口腔科手术显微镜下定位上颌第一磨牙近中颊根第二根管的研究  

Application of root canal microscope for location of second mesiobuccal canal in permanent maxillary first molars

作　　者：刘立访[1] 谭家莉[1] 于春梅[1] 方溢云[1] 

机构地区：[1]佛山市第一人民医院口腔医学中心,广东佛山528000

出　　处：《广东牙病防治》2015年第8期417-420,共4页Journal of Dental Prevention and Treatment

基　　金：国家自然科学基金青年科学基金(81100240)

摘　　要：目的探讨口腔科手术显微镜下定位上颌第一磨牙近中颊根第二根管(second mesiobuccal canal,MB2)的价值。方法收集因牙周病拔除的上颌第一磨牙248颗,先行锥形束CT(corn beam computed tomography,CBCT)扫描定位MB2,然后在口腔科手术显微镜下去除髓室内近中继发性牙本质及髓石后定位MB2,以CBCT扫描结果为标准,分析应用口腔科手术显微镜对上颌第一磨牙MB2的检出和定位效果。结果口腔科手术显微镜对上颌第一磨牙近中颊根根管Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型、其他类型检出率分别为15.72%、37.50%、27.42%、17.74%、2.02%,MB2检出率为82.66%,与CBCT扫描得到的Ⅰ型、Ⅱ型、Ⅲ型、Ⅳ型、其他类型和MB2检出率(分别为12.90%、37.50%、28.23%、18.95%、2.42%和84.68%)比较,差异均无统计学意义(P>0.05);以CBCT扫描结果为标准,口腔科手术显微镜检出上颌第一磨牙MB2的灵敏度、特异度、准确性、阳性预测值、阴性预测值和Kappa值分别为97.62%、100.00%、97.98%、100.00%、88.37%和0.926;CBCT与口腔科手术显微镜检测出上颌第一磨牙MB2根管口位于近中颊根颊侧根管口与腭侧根管口连线的近中的发生率差异无统计学意义(P>0.05);应用口腔科手术显微镜检查发现上颌第一磨牙MB2根管口至近中颊根颊侧根管口距离为(1.38±0.35)mm,与CBCT扫描结果(1.37±0.29)mm比较差异无统计学意义(P>0.05)。结论口腔科手术显微镜在上颌第一磨牙MB2检出和定位中均具有较高的临床价值。Objective To explore the role of root canal microscope for location of second mesiobuccal canal（ MB2） in permanent maxillary first molars. Methods Two hundred and forty-eight permanent maxillary first molars were removed and collected because of periodontal disease. Corn beam computed tomography（ CBCT） was applied to locate mesiobuccal root MB2 before root canal microscope detections. CBCT scan was taken as the gold standard to analyze the value ofroot canal microscope. Results The total MB2 detection rate of maxillary first molar detected by root canal microscope was82. 66%, which had no statistical significant differences when compared with the results of CT scans（ 84. 68%）（ P〉0. 05）. Compared with CT scan results, the sensitivity, specific, accuracy, positive predictive value, negative predictive value and Kappa value of root canal microscopedetections were 97. 62%, 100. 00%, 97. 98%, 100. 00%, 88. 37% and0. 926 respectively. The differences of incidence of maxillary first molar MB2 located near mesiobuccal and palatal root canal orifices detected by CT and root canal microscope have no statistical significance（ P〉0. 05）. Conclusion Root canal microscope detection and positioning maxillary first molar buccal root MB2 has high clinical value.

关 键 词：口腔科手术显微镜 定位 上颌第一磨牙 近中颊根第二根管 

分 类 号：R781.05[医药卫生—口腔医学]