青少年三根型下颌第一恒磨牙牙根外形解剖数据的锥形束CT测量分析

口腔生物医学 ›› 2021, Vol. 12 ›› Issue (1): 46-52.

青少年三根型下颌第一恒磨牙牙根外形解剖数据的锥形束CT测量分析

石方玉^1,2，迟江蓬²，王丽丽³，朱祥奎²，刘玲玲²，柳蓉蓉^1,2，刘树泰²

1.滨州医学院
2.烟台市口腔医院
3.招远市人民医院口腔科

收稿日期:2020-03-31 修回日期:2020-07-21 出版日期:2021-03-25 发布日期:2021-04-01
通讯作者: 刘树泰 E-mail:dentistliu@163.com

Measurement and Analysis of Anatomical Morphology of Root Surface of the Three-rooted Permanent Mandibular First Molars Using Cone-Beam Computed Tomography in adolescents

1. Binzhou Medical University 2. Yantai Stomatological Hospital 3. Department of Stomatology, Zhaoyuan People's Hospital

Received:2020-03-31 Revised:2020-07-21 Online:2021-03-25 Published:2021-04-01
Contact: shutai 无Liu E-mail:dentistliu@163.com

摘要/Abstract

摘要： 目的：利用锥形束CT测量青少年三根型下颌第一恒磨牙（PMFMs）牙根外形解剖数据，为牙周炎的预后判断和治疗提供理论支撑和临床指导。方法：选取175颗三根型PMFMs的锥形束CT影像学资料，记录牙齿发生情况、牙根长度、根柱长度、釉牙骨质界（CEJ）根方2 mm水平的根柱凹陷程度、根分叉穹窿顶点根方2 mm水平处的根分叉宽度和根面凹陷程度、近中根内侧面在不同水平的凹陷深度，统计分析。结果：近中根、远颊根、远舌根根长分别为（13.06±1.26）mm、（11.85±1.30）mm、（10.26±1.61）mm，除远舌根外，其余牙根男性根长比女性长（P<0.05）。远中侧根柱长度（4.87±1.00）mm最长，颊侧根柱长度（2.56±0.74）mm最短；远中侧在CEJ根方2 mm水平处的根柱凹陷程度最小；根分叉穹窿顶点下2 mm处的根分叉宽度在颊侧最宽，平均为（2.77±0.67）mm；近中根内侧面根面凹陷深度和程度大于远颊根；近中根根面凹陷深度从根分叉穹窿顶点下2 mm到6 mm逐渐变浅；以上差异均有统计学意义（P<0.05）。结论：三根型PMFMs远中侧根柱长，一旦病变波及根分叉，治疗难度大且预后不佳。近中根远中面凹陷明显，当病变波及此处可从颊侧分叉口进入治疗。

关键词:

锥形束CT, 三根型下颌第一恒磨牙, 远舌根, 根分叉, 根柱

Abstract: Objective：To measure the anatomical data of root surface of three-rooted PMFMs in adolescents with CBCT, to provide theoretical support and clinical guidance for the prognosis and treatment of periodontitis. Methods：175 CBCT images of three-rooted PMFMs were collected. The occurrence of teeth, the length of root, the length of root trunk, the degree of concavities of root trunk at the level of 2mm below CEJ, the width of root bifurcation and the degree of root concavities at the level of 2mm below apex of root bifurcation vault and the depth of concavities at different levels of mesial root surface were recorded and analyzed. Results：The length of mesial root、distal buccal root and distal lingual root were 13.06±1.26mm,11.85±1.30mm and 10.26±1.61mm respectively. Except for distal lingual root,the root length of male was longer than that of female(P<0.05).The length of distal root trunk (4.87±1.00) mm was the longest, and the length of buccal root trunk(2.56±0.74) mm was the shortest.The degree of root trunk concavities at the distal side was the smallest at the level of 2mm below CEJ.The width of buccal root bifurcation was the broadest at the level of 2mm below apex of root bifurcation vault , with an average width of 2.77±0.67mm.The depth and degree of concavities of the mesial root-surface were greater than those of the distal buccal one. From the level of 2mm to 6mm below apex of root bifurcation vault, the depth of the concavities of mesial root surface became shallow gradually.The above differences were statistically significant(P<0.05).Conclusions:The three-rooted PMFMs had long distal root trunk.Once the lesion extends to the root bifurcation,the treatment will be difficult and the prognosis will be poor. The mesial root was obviously depressed.When the lesion spreads here, the treatment can be entered from the buccal bifurcation.

