›› 2013, Vol. 33 ›› Issue (4): 258-260.

• 基础与临床研究 • 上一篇    下一篇

口腔锥形束CT在下颌第二磨牙C形根管诊治中的应用

吴顺英1,冯浩1,邹小贤2,邵文龙1,吕凡2   

  1. 1. 无锡口腔医院
    2. 无锡口腔医院牙体牙髓科
  • 收稿日期:2012-03-29 修回日期:2012-05-25 出版日期:2013-04-28 发布日期:2013-04-18
  • 通讯作者: 冯浩 E-mail:cotadc@139.com

Oral CBCT in the diagnosis of C-shaped canals of mandibular second molars

  • Received:2012-03-29 Revised:2012-05-25 Online:2013-04-28 Published:2013-04-18

摘要: 目的 探讨牙科用锥形束CT(cone-beam computed tomography,CBCT) 在根管治疗中诊断治疗下颌第二磨牙C型根管的临床应用。方法 选取选取初次根管治疗失败的下颌第二磨牙62颗牙根尖片不能确定根管解剖形态以及可疑遗漏根管。结果 使用锥形束CT(CBCT)检查62颗下颌第二磨牙中52颗为C型根管,C型根管发生率达83.87%, C型根管中28颗为C1型变异根管(53.84%),18颗为C2型变异根管(34.62%),6颗为C3型变异根管(11.54%)。52颗患牙除2颗因根管侧穿导致根管治疗失败外,其余50颗患牙通过热牙胶充填与垂直加压技术将软化的牙胶充入不规则的根管系统,达到严密充填根管,根管再治疗后患牙成功治疗的有60颗(96.77%),均无不适症状。CBCT在根管治疗中辅助定位变异根管,定位准确率较高。结论 CBCT影像精密度高,可从三维角度分析根管,在根管治疗中诊断治疗下颌第二磨牙C型根管具有临床指导意义。

关键词: CBCT, C型根管, 根管治疗术, cone-beam computed tomography , C-shaped canal , root canal therapy

Abstract: Objective To investigate the clinical efficiency of cone-beam computed tomography (CBCT) in the diagnosis and treatment of C-shaped canals of mandibular second molars. Methods Sixty-two mandibular second molars that failed in the root canal therapy were included in this study. The periapical films could not indicate the anatomic forms of root canals and the suspicious missed canals. Results Fixty-two canals (83.87%) were diagnosed as C-shaped canals, among which the numbers of C1 type, C2 type and C3 type were 28 (53.84%), 18 (34.62%) and 6 (11.54%), respectively. Among the 62 teeth with C-shaped canals, 2 teeth failed to receive the root canal therapy due to root canal perforation, and 60 teeth received gutta-percha filling through warm gutta-percha obturation and vertical condensation. After endodontic retreatment, 60 teeth (96.77%) showed satisfactory outcome with no complications identified. CBCT functioned in positioning the lesioned root canals with a high accuracy. Conclusions CBCT can analyze the configuration of root canals in a three-dimensional view, which is of prime importance in the diagnosis and treatment of C-shaped canals of mandibular second molars.

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