上颌前磨牙根管壁厚度和牙根直径的CBCT测量分析
发布时间：2018-11-27 16:13
【摘要】：目的：测量分析浙江省人群上颌前磨牙根管壁的厚度,牙根直径和牙根长度。 方法：选取2012年12月至2014年1月期间前来浙江大学医学院附属口腔医院就诊因治疗前检查而拍摄CBCT的130名患者的246颗上颌前磨牙,其中上颌第一前磨牙129颗,上颌第二前磨牙117颗,患者年龄范围为19-63岁,平均年龄35岁。利用CBCT自带软件(NNT软件)对所选前磨牙在距根尖4mm、5mmm、6mm、7mm.8mm、9mm处测量牙根横截面的根管壁厚度,牙根直径和牙根长度。理论计算1#～3#P钻(工作直径分别为0.7mm、0.9mm和1.1mm)预备单根单根管型前磨牙后剩余根管壁厚不小于1mm的概率。 结果：上颌前磨牙近远中侧根管壁较薄,距离根尖6mm以下四分位数P25均小于1mm。单根型上颌前磨牙近远中径较窄,上颌第一前磨牙距离根尖7mm以下和上颌第二前磨牙距离根尖6mm以下P25小于2.7mm。理论计算P钻预备后剩余根管壁厚不小于1mm的概率,上颌第一前磨牙使用1#P钻在距离根尖9mm以上,上颌第二前磨牙使用1#P钻在8mm以上和2#P钻9mm以上的概率大于80%。双根管型比单根管型的近远中直径更小(P0.05),距离根尖9mm处中位数仅为2.5-2.6mm,越往根尖越小,理论计算P钻桩道预备后剩余根管壁厚大多不足1mm。上颌第一前磨牙根分叉位置均在距离根尖7mm以下,根分叉以下颊侧根的腭侧壁和舌侧根的近远中壁较薄,其P25均小于1mm。上颌第一、二前磨牙的牙根长度分别为12.9±1.7mm和12.8±2.0mm。 结论：上颌前磨牙近远中侧根管壁较薄,近远中径较窄,根分叉以下的颊根腭侧壁和舌根近远中侧壁较薄。临床建议在必须进行桩修复时,(1)避免距离根尖6mm以下的桩道预备,在保证冠根比的前提下,尽量减小桩的长度,减少对近远中壁的切削,(2)单根单根管型上颌第一前磨牙可在距离根尖9mm以上使用1#P钻,上颌第二前磨牙可在距离根尖8mm处使用1#P钻,9mm处使用2#P钻,(3)避免将双根管型上颌前磨牙的颊舌两个根管联通为一个扁形根管,(4)上颌前磨牙在根分叉以下不建议进行桩道预备。
[Abstract]:Objective: to measure the thickness of root canal wall, root diameter and root length of maxillary premolar in Zhejiang province. Methods: from December 2012 to January 2014, two hundred and thirty-six maxillary premolars (including 129 maxillary first premolars) were taken from 130 patients with CBCT who were admitted to the affiliated Stomatology Hospital of Zhejiang University Medical College from December 2012 to January 2014. 117 maxillary second premolars with an age range of 19-63 years with an average age of 35 years. The root canal wall thickness, root diameter and root length of the selected premolars were measured by CBCT software (NNT software) at a distance of 4 mm to 5 mm to 6 mm to 7 mm. 8 mm to 9 mm from the root tip. The probability of 1 #P drill (working diameters of 0.7 mm and 0.9 mm and 1.1mm) in preparing the residual root wall thickness of single canal premolars was calculated theoretically. The thickness of residual root canal wall was not less than 1mm. Results: the wall of proximal distal lateral root canal of maxillary premolars was thinner and the quartile P25 below the apical 6mm was less than 1 mm. The distance between maxillary first premolars and maxillary second premolars was less than 2.7mm. the distance between maxillary first premolars and maxillary second premolars was lower than 7mm and the distance between maxillary second premolars and apical 6mm was less than 2.7mm. The probability of remaining root canal thickness after preparation of P drill is not less than 1mm. The maxillary first premolars were drilled above the apical 9mm with 1 #P drill. For maxillary second premolars, the probability of using 1 #P drill above 8mm and 2 #P drill 9mm was higher than 80%. The proximal and middle diameter of double root canal type was smaller than that of single root canal type (P0.05), and the median distance to root tip 9mm was only 2.5-2.6 mm, and the thickness of remaining root canal wall was less than 1 mm after the preparation of P drilling pile. The root bifurcation of maxillary first premolar was below the apical 7mm. The palatal lateral wall of the buccal lateral root and the proximal distal wall of the lingual lateral root were thinner than those of the root tip, and the P25 was less than 1 mm. The root length of maxillary first and second premolars was 12.9 卤1.7mm and 12.8 卤2.0mm. Conclusion: the proximal distal lateral canal wall of maxillary premolar is thinner and the proximal distal diameter of maxillary premolar is narrower than that of maxillary premolar. It is suggested that when pile repair is necessary, (1) avoiding the preparation of the pile path below the root tip 6mm, reducing the length of the pile and cutting the proximal and middle wall under the premise of ensuring the ratio of crown to root. (2) 1 #P drill can be used for the first maxillary premolars with a single canals above the apical 9mm, 1 #P drill for the maxillary second premolars can be used at the distance from the root tip 8mm, and 2 #P drill can be used for the 9mm. (3) avoid connecting the two root canals of the two canals of maxillary premolars into a flat root canal, and (4) it is not recommended that the maxillary premolars should be prepared with piles below the forks of the maxillary premolars.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R781.05