Key words: cone beam computed tomography; three-rooted PMFMs, distal lingual root; furcation ;root trunk

石方玉迟江蓬王丽丽朱祥奎刘玲玲柳蓉蓉刘树泰. 青少年三根型下颌第一恒磨牙牙根外形解剖数据的锥形束CT测量分析[J]. 口腔生物医学, 2021, 12(1): 46-52.

参考文献 20

[1]	Newman MG, Takei HH, Carranza FA. Carranzas’Clinical Periodontology. 11th ed. Philadelphia: WB Saunders Co, 2012.
[2]	Huang R Y, Lin C D, Lee M S, et al. Mandibular Disto-Lingual Root: A Consideration in Periodontal Therapy[J].Journal of Periodontology, 2007, 78(8):1485-1490.
[3]	樊华.下颌第一磨牙远中舌根变异对其牙周状况的影响观察[D].山东大学，2010.
[4]	Walter C, Schmidt J C, Dula K, et al. Cone beam computed tomography (CBCT) for diagnosis and treatment planning in periodontology: A systematic review.[J]. Quintessence International, 2016, 47(1):25.
[5]	刘晓静，杨博，郝靖惠，等. 西北地区中国人下颌第一恒磨牙牙根根管数目的锥束CT研究[J]. 牙体牙髓牙周病学杂志，2012，22(7)：375-378.
[6]	Alvesalo L, Varrela J. Taurodontism and the presence of an extra Y chromosome: study of 47,XYY males and analytical review. Human Biology, 1991,63(1):31-38.
[7]	Scott RG, Turner CG II. The Anthropology of Modern Human Teeth. 1997,London: Cambridge University Press.
[8]	顾永春.下颌第一恒磨牙远舌根变异的形态学研究[D]. 第四军医大学，2011.
[9]	孟洋, 王万春, 栾庆先. 根分叉病变发生、发展与治疗研究进展[J]. 中国实用口腔科杂志, 2016, 9(4):237-242.
[10]	Bowers GM, Schallhorn R G, Mcclain P K, et al. Factors Influencing the Outcome of Regenerative Therapy in Mandibular Class II Furcations: Part I[J]. Journal of Periodontology, 2003,74(9):1255-1268.
[11]	王丽霞，申静，韩磊，等. 下颌第一磨牙根分叉区解剖形态的CBCT研究[J]. 口腔医学研究，2018，34(7): 738-741.
[12]	Do Vale HF, Del Peloso Ribeiro E, Bittencourt S, et al. Radiographic characteristics of furcation involvements in mandibular molars as prognostic indicators of healing after nonsurgical periodontal therapy[J]. J Am Dent Assoc,2009,140(4):434-440.
[13]	Chiu BM, Zee KY, Corbet E F,et al. Periodontal Implications of Furcation Entrance Dimensions in Chinese First Permanent Molars[J]. Journal of Periodontology, 1991, 62(5):308-311.
[14]	Bower RC. Furcation morphology relative to periodontal treatment. Furcation entrance architecture.J Periodontol 1979;5:23-27.
[15]	Aleo J J, De Renzis F A, Faber P A. In vitro attachment of human gingival fibroblasts to root surfaces. J Periodontol 46(ll):639-645, 1975.
[16]	Novaes AB, Tamani JP, Oliveira PT, et al. Root trunk concavities as a risk factor for regenerative procedures of classⅡ furcation lesions in dogs[ J] .JPeriodontol,2001, 72:612-619.
[17]	Barboza C, Rodrigues D, Petersen R, et al. Biometric Study of the Prefurcation Area of Human Mandibular First Molars[J].The International Journal of Periodontics and Restorative Dentistry, 2014, 34(6):857-861.
[18]	Gram Sv?rdstr?m, Jan L. Wennstr?m. Furcation topography of the maxillary and mandibular first molars[J]. Journal of Clinical Periodontology, 1988, 15(5):5.
[19]	Anderson R W, Mcgarrah H E, Lamb R D, et al. Root Surface Measurements of Mandibular Molars Using Stereophotogrammetry[J]. The Journal of the American Dental Association,1983, 107(4):613-615.
[20]	Knowles J, Burgette F, Nissie R,Ranfjord S. Comparisan of resuits following three modalities of periodontal therapy related to tooth type and initial pocket depth. J Clin Periodontol 1980;7:32-47.