State Key Laboratory of Oral Diseases, Sichuan University, Chengdu 610041, China.
Int J Oral Sci. 2011 Jul;3(3):135-40. doi: 10.4248/IJOS11050.
The aim of this study was to analyze the specific influence of root canal anatomy on the accessibility of working length during root canal therapy. Four hundred seventy-six root canal therapy cases (amounting to a total of 1 005 root canals) were examined. The anatomy risk factors assessed in each case included: tooth type (tooth location), root canal curvature, and root canal calcification, as well as endodontic retreatment. The investigation examined the correlation between each of these anatomic factors and the working length, with statistical analysis consisting of Chi-square tests and multiple logistic regression analysis. In an independent factor analysis, tooth type (tooth location), root canal curvature, canal calcification, and endodontic retreatment were determined to be the primary risk factors. In a multiple-factor regression model, root curvature and canal calcification were found to most significantly influence root canal working length accessibility (P<0.05). Root canal anatomy increases the difficulty of root canal preparation. Appropriate consideration of tooth anatomy will assist in accurate determination of preparation difficulty before instrumentation. This study alerts clinical therapists to anatomical factors influencing the working length accessibility, and allows for a direct estimate of success rate given in situ measurements of tooth factors during the root canal treatment procedure.
本研究旨在分析根管解剖结构对根管治疗中工作长度可达性的具体影响。共检查了 476 例根管治疗病例（共计 1005 个根管）。每个病例评估的解剖风险因素包括：牙齿类型（牙位）、根管弯曲度和根管钙化，以及牙髓再治疗。研究分析了这些解剖因素与工作长度之间的相关性，统计分析包括卡方检验和多因素逻辑回归分析。在独立因素分析中，牙齿类型（牙位）、根管弯曲度、管腔钙化和牙髓再治疗被确定为主要危险因素。在多因素回归模型中，发现根管弯曲度和管腔钙化对根管工作长度可达性的影响最大（P<0.05）。根管解剖增加了根管预备的难度。在器械预备前，适当考虑牙齿解剖结构有助于准确确定预备难度。本研究提醒临床治疗师注意影响工作长度可达性的解剖因素，并允许根据根管治疗过程中牙齿因素的现场测量值直接估计成功率。
