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1、臨床口腔醫(yī)學雜志2009年5月第25卷第5期JClinStomatol,Mar,2009,Vol.25,No.5·289·下頜前磨牙C形根管的診斷和治療*12**方溢云,林正梅(1.佛山市第一人民醫(yī)院口腔醫(yī)學中心廣東佛山528000;2.中山大學光華口腔醫(yī)學院附屬口腔醫(yī)院牙體牙髓科廣東廣州510055)[摘要]目的:探討下頜前磨牙C形根管的發(fā)現(xiàn)率及其診治方法。方法:選取需要根管治療的下頜前磨牙300個,拍攝術(shù)前正位和偏位X線牙片。多根管牙插診斷絲攝片。結(jié)合C形根管的診斷標準,診斷為C形根管的患牙,記錄髓室底形態(tài)和X線影像類型。所有患牙
2、使用鎳鈦機動根管器械預備,側(cè)方加壓法充填根管。根據(jù)術(shù)前、術(shù)中和術(shù)后X線片評價根管預備和充填效果。結(jié)果:第一和第二前磨牙C形根管的發(fā)現(xiàn)率依次為5.56%和2.50%。髓室底以C2型多見,X線影像以尖部融合型多見。治療中無根管堵塞等并發(fā)癥的發(fā)生。根管充填效果,13例C形根管中有5例超充,8例恰充。結(jié)論:髓腔探察和插診斷絲拍片是診斷下頜前磨牙C形根管的有效方法。[關(guān)鍵詞]下頜前磨牙;C形根管;根管治療[中圖分類號]R781.05[文獻標識碼]A[文章編號]1003-1634(2009)05-0289-03Thediagnosisandtre
3、atmentofmandibularpremolarswithC-shapedcanalsystem.FANGYi-yun1,LINZheng-mei2.1.DepartmentofStomatology,F(xiàn)oshanFirstPeople'sHospital,GuangdongFoshan528000,China;2.Depat-mentofEndodontics,GuanghuaSchoolofStomatology,SunYat-senUniversity,GuangdongGuangzhou510055,China[Abstr
4、act]Objective:ToinvestigatethemorphologicalcharacteristicsofC-shapedcanalsysteminmandibularfirstpremolars.Method:Atotalof300mandibularfirstpremolarsweretreatedendodontically.Twopreoperativeradiographsweretakenrespectively,usingstraightprojectionandeccentricprojection.Af
5、teraccessopening,thefileswereplacedinthecanalsandtwootherradiographsweretaken.Therootcanalmorphologyofthepremolarswithc-shapedsystemwereclass-fiedandrecorded.TheteethwereshapedusingNiTirotaryinstrumentsandobturatedwithlateralcondensationmethod.Theefficiencyofpreparation
6、andobturationwasanalyzedwithradiographsbefore,duringandafteroperation.Result:Theinci-denceofc-shapedcanalsystemwas5.5%inmandibularfirstpremolarsand2.5%inmandibularsecondpremolars.TypeC2andthetypewhichcanalsmerciedinapicalwerethemostcommoninc-shapedsystemofmandibularprem
7、olars.Therewerenotransportation,andapicalblockageinallcases.In13casesofC-shapedcanalsystem,8teethwerefilledwell,5wereslightover-filling.Conclusion:ThemandibularfirstpremolarshadahighfrequencyC-shapedcanalsystem.UsingExploringandradiographswithfileisausefulwayinjudgingth
8、ecanalcategories.[Keywords]mandibularpremolar;C-shapedcanalsystem;rootcanaltreatment根管預備不充分可導致根管治療失敗。在根管預2治療方法