Health Division Glòria, City Hall of Joinville, Joinville, SC, Brazil.
Acta Odontol Scand. 2013 Jan;71(1):205-9. doi: 10.3109/00016357.2011.654262. Epub 2012 Feb 9.
The success of endodontic treatment depends on the identification of all root canals. Technological advances have facilitated this process as well as the assessment of internal anatomical variations. The aim of this study was to compare the efficacy of clinical and radiological methods in locating second mesiobuccal canals (MB2) in maxillary first molars.
Fifty patients referred for analysis; access and clinical analysis; cone-beam endodontic treatment of their maxillary first molars were submitted to the following assessments: analysis; access and clinical analysis; cone-beam computed tomography (CBCT); post-CBCT clinical analysis; clinical analysis using an operating microscope; and clinical analysis after Start X ultrasonic inserts in teeth with negative results in all previous analyses.
Periapical radiographic analysis revealed the presence of MB2 in four (8%) teeth, clinical analysis in 25 (50%), CBCT analysis in 27 (54%) and clinical analysis following CBCT and using an operating microscope in 27 (54%) and 29 (58%) teeth, respectively. The use of Start X ultrasonic inserts allowed one to detect two additional teeth with MB2 (62%). According to Vertucci's classification 48% of the mesiobuccal canals found were type I, 28% type II, 18% type IV and 6% type V. Statistical analysis showed no significant differences (p > 0.5) in the ability of CBCT to detect MB2 canals when compared with clinical assessment with or without an operating microscope. A significant difference (p < 0.001)was found only between periapical radiography and clinical/CBCT evaluations.
Combined use of different methods increased the detection ofthe second canal in MB roots, but without statistical difference among CBCT, operating microscope, Start X and clinical analysis.
根管治疗的成功取决于所有根管的识别。技术进步不仅方便了这一过程，还方便了对内部解剖结构变化的评估。本研究旨在比较临床和影像学方法在定位上颌第一磨牙第二近中颊根管（MB2）方面的效果。
50 名患者接受分析；对他们的上颌第一磨牙进行治疗；接受以下评估：分析；访问和临床分析；锥形束计算机断层扫描（CBCT）；CBCT 后临床分析；使用手术显微镜进行临床分析；以及在所有先前分析均为阴性的牙齿中使用 Start X 超声插入物进行临床分析。
根尖放射线分析显示有 4 颗（8%）牙齿存在 MB2，临床分析显示有 25 颗（50%）牙齿存在 MB2，CBCT 分析显示有 27 颗（54%）牙齿存在 MB2，临床分析显示有 27 颗（54%）和 29 颗（58%）牙齿存在 MB2，分别为在使用 Start X 超声插入物后，又发现了两颗有 MB2 的牙齿（62%）。根据 Vertucci 的分类，发现的近中颊根管中 48%为 I 型，28%为 II 型，18%为 IV 型，6%为 V 型。统计分析显示，与临床评估（无论是否使用手术显微镜）相比，CBCT 检测 MB2 管的能力无显著差异（p>0.5）。仅在根尖射线照相和临床/CBCT 评估之间发现了显著差异（p<0.001）。
联合使用不同方法可提高对 MB 根第二根管的检测率，但 CBCT、手术显微镜、Start X 和临床分析之间无统计学差异。
