CBCT与RVG对下颌恒切牙根管形态评估的对比研究  

Comparison of Root Canal Morphology of Mandibular Incisors with Cone-beam Computed Tomography and RVG

作　　者：计艳[1] 王铁梅[2] 刘澍[2] 文珊辉 林梓桐[2] 

机构地区：[1]南京大学医学院附属口腔医院预防口腔科,江苏南京210008 [2]南京大学医学院附属口腔医院口腔颌面医学影像科,江苏南京210008

出　　处：《口腔医学研究》2017年第1期65-69,共5页Journal of Oral Science Research

基　　金：江苏省自然科学基金(编号:BK20150089;BK20141083);南京市医学科技发展项目(编号:ZKX14049;YKK15116);南京市卫生青年人才(编号:QRX11264)

摘　　要：目的:对比CBCT法与数字化X线成像法(RVG)对下颌恒切牙根管形态评估的差异。方法:对101颗离体牙进行唇舌向及近远中向数字化X线片拍摄和CBCT高清牙列模式扫描,对图像进行根管数目、Vertucci根管分型、根管钙化和根尖口开口位置的评估,并通过CBCT图像建立偏角度投照的三角函数模型,计算偏向投照的角度。结果:CBCT法显示有30颗为双根管,RVG近远中向投照显示有36颗为双根管,卡方检验显示对根管数目和Vertucci根管分型两种方法均具有显著性差异(P<0.05)。两种方法对根管钙化和根尖口开口位置的评估均不具有显著性差异。30颗双根管牙中下颌恒切牙唇舌向双根管的最大距离(LaL)在0~1.5 mm之间的,85.7%的为Vertucci III型,LaL在1.5~2mm之间的,66.7%为Vertucci IV和V型。以根尖片上双根管显示距离为1mm计算,LaL在1~2mm之间的,偏向投照角度为26.6°~45.0°,LaL在0.1~1mm之间的,偏向投照角度为45.0°~84.3°。结论:CBCT高清牙列模式扫描和RVG投照对于根管数目和Vertucci根管分型的评估具有显著性差异,对于根管钙化和根尖口开口位置的评估不具有显著性差异。LaL在1~2 mm之间时,偏角度投照的临床可操作性较强。Objective：To compare the differences between Cone-beam computed tomography（CBCT）and Radio visio graphy（RVG）technique in evaluating root canal morphology of mandibular incisors.Methods：One hundred and one extracted mandibular incisors were used in this study.Labial-lingual,mesial-distal RVG projection and CBCT scan at the HZ DS mode were done.The number of root canals,the Vertucci＇s classification,the calcification of root canal and the position of apex were evaluated.A mathematical model was established to calculate the angle of x-ray tube inclination.Results：Thirty-six teeth were found to have a second root canal in mesial-distal RVG images,and 30 incisors were considered to have two root canals in CBCT images.There were significant differences between CBCT and RVG as to the number of root canals and Vertucci＇s classification（P〈0.05）,but insignificant differences with regard to calcification of root canal and the position of apex.In the 30 incisors with two root canals,when the distance between the labial and lingual root canal（LaL）ranged between 0and 1.5mm,85.7% was Vertucci type III;when LaL ranged between 1.5and 2mm,66.7% were Vertucci type IV and V.If the distance pre-sent on the RVG images was set to 1mm,the projecting angle should be from 26.6°to 45.0°for the teeth with LaL ranged between 1and 2mm,and from 45.0°to 84.3°with LaL ranged between 0.1and 1mm.Conclusion：There were significant differences between CBCT and RVG for evaluation of the number of root canals and Vertucci＇s classification but insignificant differences for evaluation of calcification ofroot canal and the position of apex.It was more practical to do mesial-distal projection mandibular incisors with LaL ranged between 1and 2mm.

关 键 词：锥形束CT 数字化X线成像法 下颌恒切牙 根管形态 

分 类 号：R781.05[医药卫生—口腔医学]