上颌第一前磨牙和上颌第一磨牙根管的锥形束CT影像学研究

发布时间：2018-04-20 21:03

本文选题：上颌第一磨牙 + 锥形束CT　；参考：《重庆医科大学》2012年硕士论文

【摘要】：目的：利用锥形束CT（CBCT）研究活体上颌第一磨牙和上颌第一前磨牙根中上2/3和根尖1/3的根管影像以及上颌第一磨牙近颊第二根管（MB2）的发生率和根管影像，为临床根管治疗提供相应的影像学依据。方法：截取所选病例上颌第一磨牙、上颌第一前磨牙根中上2/3和根尖1/3的横断面影像，针对上颌第一磨牙和上颌第一前磨牙根管数目进行分析研究。截取上颌第一磨牙根管口横断面影像，针对上颌第一磨牙第二根管根管口的位置以及发现率进行分析研究。结果：上颌第一磨牙近颊根管根下1/3单根管发生率最高85.95%，双根管同样位置最低，11.19%；远颊根管单根管根中上2/3发生率最高89.05%，双根管根下1/3最低5.95%；腭单根管根中上2/3和根下1/3发生率均高98.1%。男性根中上2/3水平横断面针对根管数较女性增多，具显著差异（P0.01）。近颊、远颊根管均出现弯曲，，一部分具有明显第二弯曲。腭部根管较为走向平直。不同年龄组上颌第一磨牙MB-MB2为1.42～1.47±0.49～1.38；MB2-DB为4.38～4.50±0.63～1.34；MB2-P为4.38～4.50±0.66～1.38。不同性别组上颌第一磨牙MB-MB2为男性1.39±0.24；女性1.42±0.62；MB2-DB为男性4.77±0.78；女性4.01±0.47；MB2-P为男性4.86±0.66；女性4.28±1.02。上颌第一磨牙MB2根管口位于近颊根管口的远中舌侧，从MB-P看，根管口在这段距离连线近中处。近颊部根中上2/3MB2检出率42.62%；根下1/3处检出率11.19%。上颌第一磨牙MB2检出率以10～19岁、20～29岁组最高67.14%；各组在近颊根中上2/3检出率存在差异性近颊部根中上2/3处男性MB2检出率最高54.75%，根中2/3处检出率男女具差异性（p0.01）。上颌第一前磨牙单根管的上颌前磨牙的颊、舌径较宽,单根单根管的牙齿未见明显的颊、舌向弯曲。单根多根管的牙齿,可见少数牙齿弯曲(占单根牙的11%)。牙齿分叉为双根或半双根时,则易出现根管弯曲(占双根牙的37%)。不同年龄组根管横截面形状分布有差异(P0.05):根尖段横截面形状以圆形为主;根中上段横截面形状以扁形为主，随着年龄的增长，扁形比例下降，圆形比例增大。结论： 1、CBCT技术可以较为准确地对上颌第一磨牙和上颌第一前磨牙根管数目进行确定。 2、CBCT技术可以准确扫描上颌第一磨牙和上颌第一前磨牙不同位置根管弯曲的解剖形态，为诊疗提供依据。 3、CCBT可以准确定位上颌第一磨牙近颊中第二根管的位置。 4、CBCT可以真实反映上颌第一磨牙近中颊侧第二根管的解剖形态，图像清晰，可以给临床工作提供重要的参考依据。 5、CBCT技术可以明显提高上颌第一磨牙MB2的发现率。 6、CBCT对MB2的发现率会因外在因素的影响而有所降低。
[Abstract]:Objective: to study the incidence and root canal imaging of maxillary first molars and maxillary first premolars in the first maxillary molars and maxillary first premolars by means of CT-CBCTT in the presence of 2 / 3 and 1 / 3 of the root canals and the second buccal canals of the maxillary first molars. To provide the corresponding imaging basis for clinical root canal therapy. Methods: the cross-sectional images of maxillary first molar, maxillary first premolar and maxillary first premolar were obtained. The root canals of maxillary first molar and maxillary first premolar were analyzed and studied. The cross-sectional images of the root canal orifice of the maxillary first molar were taken and the location and the discovery rate of the second root canal orifice of the maxillary first molar were analyzed and studied. Results: the incidence of 1 / 3 single root canal in the first maxillary first molar was the highest at 1 / 3 of the proximal root canal, and the lowest was 11.19% in the same position of the double root canal; the highest incidence was 89.05 in the single root canal root of the distal buccal canal, the lowest 5.95 in the 1 / 3 in the lower root canal root, the 2 / 3 in the palatine root canal root canal root and the lowest in the palatine root canal root canal root. The incidence of subroot 1 / 3 was 98.1% higher. The number of root canals in male was significantly higher than that in female at the level of 2 / 3 in upper root (P 0.01). The proximal and distal buccal root canals were all curved, and some of them had obvious second curvature. The root canal of the palate is more straight. The MB-MB2 of maxillary first molars in different age groups was 1.42 卤0.49, 1.38B ~ (2-DB), 4.38 ~ 4.50 卤0.63 ~ (1.34) B ~ (2-P), 4.38 ~ 4.50 卤0.660.66 ~ (1.38), respectively. The MB-MB2 of maxillary first molar in different sex group was 1.39 卤0.24 in male, 4.77 卤0.78 in female in 1.42 卤0.62MB2-DB, 4.86 卤0.66 in male and 4.28 卤1.02in female. The MB2 root canal orifice of the maxillary first molar is located at the distal lingual side of the proximal root canal orifice. From the MB-P view, the root canal orifice is near the line. The detection rate of 2/3MB2 was 42.62% in proximal root and 11.19% in 1 / 3 under root. The detection rate of MB2 in maxillary first molar was the highest in the group of 10 ~ 19 years old and 20 ~ 29 years old, and there was a difference in the detection rate of MB2 in the upper 2 / 3 of the proximal buccal root in each group. The highest detection rate of MB2 was 54.75 in the upper 2 / 3 of the proximal buccal root, and the difference was found in the 2 / 3 of the male and the female in the root of the maxillary first molar. The maxillary premolars of the first maxillary premolars with a single root canal had a wider tongue diameter, but no obvious buccal appearance in the single root canal, and the tongue was curved in the direction of the tongue. A few teeth are curved (11% of a single tooth) with multiple canals. When the tooth forks into two or half double roots, root canal bending is easy. The distribution of cross section of root canal in different age groups was different (P 0.05): the shape of cross section of root tip was mainly circular, and the shape of cross section of middle and upper part of root was flat. With the increase of age, the proportion of flat shape decreased and the ratio of circle increased. Conclusion: 1 CBCT can accurately determine the number of root canals of maxillary first molar and maxillary first premolar. 2CBCT technique can accurately scan the anatomic morphology of root canal bending in different positions of maxillary first molar and maxillary first premolar, which provides basis for diagnosis and treatment. CCBT can accurately locate the second canals in the proximal cheek of maxillary first molar. 4CBCT can truly reflect the anatomic morphology of the second canals of the proximal buccal side of maxillary first molar, and the image is clear, which can provide important reference for clinical work. 5) MB2 of maxillary first molar could be detected by CBCT. The detection rate of MB2 was decreased by external factors.
【学位授予单位】：重庆医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R816.98

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