剖依据。方法  拍摄269颗离体第一磨牙颊舌向、近远中向RVG和CBCT后,再制作根管染色透明牙,应用RVG、CBCT和透明牙对各牙根中上2/3、根尖1/3区根管系统和管间交通支进行分类统计,以评估CBCT在根管诊断中的应用价值。结果  CBCT对第一磨牙主根管中上2/3区的显示率达96.55%;CBCT、透明牙对第一磨牙根尖1/3区根管系统的显示差异有统计学意义(P<0.05)。上、下颌第一磨牙近中根变异较大,双或多根管与管间交通支发生率均较高。结论 CBCT与透明牙在显示第一磨牙主根管系统(牙根中上2/3区)方面基本等效;在根尖1/3区透明牙对细小分歧根管的显示明显优于CBCT;RVG对多根管牙根、根尖细小分歧根管的显示明显受限;上、下颌第一磨牙近中根双或多根管与管间交通支发生率均较高。CBCT对牙根、根管的显示具有清晰直观、准确快捷的优点,是目前无创诊断根管疾病最可靠方法。

关键词: 锥形束CT, 牙科数字成像系统, 透明牙, 根管形态, 管间峡区/管间交通支

Abstract:

Objective  To compare and analyze the performances of radio visio graphy (RVG), cone-beam computed to-mography (CBCT), and transparent teeth in diagnosing the first molar root canal system in vitro; to provide an anatomical image of the first molar root canal therapy and analyze the relationship between the first molar root canal image and root canal anatomy. Methods  A total of 269 extracted first molars were examined by RVG and CBCT in the mesiodistal and buccolin-gual sections. Transparent teeth were then constructed using dying root canals. The root canal system and the communicating branches between the pipes of the coronal 2/3 and apical 1/3 areas of each root canal were displayed using RVG, CBCT, and transparent teeth. The performance of CBCT in the diagnosis was evaluated. Results The display rate of the first molar root (coronal 2/3) was 96.55% in CBCT. A significant difference was found between CBCT and the transparent teeth in the apical 1/3 area of the first molars (P<0.05). The shapes of the mesial roots of the mandibular and maxillary first molars exhibited significant variance. The incidence rates of double and multiroot canals and pipe transport were high. Conclusion  CBCT and transparent teeth exhibit nearly equal performance in displaying the coronal 2/3 area of the root canal system. However, the performance of transparent teeth in displaying the apical 1/3 area is higher than that of CBCT. Meanwhile, the RVG-provided display of the multiroot canal and bifurcate root canals is limited. The incidence rates of double or multiroot canals and pipe transport in the mesial roots of the mandibular and maxillary first molars are high. CBCT has numerous advantages in dis-playing the root canal; it is also the most reliable method for diagnosing root diseases without trauma.

Key words: cone-beam computed tomography, radio visio graphy, transparent teeth, root canal morphology, isthmus/pipe transport