计算机辅助下颌第一磨牙远舌根根管疏通的应用研究  

An applied research on computer-aided canal negotiation of the distal lingual root of mandibular first molar for endodontic treatment

作　　者：许裕权 傅裕杰 张旗[1] XU Yu-quan;FU Yu-jie;ZHANG Qi(Department of Endodontics,School and Hospital of Stomatology,Tongji University,Shanghai Engineering Research Center of Tooth Restoration and Regeneration,Shanghai 200072,China)

机构地区：[1]同济大学口腔医学院·同济大学附属口腔医院牙体牙髓病科,上海牙组织修复与再生工程技术研究中心,上海200072

出　　处：《牙体牙髓牙周病学杂志》2024年第9期504-508,515,共6页Chinese Journal of Conservative Dentistry

摘　　要：目的:本研究旨在对比传统方法与计算机辅助方法在处理下颌第一磨牙远舌根根管疏通时的效果差异。方法:选取了25个离体下颌第一磨牙,重建三维模型后,每个牙齿3D打印6份模型。将模型牙分为两组(n=75):传统组与计算机辅助组。2组由相同3名牙体牙髓住院医师分别完成25个牙齿的根管疏通。记录两组根管疏通率、完成时间及疏通后根管偏移情况。结果:3人在传统组中平均疏通完成率为56.00%,而计算机辅助组的根管疏通完成率为74.67%,效率提高了33.34%,显著高于传统组(P<0.05)。传统组与计算机辅助组时间分别为(351.32±21.13)s和(360.42±36.99)s,与传统组相比,计算机辅助组消耗较多的时间,但无显著影响(P>0.05)。计算机辅助组在根管疏通后在距离根尖1 mm与4 mm处根管偏移量上明显低于传统组(P<0.05),且疏通后根管的中心率也显著高于传统组,根管切削量更少(P<0.05)。结论:研究表明采用计算机辅助分析术前CBCT影像的方法对下颌第一磨牙远舌根管的疏通时间并无显著影响。然而,计算机辅助分析能够更准确地选择合适的器械和疏通方法,从而在保持根管原有形态的同时,减少疏通过程中可能出现的台阶等并发症,显著提高疏通效率和质量。AIM:This study aims to compare the effectiveness of traditional versus computer-aided methods in the negotiation of the distal lingual canal(DLC)in mandibular first molars.METHODS:A total of 25 extracted mandibular first molars were selected and their three-dimensional(3D)models were reconstructed.Six 3D-printed replicas of each tooth were produced,resulting in a total of 150 models.These models were then divided into two groups(n=75 each):A traditional group and a computer-aided group.Three endodontic residents,with equal experience,performed canal negotiation on the same 25 teeth in both groups.The success rate of canal negotiation,the time required for completion,and the degree of canal deviation post-negotiation were recorded and analyzed.RESULTS:In the traditional group,the average success rate of canal negotiation was 56.00%,whereas in the computer-aided group,it was 74.67%,representing a significant improvement of 33.34%compared to the traditional method(P<0.05).The average procedural time for the traditional and computer-aided groups was(351.32±21.13)s,(360.42±36.99)s,respectively.Although the computer-aided group required slightly more time,this difference was not statistically significant(P>0.05).Notably,the computer-aided group demonstrated significantly less canal deviation at 1mm and 4mm from the apical foramen compared to the traditional group(P<0.05).Additionally,the canal centering ratio was significantly higher in the computer-aided group,indicating less canal transportation during negotiation(P<0.05).CONCLUSION:This study demonstrates that while the use of computer-aided analysis of preoperative CBCT images does not significantly impact the duration of canal negotiation in the distal lingual canal of mandibular first molars,it significantly enhances the efficiency and quality of the procedure.By enabling more precise selection of instruments and negotiation techniques,computer-aided analysis minimizes the risk of complications such as ledges and zipping,while preserving the original canal morp

关 键 词：计算机辅助 根管疏通 根管偏移 

分 类 号：R781.05[医药卫生—口腔医学]