A Retrospective CBCT Analysis of the Characteristics of Root Canal Systems of Mandibular Molars in a Kunming Population
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摘要:
目的 回顾性分析昆明地区人群下颌第1和第2磨牙根管系统的CBCT资料，研究其根管形态的规律。 方法 收集云南省第一人民医院口腔医学中心358名患者总共1229颗下颌第1和第2磨牙的CBCT资料，计算根管数量和类型、远舌根管和C形根管发生率，分析根管形态特征。 结果 下颌第1磨牙73.96%为4根管，19.73%为3根管，4.48%为5根管，0.33%为2根管，远舌根平均发生率为14.43%。下颌第2磨牙C形根管平均发生率为30.83%，女性高于男性（34.95% > 26.81%，P < 0.05），牙位或各年龄间无显著性差异（P > 0.05）。C形根管在根管口水平面81.35%表现为C1和C2型，根中水平70.47%为C2和C3型，根尖3 mm水平83.42%为C3和C4型。 结论 昆明地区人群下颌第1磨牙远舌根管和第2磨牙C形根管发生率较高，治疗时需特别注意。 Abstract:Objective To investigate the characteristics of root canal system of mandibular first and second molars ina Kunming population with cone-beam computed tomography technology. Methods CBCT dada of 1229 mandibular first and second molar from 358 patients were collected. The root canal number, classification and incidence of radix entomolaris and C-shaped canalswere calculated to conclude their characteristics. Results The majority of mandibular first molars （73.96%） showed 4 canals, 19.73% with 3 canals, 4.48% with 5 canals, 0.33% with 2 canals. The incidence of radix entomolaris was 14.43%. The incidence of C-shaped canals in mandibular second molars was 30.83%.There was a significant difference of incidence in female than that in male （34.95% > 26.81%, P < 0.05）. The incidence of C-shaped canals in group 1 and 2 was higher than that in group 3 and 4 （P < 0.05）. Most of the C-shaped canals were C1 and C2 type at the level of orifice （81.35%）, 70.47% being C2 and C3 type at the level of middle and 83.42% being C3 and C4 type at the level of apical 3mm. Conclusion More attention must be paid when treating mandibular first and second molars in Kunming population bucause there is a high incidence of radix entomolaris and C-shaped canal. -
图 1 昆明地区人群下颌磨牙根管类型CBCT截图
下颌第一磨牙（第一行）a：3根管；b：4根管；c：4根管（RE）；d：5根管（MMC + RE）；e：C形根管下颌第二磨牙（第二行）f：C1型；g：C2型；h：C3-c型；i：C3-d型；j：C4型。
Figure 1. Cone-beam computed tomography images showing the canal category of mandibular molars in a Kunming population
表 1 昆明地区人群下颌磨牙牙根及根管数量构成比[n（%）]
Table 1. Number and distribution of roots and root canals of mandibular molars in a Kunming population [n（%）]
牙位 牙根 根管 1 2 3 2 3 4 5 6 下颌第一磨牙 0（0） 516（85.57） 87（14.43） 2（0.33） 119（19.73） 446（73.96） 27（4.48） 9（1.49） 下颌第二磨牙 193（30.83） 420（67.09） 13（2.08） 56（8.94） 360（57.51） 17（2.72） − − 
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表 2 昆明地区人群下颌第二磨牙C形根管发生率[n（%）]
Table 2. Incidence of C-shaped canalsin mandibular second molars in a Kunming population [n（%）]
项目 总数 C形根管
数量C形根管
发生率n（%）检验统计值 P值 性别 男 317 85 26.81 4.529 0.033 女 309 108 34.95 牙位 左 320 99 30.94 0.000 0.987 右 306 94 30.72 年龄
（岁）17～19 19 9 47.37 20～39 321 114 35.51 40～59 208 48 23.08 > 60 78 22 28.21 注：各年龄组比较：17～19岁与20～39岁比较，χ2 = 0.682，P = 0.409；17～19岁与40～59岁比较，χ2 = 2.576，P = 0.109；17～19岁与 > 60岁比较，χ2 = 2.469，P = 0.116；20～39岁与40～59岁比较，χ2=：3.562，P=0.059；20～39岁与 > 60岁比较，χ2 = 2.370，P = 0.124；40～59岁与 > 60岁比较，χ2 = 0.016，P = 0.899。
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表 3 昆明地区人群下颌第二磨牙C形根管构成比分析[n（%）]
Table 3. Distribution of the C-shaped canals at different level in mandibular second molarsin a Kunming population [n（%）]
部位 C1 C2 C3c C3d C4 合计 根管口 112（58.03） 45（23.32） 13（6.74） 19（9.84） 4（2.07） 193 根中部 16（8.29） 75（38.86） 61（31.61） 33（17.10） 8（4.14） 193 根尖3 mm 0（0.00） 7（3.63） 25（12.95） 92（47.67） 69（35.75） 193
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