华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

不同投照角度X线片诊断下颌第一前磨牙多根管的临床分析

何秉贞;王欢;尹兴喆;王倩倩;张成飞   

  1. 北京大学口腔医院特诊科, 北京100081
  • 收稿日期:2007-04-25 修回日期:2007-04-25 出版日期:2007-04-20 发布日期:2007-04-20
  • 通讯作者: 张成飞,Tel:010- 62173403
  • 作者简介:何秉贞(1958-),女,北京人,副主任医师,学士

Clinical Evaluation of Differ ent Angulation Radiogr aph in Diagnosing Multiple Canals of Mandibular Fir st Pr emolar s in vivo

WANG Huan, YIN Xing- zhe, WANG Qian- qian, ZHANG Cheng- fei   

  1. Special Department, School of Stomatology, Peking University, Beijing 100081, China
  • Received:2007-04-25 Revised:2007-04-25 Online:2007-04-20 Published:2007-04-20
  • Contact: ZHANG Cheng- fei,Tel:010- 62173403

摘要:

目的探讨不同投照角度X线片在诊断下颌第一前磨牙多根管中的作用。方法选取需行根管治疗的88颗下颌第一前磨牙为研究对象。每颗患牙均拍摄术前X线正位、偏位投照片判断是否为多根管牙;K型锉探查和定位根管口,冠下法预备根管,冷侧压法充填根管,充填时记录根管形态及数量,并拍摄根管充填术后X线正位和偏位投照片,对根管进行分型。结果88颗下颌第一前磨牙中,术前X线片诊断多根管31颗,临床发现多根管30颗。术前X线诊断为多根管的31颗牙,临床治疗中3颗未定位到多根管;而术前诊断为单根管的2颗牙,在临床治疗中发现为多根管。术前正位X线片诊断多根管牙13颗,术前偏位X线片诊断多根管牙25颗,其中7颗牙的术前正位和偏位X线片均表现为多根管影像。下颌第一前磨牙多根管的临床发现率为34.09%(30/88),其中Ⅳ、Ⅴ型根管为21颗,占多根管牙的70.00%。结论不同投照角度X线片有助于提高下颌第一前磨牙多根管的临床发现率。

关键词: 下颌第一前磨牙, 多根管, X线诊断

Abstract:

Objective To investigate the efficiency of different angle projection radiograph in diagnosing multiple canals of mandibular first premolars. Methods Eighty- eight mandibular first premolars that needed endodontic treatment in vivo were selected. The radiograph was taken at a horizontal angles of 0, 20 - 30 degrees from mesial or distal direction of the tooth preoperative. According to the different angle projection radiographic evaluation, radiographic diagnosis of multiple canals were suspected. After the root canal orifice were detected and located with K files, the root canals were prepared using crown- down technique and obturated using cold lateral condensation technique. The configurations and numbers of root canals were identified and recorded. The postoperative radiograph was taken. According to configurations and postoperative radiograph, the root canal configuration was classified into typeⅠ - Ⅴ. Results In eighty- eight mandibular first premolars, 31 multiple canals teeth were suspected in preoperative radiographic diagnosis, 30 multiple canal teeth were detected under clinical evaluation. In case of 31 multiple canal teeth suspected by preoperative radiographic diagnosis, 3 teeth were not found multiple canals under clinical evaluation. While in case of 2 teeth of one canal suspected by preoperative radiographic diagnosis, multiple canal was detected under clinical evaluation. In 31 multiple canal teeth suspected by preoperative radiographic diagnosis, 13 teeth were detected at a horizontal angles of 0 degree and 25 teeth were detected at a horizontal angles of 20- 30 degree, 7 teeth were suspected at different angle projection. Clinical detected rate of multiple canal in mandibular first premolar were 34.09%(30/88), 70.00% of which were type Ⅳ and Ⅴ. Conclusion Different angulation radiograph of preoperative will assist to increase clinical detection rate of multiple canals in mandibular first premolar.

Key words: mandibular first premolar, multiple canals, radiographic diagnosis