藏族人下颌切牙根管横截面形态的显微CT研究  

Study of cross-sectional morphology of root canals in Tibetan mandibular incisors by micro-CT

作　　者：徐珺[1] 次仁德吉 李欣[3] 雷建锋 周建 侯本祥[6] Xu Jun;Ciren Deji;Li Xin;Lei Jianfeng;Zhou Jian;Hou Benxiang(Department of General Dentistry and Emergency Dental Care,Capital Medical University School of Stomatology,Beijing 100050,China;Department of Stomatology,Tibetan Hospital of Traditional Tibetan Medicine,Lasa 850002,China;Department of Preventive Dentistry,Capital Medical University School of Stomatology,Beijing 100050,China;Core Facility Center,Capital Medical University,Beijing 100069,China;Department of VIP Dental Service,Capital Medical University School of Stomatology,Beijing 100050,China;Center for Microscope Enhanced Dentistry,Capital Medical University School of Stomatology,Beijing 100162,China)

机构地区：[1]首都医科大学口腔医学院急诊综合诊疗中心,北京100050 [2]西藏自治区藏医院口腔科,拉萨850002 [3]首都医科大学口腔医学院预防科,北京100050 [4]首都医科大学中心实验室,北京100069 [5]首都医科大学口腔医学院特诊特需科,北京100050 [6]首都医科大学口腔医学院口腔显微诊疗中心,北京100162

出　　处：《中华口腔医学杂志》2022年第7期739-744,共6页Chinese Journal of Stomatology

基　　金：国家自然科学基金(81570939);北京市科学技术委员会科技计划(Z191100006619037);首都医科大学附属北京口腔医院学科建设基金(19-09-05)。

摘　　要：目的使用显微CT扫描技术研究藏族人下颌切牙根管系统横截面的解剖形态。方法收集2019年10月至2020年10月西藏自治区藏医院口腔科因重度牙周炎拔除的下颌切牙136颗[牙齿来源于藏族患者,年龄(51.9±16.4)岁(25~80岁)],对离体牙样本进行显微CT扫描和三维重建,其中下颌中切牙84颗,下颌侧切牙52颗,扫描层厚23μm。记录下颌切牙从釉质牙骨质界(cemento-enamel junction,CEJ)至根尖的牙根长度,按长度将牙根分为根上1/3、根中1/3和根尖1/3,并记录根管数量。单根管下颌切牙测量根管每毫米横截面的最大径、最小径和面积,并计算最大径与最小径的比值和圆度进行形态分析;多根管下颌切牙记录从CEJ至根尖的横截面上根管分叉及汇合位置。结果藏族人下颌中切牙单根管的横截面最大径与最小径比值在根中1/3最大[1.99(1.31,2.79)],与根上1/3及根尖1/3相比差异均有统计学意义(P=0.010,P=0.003);圆度在根中1/3最小[0.47(0.31,0.66)],与根上1/3及根尖1/3相比差异均有统计学意义(P=0.010,P=0.001);多根管发生率为40.5%(34/84),在根中1/3检出率为32.1%(27/84)。藏族人下颌侧切牙单根管的横截面圆度在根尖1/3最大[0.61(0.49,0.71)],与根上1/3及根中1/3相比差异均有统计学意义(P=0.001,P=0.001),多根管发生率为34.6%(18/52),均在根尖1/3检出。结论藏族人下颌中切牙的根管横截面形态在根中1/3狭长,多根管好发;下颌侧切牙根管横截面形态在根尖1/3接近圆形,但形态仍不规则,且有根尖分叉的可能。Objective To study the cross-sectional morphology of root canal system of Tibetan mandibular incisors by micro-CT.Methods From October 2019 to October 2020,one hundred and thirty-six mandibular incisors were collected from Tibetan patients[(51.9±16.4)years old,range from 25 to 80 years]who underwent teeth extraction due to severe periodontitis at the Department of Stomatology,Tibetan Hospital of Traditional Tibetan Medicine,including 84 mandibular central incisors and 52 mandibular lateral incisors.These teeth were scanned at 23μm voxel size resolution.Root lengths from cemento-enamel junction(CEJ)to apex of mandibular incisors were measured.According to the length,the root was divided as cervical 1/3,middle 1/3 and apical 1/3,and the numbers of root canals were recorded simultaneously.The major diameter,minor diameter,and dimension were measured per millimeter in cross section for mandibular incisor with single root canal,and the ratio of major diameter to minor diameter(Dmax/Dmin)as well as roundness were calculated for morphological analysis.The diversions and conversions from CEJ to apex in cross section were recorded for mandibular incisor with multiple root canals.Results For mandibular central incisors with single root canal,the Dmax/Dmin was highest in middle 1/3 of the root[1.99(1.31,2.79)],which was significantly higher than cervical 1/3 and apical 1/3(P=0.010,P=0.003).The roundness was least in middle 1/3[0.47(0.31,0.66)],which was significantly lower than cervical 1/3 and apical 1/3(P=0.010,P=0.001).For mandibular central incisor with multiple root canals,the highest incidence of multiple root canals was 40.5%(34/84),and mainly detected in middle 1/3 of the root[32.1%(27/84)].For mandibular lateral incisor with single root canal,the roundness was greatest in apical 1/3 of the root[0.61(0.49,0.71)],which was significantly higher than cervical 1/3(P=0.001)and middle 1/3(P=0.001).The highest incidence of multiple root canals was 34.6%(18/52),all of which were detected in apical 1/3.Conclusions In Tibet

关 键 词：切牙 解剖学 横断面 藏族人 下颌切牙 根管系统 显微CT 

分 类 号：R782.1[医药卫生—口腔医学] R816.98[医药卫生—临床医学]