藏族人群下颌第一恒磨牙牙根及根管形态的CBCT研究  

Cone beam computed tomography study on the root and root canal morphology of mandibular first permanent molars in a Tibetan population

作　　者：次仁卡卓[1] 陈立 白玛德吉[1] 安生琴[1] 卓玛巴央 旦增确旦 CI Ren Ka Zhuo;CHEN Li;BAI Ma De Ji;AN Shengqin;ZHUO Ma Ba Yang;DAN Zeng Que Dan(Department of Stomatology,People's Hospital of Tibetan Autonomous Region,Lhasa 850000,China;Department of Prosthodontics,Peking University School and Hospital of Stomatology,Beijing 100081,China)

机构地区：[1]西藏自治区人民医院口腔科,西藏自治区拉萨850000 [2]北京大学口腔医学院·口腔医院修复科,北京100081

出　　处：《口腔疾病防治》2023年第12期877-882,共6页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：西藏自治区自然科学基金组团式援藏医学项目(XZ2021ZR⁃ZY07(Z))。

摘　　要：目的应用锥形束计算机体层摄影术(cone⁃beam computed tomography,CBCT),研究分析西藏地区藏族人群的下颌第一恒磨牙的牙根及根管形态,为藏族人群临床根管治疗提供参考。方法本研究已通过单位伦理委员会审查批准,并获得患者知情同意。纳入300例藏族患者的300颗下颌第一恒磨牙的CBCT影像学资料,记录患者年龄及其下颌第一恒磨牙牙根数目,并用Vertucci分类法统计分析近中牙根及远中牙根根管形态及发生率。结果300颗下颌第一恒磨牙中双根牙198颗;三根牙102颗,三根牙中有1颗存在近中舌根,其余为远中舌根,远中舌根发生率为33.7%(101/300)。近中根最常见根管构型为VertucciⅣ型65.7%(197/300),其次为VertucciⅡ型20.3%(61/300)。近中中央根管(middle mesialcanal,MMC)发生率为6%(18/300),其中20~40岁年龄段发生率最高,为9%(9/100)。远中单根的下颌第一恒磨牙远中根以VertucciⅠ型根管为主,占比66.8%(133/199),其次为VertucciⅡ型14.6%(29/199)和VertucciⅣ型11.6%(23/199);远中为双根的下颌第一恒磨牙,96%(97/101)的远颊根根管和100%(101/101)远舌根根管为VertucciⅠ型。结论藏族人群的下颌第一恒磨牙形态复杂多变,约1/3的患者具有远中舌根,临床医生应在CBCT的指导下仔细探查根管。Objective To investigate and analyze the root and root canal morphology of mandibular first molars(MFMs)in the Tibetan population using conebeam computed tomography(CBCT)and to provide references for clinical root canal treatment in the Tibetan population.Methods This study was reviewed and approved by the Ethics Committee,and informed consent was obtained from the patients.CBCT imaging data of 300 mandibular first molars from 300 Tibetan patients were included.Patient age,the number of roots in mandibular first molars were recorded.The morphology and incidence of mesial root and mesial root canals and the morphology and incidence of distal root and distal root canals were statistically analyzed by Vertucci classification.Results There were 198 doubleroot teeth and 102 threeroot teeth in the 300 mandibular first permanent molars.Among the threerooted molars,1 case had mesiolingual roots,and the rest had distolingual roots.The incidence rate of the distolingual root was 33.7%(101/300).The most common root canal configuration was VertucciⅣ65.7%(197/300),followed by VertucciⅡ20.3%(61/300)in the mesial roots.The overall incidence of middle mesial canals(MMCs)was 6%(18/300),with the highest incidence of MMCs in the 2040 yearold group at 9%(9/100).The distal roots canals of singledistalrooted mandibular first molars were mainly VertucciⅠ66.8%(133/199),followed by VertucciⅡ14.6%(29/199)and VertucciⅣ11.6%(23/199).For the mandibular first permanent molars with two distal roots,96%(97/101)of the distal buccal roots and 100%(101/101)of the distal lingual roots were VertucciⅠroot canals.Conclusion The root and root canal morphology of mandibular first permanent molars in a Tibetan population is complex and variable.Approximately onethird of patients have distolingual roots,and clinicians should carefully explore the root canals under the guidance of CBCT.

关 键 词：藏族人群 下颌第一恒磨牙 锥形束计算机体层摄影术 近中中央根管 远中舌根 

分 类 号：R78[医药卫生—口腔医学]