人上前牙根管治疗难度评估的实验研究  

Difficulty assessment of root canal therapy in Chinese permanent maxillary anterior teeth

作　　者：高小洁[1] 黄定明[1] 谭红[1] 贾刘合[1] 周学东[1] 郑广宁[1] 

机构地区：[1]四川大学华西口腔医学院牙体牙髓病研究室,四川成都610041

出　　处：《上海口腔医学》2006年第5期512-516,共5页Shanghai Journal of Stomatology

基　　金：卫生部临床学科重点建设项目(卫2004-468);国家"十五"攻关课题资助项目(2004BA720A23)~~

摘　　要：目的:利用X线放射影像学方法,评估人离体上前牙根管治疗的难度。方法:对80颗中国成人离体上前牙使用放射影像学等方法,获取解剖评估资料(共3组:正位片、侧位片、最大角度位片);采用根管治疗难度系数评估标准,进行根管治疗难度评估;采用多样本比较的秩和检验进行统计学分析。结果:①牙位2、3根管治疗的难度大于1,P<0.05,差异有统计学意义;2与3两者间差异无统计学意义,P>0.05。②1在3种不同投照片上难度总评的差异有统计学意义(P<0.05),最大角度位片>正位片>侧位片;2和3均无统计学意义(P>0.05)。③以正位片为考察对象,危险因素影响效力总体间差异有统计学意义的牙位是1(P<0.05)和2(P<0.01),弯曲度导致的难度>钙化度>牙长度;3无统计学意义(P>0.05)。结论:正位片能够正确反映上颌前牙各牙位的难度并作为评估依据。在上颌前牙中,1是难度总评最小的牙,2是弯曲度最大的牙。弯曲度是对1和2根管治疗产生最大难度效力的危险因素,而在3,3个危险因素均起同等的重要作用。PURPOSE： To assess the difficulty of root canal therapy in Chinese permanent maxillary anterior teeth by radiographic methods in vitro. METHODS： 80 maxillary anterior teeth including 27 maxillary central incisors, 22 maxillary lateral incisors and 31 maxillary canines were collected and X-rayed in 3 individual directions： labiopalatal projection, mesiodistal projection and the maximal angle shot. Three anatomic risk factors： root curvature, calcification and working length of root canal therapy were assessed by difficulty assessment standards and criterions. Kruskal-Wallis test was used to analyze the data. RESULTTS： The results showed that the root canal therapy of 2 and 3 were significantly more difficult thanl,P〈0.05;while there was no significant difference between 2 and 3,P〉0.05.In 1 ,the results of difficulty assessment of root canal firerapy were significantly different among 3 individual X-rays which were projected from 3 different directions （P〈0.05）. The difficulty caused by root curvature was significantly greater than calcification and working length in labiopalatal X-ray in 1（P〈0.05 ） and 2（P〈0.01 ）, while there was no significant difference among these 3 risk factors in 3 in labiopalatal projection （P〉0.05）. CONCLUSIONS： The results suggest that the labiopalatal X-rays can be safely regarded as the reliable projection shot for difficulty assessment before endodontic procedures. Root curvature was by far the most important risk factor that affected the difficulty of root canal therapy in 1 and 2 while root curvature, calcification and working length played the same roles in root canal therapy of 3.

关 键 词：根管治疗 难度系数评估 上颌恒前牙 根管解剖 

分 类 号：R781.05[医药卫生—口腔医学]