华西口腔医学杂志

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显微CT与数字成像系统观察下颌第一前磨牙根管形态的比较研究

李向杰1,2 刘娜1 刘锐1 董正谋1 刘鲁川1 邓蔓菁1   

  1. 1.第三军医大学大坪医院野战外科研究所口腔科, 重庆400042; 2.成都军区总医院口腔科, 成都610083
  • 收稿日期:2012-02-25 修回日期:2012-02-25 出版日期:2012-02-01 发布日期:2012-02-01
  • 通讯作者: 邓蔓菁,Tel:023-68757575
  • 作者简介:李向杰(1978—),男,四川人,主治医师,硕士

Comparative study of root canal morphology of mandibular first premolar by micro-CT and radio visio graphy

Li Xiangjie1,2, Liu Na1, Liu Rui1, Dong Zhengmou1, Liu Luchuan1, Deng Manjing1   

  1. 1. Dept. of Stomatology, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing 400042, China; 2. Dept. of Stomatology, Chengdu Military General Hospital, Chengdu 610083, China
  • Received:2012-02-25 Revised:2012-02-25 Online:2012-02-01 Published:2012-02-01
  • Contact: Deng Manjing,Tel:023-68757575
  • About author:Li Xiangjie(1978—),男,四川人,主治医师,硕士

摘要:

目的采用显微CT与数字成像系统(RVG)观察下颌第一前磨牙根管形态,比较2种方法对根管分型结果的一致性。方法随机选取根尖发育完全、牙根完整、未进行过牙髓治疗的离体下颌第一前磨牙100颗,拍摄颊舌向和近远中向RVG数字影像(RVG法),并采用显微CT进行扫描和三维重建(显微CT法),以Vertucci根管分型为标准对下颌第一前磨牙根管进行分型,并对2种方法的结果进行一致性分析。结果显微CT法发现:下颌第一前磨牙根管中,Ⅰ型67%,Ⅲ型3%,Ⅴ型18%,Ⅶ型2%,其他类型10%;RVG法发现:Ⅰ型71%,Ⅲ型2%,Ⅴ型23%,Ⅶ型1%,其他类型3%。显微CT法和RVG法同时判读为单根管和复杂根管的比率分别为63%、25%。2种方法分型结果间的Kappa值为0.541,为中度一致。82.8%的含根面沟的下颌第一前磨牙有2个或2个以上的根管。结论数字成像系统基本能反映离体下颌第一前磨牙根管类型,但对复杂根管分型准确性较差;显微CT三维影像能清晰、准确地显示离体下颌第一前磨牙根管形态。

关键词: 显微CT, 数字成像系统, 下颌第一前磨牙, 根管类型

Abstract:

Objective To compare the consistency of root canal configuration types of mandibular first premolar by using micro-CT and radio visio graphy(RVG). Methods One hundred extracted mandibular first premolars with complete dental root and apex which received no endodontic treatment were randomly selected. Each tooth was radiographed with RVG through a buccolingual and mesiodistal direction, and then scanned with micro-CT and reconstructed. The classifications of the root canal types according to Vertucci’s type with the two methods were compared. Results The canal patterns were classified as type Ⅰ(67%), type Ⅲ(3%), type Ⅴ(18%), type Ⅶ(2%), additional type(10%) with micro-CT and canal patterns as type Ⅰ(71%), type Ⅲ(2%), type Ⅴ(23%), type Ⅶ(1%), additional type(3%) with RVG. 63% of teeth showed one canal in both micro-CT and RVG. Only 25% of teeth were diagnosed  as complex canal by the same canal type in both micro-CT and RVG. The Kappa value between micro-CT and RVG was 0.541 which suggested that the two kinds of methods had intermediate consistency. 82.8% of the premolars with root groove had two or more than two canals. Conclusion Although RVG can basically reflect the root canal system type of the mandibular first premolars in vitro, it offers poor accuracy images to complex root canals. Micro-CT threedimensional images could clearly and precisely display the root canal system morphology of the mandibular first premolars in vitro.

Key words: micro-CT, radio visio graphy, mandibular first premolar, root canal type