[Abstract]:Objective: to measure the thickness of root canal wall, root diameter and root length of maxillary premolar in Zhejiang province. Methods: from December 2012 to January 2014, two hundred and thirty-six maxillary premolars (including 129 maxillary first premolars) were taken from 130 patients with CBCT who were admitted to the affiliated Stomatology Hospital of Zhejiang University Medical College from December 2012 to January 2014. 117 maxillary second premolars with an age range of 19-63 years with an average age of 35 years. The root canal wall thickness, root diameter and root length of the selected premolars were measured by CBCT software (NNT software) at a distance of 4 mm to 5 mm to 6 mm to 7 mm. 8 mm to 9 mm from the root tip. The probability of 1 #P drill (working diameters of 0.7 mm and 0.9 mm and 1.1mm) in preparing the residual root wall thickness of single canal premolars was calculated theoretically. The thickness of residual root canal wall was not less than 1mm. Results: the wall of proximal distal lateral root canal of maxillary premolars was thinner and the quartile P25 below the apical 6mm was less than 1 mm. The distance between maxillary first premolars and maxillary second premolars was less than 2.7mm. the distance between maxillary first premolars and maxillary second premolars was lower than 7mm and the distance between maxillary second premolars and apical 6mm was less than 2.7mm. The probability of remaining root canal thickness after preparation of P drill is not less than 1mm. The maxillary first premolars were drilled above the apical 9mm with 1 #P drill. For maxillary second premolars, the probability of using 1 #P drill above 8mm and 2 #P drill 9mm was higher than 80%. The proximal and middle diameter of double root canal type was smaller than that of single root canal type (P0.05), and the median distance to root tip 9mm was only 2.5-2.6 mm, and the thickness of remaining root canal wall was less than 1 mm after the preparation of P drilling pile. The root bifurcation of maxillary first premolar was below the apical 7mm. The palatal lateral wall of the buccal lateral root and the proximal distal wall of the lingual lateral root were thinner than those of the root tip, and the P25 was less than 1 mm. The root length of maxillary first and second premolars was 12.9 卤1.7mm and 12.8 卤2.0mm. Conclusion: the proximal distal lateral canal wall of maxillary premolar is thinner and the proximal distal diameter of maxillary premolar is narrower than that of maxillary premolar. It is suggested that when pile repair is necessary, (1) avoiding the preparation of the pile path below the root tip 6mm, reducing the length of the pile and cutting the proximal and middle wall under the premise of ensuring the ratio of crown to root. (2) 1 #P drill can be used for the first maxillary premolars with a single canals above the apical 9mm, 1 #P drill for the maxillary second premolars can be used at the distance from the root tip 8mm, and 2 #P drill can be used for the 9mm. (3) avoid connecting the two root canals of the two canals of maxillary premolars into a flat root canal, and (4) it is not recommended that the maxillary premolars should be prepared with piles below the forks of the maxillary premolars.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R781.05
【共引文献】
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