上颌磨牙近中颊根的根尖孔位置及其临床意义  

In Vitro Study on the Apical Foramenal Location in the Mesiobuccal Root Canal of the Maxillary Molars and Its Clinical Significance

作　　者：高燕[1] 凌均棨[1] 胡晓莉[1] 谷海晶[1] 

机构地区：[1]中山大学光华口腔医学院.附属口腔医院,广东广州510055

出　　处：《中山大学学报（医学科学版）》2004年第6期577-580,共4页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：广东省医学科研基金资助项目(B2001045)

摘　　要：【目的】研究国人离体上颌第一、二磨牙近中颊根的根尖孔位置,并讨论其临床意义,为临床治疗该根管提供解剖依据。【方法】收集离体上颌第一、二磨牙共275颗,制成透明标本,牙科显微镜(dentaloperatingmicroscope,DOM)下观察近中颊根的根管数目、类型、根尖孔位置及根尖孔至解剖根尖的距离。【结果】①上颌第一磨牙和第二磨牙近中颊根的双根管率分别为81.48%和49.70%。②上颌磨牙近中颊根的3种主要类型根管(1-1型,2-1型,2-2型)中,近中颊根第二根管(MB2)的根尖孔在第一磨牙和第二磨牙分别仅7.32%和25.81%位于根尖顶。③2-2型根管中,第一磨牙和第二磨牙MB2的根尖孔至解剖根尖的平均距离分别为2.03mm和1.82mm,而MB的根尖孔距离解剖根尖的平均距离分别为0.53mm和0.51mm,差异有统计学意义,P<0.01;④2-1型根管中,两根管融合处至解剖根尖的平均距离在上颌第一磨牙和第二磨牙分别为4.80mm和4.83mm,差别无统计学意义。【结论】临床确定上颌磨牙近中颊根第二根管工作长度时,不能以常规的根尖孔至解剖根尖的距离0.5～1mm作为测量标准,建议参考本实验数据,并结合术者手感、患者的痛感、不同角度拍摄的X线片和电子根尖定位仪来确定MB2的工作长度。ObjectiveTo investigate the location of foramina at the apices and the distances from the foramina to the anatomic root apex in the mesiobuccal root canal of the maxillary first and second molars in Chinese population using the clearing technique. MethodsA total of 275 extracted human maxillary first and second molars were cleared. Under dental operating microscope (DOM), the location and the distances from their apices of the apical foramen in the mesiobuccal root canal were determined. Results(1)81.48%of first molars and 49.70%of second molars in the mesiobuccal roots had two canals. (2) In only 7.32%of first molars and 25.81%of second molars, the MB2 deviated to the apical central. (3) The average distances from the MB2 apical foramen to the anatomic root apex were 2.03 mm for first molars and 1.82 mm for second molars. (4) In type 2-1 roots, the mean distance where the MB2 joined the MB was 4.80 mm for first molars and 4.83 for second molars. ConclusionThe distance from the MB2 foramina openings to the tips of the apices may provide anatomic evidence for clinical working length determination of mesiobuccal root canal in maxillary molars.

关 键 词：根尖孔 近中颊根 根管 第二磨牙 上颌磨牙 解剖 MB 数目 离体 位置 

分 类 号：R781[医药卫生—口腔医学] R322.41[医药卫生—临床医学]