上颌前磨牙牙根及根管形态的锥形束CT研究  

A cone-beam computed tomography study of the root and canal morphology of maxillary premolars

作　　者：孔倩颖 梁立中[2] 王广勇 覃诗淇 KONG Qianying;LIANG Lizhong;WANG Guangyong;QIN Shiqi(Department of Oral Implantology,Zhuhai Stomatology Hospital,Zhuhai 519000,China;Department of Stomatology,The Fifth Affiliated Hospital of Sun Yat-Sen University,Zhuhai 519000,China;Judicial Appraisal Office of the Intermediate People's Court of Huangshan City,Huangshan 245000,China)

机构地区：[1]珠海市口腔医院种植科,广东珠海519000 [2]中山大学附属第五医院口腔科,广东珠海519000 [3]安徽省黄山市中级人民法院司法鉴定处,安徽黄山245000

出　　处：《口腔疾病防治》2020年第4期246-251,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：广东省科技发展专项资金(公益研究与能力建设方向)项目计划(2016A020215031)

摘　　要：目的研究上颌前磨牙牙根形态、三根管的发生率和根管解剖形态,为临床诊疗提供参考。方法选取珠海市口腔医院412名患者,共779颗上颌第一前磨牙,728颗上颌第二前磨牙的锥形束CT(cone-beam computed tomography,CBCT)扫描数据,分析上颌前磨牙的牙根及根管形态,三根管的发生率、双侧对称性、根管分叉位置等。结果上颌第一前磨牙三根管发生率为1.8%,上颌第二前磨牙三根管发生率为0.3%,上颌第一前磨牙三根管发生率显著高于上颌第二前磨牙(X^2=8.304,P=0.004)。上颌第一前磨牙三根管对称率为27.3%,上颌第二前磨牙无对称三根管结构出现。上颌前磨牙解剖形态可为单根、双牙根或三牙根,其内部根管形态复杂,存在七种Vertucci根管类型,上颌第一前磨牙以VertucciⅣ型为主,上颌第二前磨牙则以VertucciⅠ型常见。三根管上颌前磨牙的根管分叉位置多见于根中或根上1/3,16颗三根管上颌前磨牙都具有三个独立的根尖孔。结论上颌前磨牙根管形态复杂多变,CBCT对发现变异和额外根管具有重要辅助作用。Objective To study root morphology, the incidence of three root canals and the root canal anatomy ofmaxillary premolars.MethodsThe cone-beam computed tomography(CBCT) data of 779 maxillary first premolars and728 maxillary second premolars were collected from 412 patients in Zhuhai Stomatological Hospital. The root and canalmorphology, incidence of three canals, bilateral symmetry and location of root canal bifurcation were analyzed.ResultsThe incidence of three canals in the maxillary first premolars was 1.8% and that in the maxillary second premo-lars was 0.3%. The incidence of three canals in the maxillary first premolars was significantly higher than that in themaxillary second premolars(X^2=8.304, P=0.004). The symmetrical ratio of the three-canal maxillary first premolarwas 27.3%. There was no symmetrical three-canal maxillary second premolar. The anatomical morphology of the maxil-lary premolar can be single root, double root or trident root. Its internal root canal system is complex and diverse. Thereare seven kinds of Vertucci morphology: the first maxillary premolar is mainly Vertucci IV type, and the second maxillary premolar is mainly Vertucci I type. Most of the root canal bifurcations of the three-canal maxillary premolars wereobserved in the midthird or the cervical third of the root. All three-canal maxillary premolars had three independent api-cal foramens.ConclusionThe root canal morphology of maxillary premolars is complex and changeable. CBCT playsan important role in the discovery of variation and extra root canals.

关 键 词：锥形束CT 上颌 前磨牙 上颌第一前磨牙 上颌第二前磨牙 牙根形态 根管解剖 三根管 根管分叉位置 根尖孔 Vertucci分类 

分 类 号：R781.05[医药卫生—口腔医学]