【摘要】：目的：測量分析浙江省人群上頜前磨牙根管壁的厚度,牙根直徑和牙根長度。 方法：選取2012年12月至2014年1月期間前來浙江大學(xué)醫(yī)學(xué)院附屬口腔醫(yī)院就診因治療前檢查而拍攝CBCT的130名患者的246顆上頜前磨牙,其中上頜第一前磨牙129顆,上頜第二前磨牙117顆,患者年齡范圍為19-63歲,平均年齡35歲。利用CBCT自帶軟件(NNT軟件)對所選前磨牙在距根尖4mm、5mmm、6mm、7mm.8mm、9mm處測量牙根橫截面的根管壁厚度,牙根直徑和牙根長度。理論計算1#～3#P鉆(工作直徑分別為0.7mm、0.9mm和1.1mm)預(yù)備單根單根管型前磨牙后剩余根管壁厚不小于1mm的概率。 結(jié)果：上頜前磨牙近遠中側(cè)根管壁較薄,距離根尖6mm以下四分位數(shù)P25均小于1mm。單根型上頜前磨牙近遠中徑較窄,上頜第一前磨牙距離根尖7mm以下和上頜第二前磨牙距離根尖6mm以下P25小于2.7mm。理論計算P鉆預(yù)備后剩余根管壁厚不小于1mm的概率,上頜第一前磨牙使用1#P鉆在距離根尖9mm以上,上頜第二前磨牙使用1#P鉆在8mm以上和2#P鉆9mm以上的概率大于80%。雙根管型比單根管型的近遠中直徑更小(P0.05),距離根尖9mm處中位數(shù)僅為2.5-2.6mm,越往根尖越小,理論計算P鉆樁道預(yù)備后剩余根管壁厚大多不足1mm。上頜第一前磨牙根分叉位置均在距離根尖7mm以下,根分叉以下頰側(cè)根的腭側(cè)壁和舌側(cè)根的近遠中壁較薄,其P25均小于1mm。上頜第一、二前磨牙的牙根長度分別為12.9±1.7mm和12.8±2.0mm。 結(jié)論：上頜前磨牙近遠中側(cè)根管壁較薄,近遠中徑較窄,根分叉以下的頰根腭側(cè)壁和舌根近遠中側(cè)壁較薄。臨床建議在必須進行樁修復(fù)時,(1)避免距離根尖6mm以下的樁道預(yù)備,在保證冠根比的前提下,盡量減小樁的長度,減少對近遠中壁的切削,(2)單根單根管型上頜第一前磨牙可在距離根尖9mm以上使用1#P鉆,上頜第二前磨牙可在距離根尖8mm處使用1#P鉆,9mm處使用2#P鉆,(3)避免將雙根管型上頜前磨牙的頰舌兩個根管聯(lián)通為一個扁形根管,(4)上頜前磨牙在根分叉以下不建議進行樁道預(yù)備。
[Abstract]:Objective: to measure the thickness of root canal wall, root diameter and root length of maxillary premolar in Zhejiang province. Methods: from December 2012 to January 2014, two hundred and thirty-six maxillary premolars (including 129 maxillary first premolars) were taken from 130 patients with CBCT who were admitted to the affiliated Stomatology Hospital of Zhejiang University Medical College from December 2012 to January 2014. 117 maxillary second premolars with an age range of 19-63 years with an average age of 35 years. The root canal wall thickness, root diameter and root length of the selected premolars were measured by CBCT software (NNT software) at a distance of 4 mm to 5 mm to 6 mm to 7 mm. 8 mm to 9 mm from the root tip. The probability of 1 #P drill (working diameters of 0.7 mm and 0.9 mm and 1.1mm) in preparing the residual root wall thickness of single canal premolars was calculated theoretically. The thickness of residual root canal wall was not less than 1mm. Results: the wall of proximal distal lateral root canal of maxillary premolars was thinner and the quartile P25 below the apical 6mm was less than 1 mm. The distance between maxillary first premolars and maxillary second premolars was less than 2.7mm. the distance between maxillary first premolars and maxillary second premolars was lower than 7mm and the distance between maxillary second premolars and apical 6mm was less than 2.7mm. The probability of remaining root canal thickness after preparation of P drill is not less than 1mm. The maxillary first premolars were drilled above the apical 9mm with 1 #P drill. For maxillary second premolars, the probability of using 1 #P drill above 8mm and 2 #P drill 9mm was higher than 80%. The proximal and middle diameter of double root canal type was smaller than that of single root canal type (P0.05), and the median distance to root tip 9mm was only 2.5-2.6 mm, and the thickness of remaining root canal wall was less than 1 mm after the preparation of P drilling pile. The root bifurcation of maxillary first premolar was below the apical 7mm. The palatal lateral wall of the buccal lateral root and the proximal distal wall of the lingual lateral root were thinner than those of the root tip, and the P25 was less than 1 mm. The root length of maxillary first and second premolars was 12.9 鹵1.7mm and 12.8 鹵2.0mm. Conclusion: the proximal distal lateral canal wall of maxillary premolar is thinner and the proximal distal diameter of maxillary premolar is narrower than that of maxillary premolar. It is suggested that when pile repair is necessary, (1) avoiding the preparation of the pile path below the root tip 6mm, reducing the length of the pile and cutting the proximal and middle wall under the premise of ensuring the ratio of crown to root. (2) 1 #P drill can be used for the first maxillary premolars with a single canals above the apical 9mm, 1 #P drill for the maxillary second premolars can be used at the distance from the root tip 8mm, and 2 #P drill can be used for the 9mm. (3) avoid connecting the two root canals of the two canals of maxillary premolars into a flat root canal, and (4) it is not recommended that the maxillary premolars should be prepared with piles below the forks of the maxillary premolars.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R781.05

【共引文獻】

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