Lynn Evan A
NYU College of Dentistry, Department of Endodontics, USA.
N Y State Dent J. 2006 Nov;72(6):32-4.
The C-shaped root canal system and treatment implications were first described by Cooke and Cox in 1979. C-shaped canals are most frequently found in mandibular second molars, but they can occur in any mandibular molar, and they have been reported in maxillary molars as well. C-shaped mandibular molars are characterized by a C-shaped groove that connects one or more root canals. This groove can occur anywhere along the root canal system, making it difficult to diagnose and treat. A C-shaped root canal system may appear completely normal at the level of the pulp chamber but can begin to manifest itself in the middle or apical one-third. Furthermore, C-shaped canals are challenging if not impossible to predict radiographically. C-shaped canals in mandibular second molars are found most frequently in the Chinese population, with reports showing up to a 31.5% incidence, as compared to an approximate 7% incidence in the general population. This case report demonstrates an incidence of a C-shaped canal that was unable to be detected radiographically and which contained three separate root canals that communicated in the apical one-third of the root canal system. Canal orifices were located approximately 2 mm below the level of the CEJ, which is in agreement with a recent micro-computed tomography study of C-shaped mandibular molars that found 98% of all C-shaped molars studied had orifices located 1 mm to 3 mm below the CEJ. The CT study also found that all C-shaped canals contained fused roots and confirmed previous findings that the C-shape configuration varies greatly throughout the length of the canal.
1979年,库克(Cooke)和考克斯(Cox)首次描述了C形根管系统及其治疗意义。C形根管最常见于下颌第二磨牙,但也可能出现在任何下颌磨牙中,上颌磨牙中也有相关报道。C形下颌磨牙的特征是有一个连接一个或多个根管的C形沟。此沟可出现在根管系统的任何部位,这使得诊断和治疗都很困难。C形根管系统在髓室水平可能看起来完全正常,但在根管中三分之一或根尖三分之一处可能开始显现出来。此外,C形根管即使不是不可能,也很难通过影像学预测。下颌第二磨牙中的C形根管在中国人群中最为常见,报告显示其发生率高达31.5%,而普通人群中的发生率约为7%。本病例报告展示了一例C形根管,其在影像学上无法检测到,且包含三个在根管系统根尖三分之一处相通的独立根管。根管口位于牙骨质界(CEJ)水平以下约2毫米处,这与最近一项关于C形下颌磨牙的显微计算机断层扫描研究结果一致,该研究发现,在所有研究的C形磨牙中,98%的根管口位于CEJ以下1毫米至3毫米处。CT研究还发现,所有C形根管都包含融合根,并证实了先前的研究结果,即C形结构在根管全长中变化很大。