Paolantonio M, Centobeni R, Scogna G, Di Murro C
Istituto di Discipline Odontostomatologiche, Università degli Studi G. D'Annunzio, Chieti.
Minerva Stomatol. 1992 Mar;41(3):105-20.
The aim of the present study has been to realize a morphometrical and morphological study on the anatomical characteristics of molar teeth root furcations. Two hundred ninety four molars (147 upper and 147 lower teeth), after extraction and elimination of periodontal ligament residuals by trypsin, have been morphometrically evaluated recording the principal anatomical characters of the furcal and radicular region (root and radicular trunk lengths, mesio-distal and vestibulo-palatal diameters at the cementum-enamel junction, inter-radicular angle width and furcal area extension). By the Pearson's correlation test data such obtained were analyzed to verify the existence of statistically significant correlations among the above mentioned anatomical characteristics. Thirty teeth, selected among the most representatives of the whole sample for their anatomical characters, have been morphologically evaluated: 10 by stereo-microscopical examination, 10 by the observation of non-demineralized histological sections and 10 by scanning electron microscopical examination. Results of the morphometrical evaluation showed that from first to second molar the radicular angle, root length and furcal area width undergo a reduction; differently radicular trunk increases his length. On the basis of this results the Authors try to explain data from recent clinical research testifying that second upper molar is the most frequently extracted tooth. In fact a long radicular trunk is associated with a more apical placement of the furcation entrance and this situation, in conjunction with a narrow inter-radicular angle, can obstruct the insertion of therapeutical instruments, justifying the bad prognosis of the second upper molar involved by periodontal disease. The statistical analysis of anatomical data showed a significant correlation (r = -0.46) among radicular trunk length and inter-radicular angle width (in upper first molars; reverse correlation), root length and inter-radicular angle width (r = 0.51) (lower first molars), vestibular-buccal diameter at the cementum-enamel junction and width of mesial and distal furcal angles (r = 0.43) (upper second molars), the extension of furcal area and the wideness of inter-radicular angle (r = 0.89/0.43). These data are in accord with those from other Authors. Morphological analysis showed the high structural complexity of furcal area in molar teeth with the common observation of cemental crests and pulpal accessory canals orifices; these structures can offer a good receptacle to the subgingival dental plaque and can cause difficulties in debridement and therapeutical treatment of the molar furcal region involved by periodontal disease.(ABSTRACT TRUNCATED AT 400 WORDS)
本研究的目的是对磨牙牙根分叉的解剖特征进行形态计量学和形态学研究。294颗磨牙(147颗上颌牙和147颗下颌牙)在拔除后,通过胰蛋白酶去除牙周膜残余物,然后进行形态计量学评估,记录分叉和牙根区域的主要解剖特征(牙根和牙根干长度、牙骨质-釉质界处的近远中径和前庭-腭径、根间角宽度和分叉区面积)。通过Pearson相关检验对所得数据进行分析,以验证上述解剖特征之间是否存在统计学上的显著相关性。从整个样本中选取30颗具有代表性解剖特征的牙齿进行形态学评估:10颗通过体视显微镜检查,10颗通过观察未脱矿组织切片,10颗通过扫描电子显微镜检查。形态计量学评估结果显示,从第一磨牙到第二磨牙,根间角、牙根长度和分叉区宽度减小;不同的是,牙根干长度增加。基于这些结果,作者试图解释近期临床研究的数据,这些数据表明上颌第二磨牙是最常被拔除的牙齿。事实上,长的牙根干与分叉入口更靠近根尖的位置相关,这种情况,再加上狭窄的根间角,会阻碍治疗器械的插入,这就解释了患有牙周病的上颌第二磨牙预后不良的原因。解剖数据的统计分析显示,牙根干长度与根间角宽度之间存在显著相关性(r = -0.46)(在上颌第一磨牙中;呈负相关),牙根长度与根间角宽度之间存在显著相关性(r = 0.51)(在下颌第一磨牙中),牙骨质-釉质界处的前庭-颊径与近远中分叉角宽度之间存在显著相关性(r = 0.43)(在上颌第二磨牙中),分叉区面积与根间角宽度之间存在显著相关性(r = 0.89/0.43)。这些数据与其他作者的数据一致。形态学分析显示磨牙分叉区具有高度的结构复杂性,常见牙骨质嵴和牙髓副根管口;这些结构可为龈下牙菌斑提供良好的容纳场所,并可能导致牙周病累及的磨牙分叉区清创和治疗困难。(摘要截断于400字)