上颌第一磨牙牙根折裂的临床特征分析  

Clinical analysis on the root fracture of the maxillary first molar

作　　者：袁志瑶 邹习宏 戴霖霖 敖慧芝 李厚轩[1] Yuan Zhiyao;Zou Xihong;Dai Linlin;Ao Huizhi;Li Houxuan(Dept.of Periodontology,Nanjing Stomatological Hospital,Medical School of Nanjing University,Nan‐jing 210008,China)

机构地区：[1]南京大学医学院附属口腔医院牙周病科,南京210008

出　　处：《华西口腔医学杂志》2021年第5期555-559,共5页West China Journal of Stomatology

基　　金：国家自然科学基金青年基金(82001050);江苏省自然科学基金青年基金(BK20190135);南京市卫生重点科技发展项目(ZKX19030)。

摘　　要：目的探讨上颌第一磨牙牙根折裂的常见类型和方向以及根管治疗对牙根折裂好发部位的影响。方法纳入274颗经锥形束CT(CBCT)诊断为牙根折裂的上颌第一磨牙,判读患牙的影像学特征,分别分析非根管治疗相关的原发性牙根折裂和根管治疗相关的继发性牙根折裂的好发部位、类型、方向及其差异。结果在上颌第一磨牙原发性牙根折裂中,腭根折裂比例(56.1%)高于近中颊根(36.1%)和远中颊根(7.8%);而在继发性牙根折裂中,近中颊根折裂比例(52.7%)高于腭根(36.5%)和远中颊根(10.8%),好发部位分布差异具有统计学意义(P<0.05)。腭根牙根纵裂常见为近远中向,而近中颊根常见为颊腭向牙根纵裂。结论在上颌第一磨牙诊治过程中,应对最粗大的腭根发生牙根折裂的可能性予以重视;近中颊根折裂可能与根管治疗相关,因此当尽可能减少医源性因素造成的近中颊根继发性牙根折裂风险;本研究结果也为上颌第一磨牙牙根折裂的临床特征提供一定流行病学依据。Objective This study aimed to investigate the common types and directions of root fractures of the maxillary first molar and the influence of root canal treatment on the prevalent sites of root fractures.Methods A total of 274 maxillary first molars with root fractures diagnosed via cone beam computed tomography were included.The root fractures of nonendodontically and endodontically treated teeth were identified to be spontaneous and secondary root fractures,respectively.The sites,types,and directions of spontaneous and secondary root fractures were determined.Results Among the spontaneous root fractures,the proportion of palatal root fractures(56.1%) was higher than those of mesial buccal root fractures(36.1%) and distal buccal root fractures(7.8%).Among the secondary root fractures,the proportion of mesial buccal root fractures(52.7%) was higher than those of palatal root fractures(36.5%) and distal buccal root fractures(10.8%).The distribution of predominant fracture sites was statistically significant(P<0.05),and vertical root fracture was the most common type.Palatal and buccal roots were commonly fractured at the mesiodistal and buccal-palatal directions,respectively.Conclusion This study provided an epidemiological basis for the clinical features of root fractures of the maxillary first molar.During the diagnosis and treatment of the maxillary first molar,the possibility of palatal root fractures should be considered.The occurrence of mesial buccal root fractures may be related to root canal treatment.Therefore,the risk of mesial buccal root fractures caused by iatrogenic factors should be minimized.

关 键 词：上颌第一磨牙 牙根折裂 锥形束CT 原发性牙根折裂 继发性牙根折裂 

分 类 号：R781.2[医药卫生—口腔医学]