Sinanoglu Alper, Helvacioglu-Yigit Dilek, Mutlu Ibrahim
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey.
Department of Endodontics, Faculty of Dentistry, Kocaeli University, Kocaeli, Turkey.
Restor Dent Endod. 2015 May;40(2):161-5. doi: 10.5395/rde.2015.40.2.161. Epub 2014 Dec 4.
Three-dimensional (3D) reconstruction of cone-beam computed tomography (CBCT) scans appears to be a valuable method for assessing pulp canal configuration. The aim of this report is to describe endodontic treatment of a mandibular second premolar with aberrant pulp canal morphology detected by CBCT and confirmed by 3D modeling. An accessory canal was suspected during endodontic treatment of the mandibular left second premolar in a 21 year old woman with a chief complaint of pulsating pain. Axial cross-sectional CBCT scans revealed that the pulp canal divided into mesiobuccal, lingual, and buccal canals in the middle third and ended as four separate foramina. 3D modeling confirmed the anomalous configuration of the fused root with a deep lingual groove. Endodontic treatment of the tooth was completed in two appointments. The root canals were obturated using lateral compaction of gutta-percha and root canal sealer. The tooth remained asymptomatic and did not develop periapical pathology until 12 months postoperatively. CBCT and 3D modeling enable preoperative evaluation of aberrant root canal systems and facilitate endodontic treatment.
锥形束计算机断层扫描（CBCT）扫描的三维（3D）重建似乎是评估牙髓腔形态的一种有价值的方法。本报告的目的是描述一例下颌第二前磨牙的根管治疗，该病例通过CBCT检测到牙髓腔形态异常，并经三维建模得以证实。一名21岁女性，主因搏动性疼痛就诊，在对下颌左侧第二前磨牙进行根管治疗时怀疑存在副根管。轴向断层CBCT扫描显示，牙髓腔在中三分之一处分为近中颊侧、舌侧和颊侧根管，并以四个独立的根尖孔结束。三维建模证实了融合牙根伴有深舌沟的异常形态。该牙的根管治疗分两次完成。采用侧向加压热牙胶和根管封闭剂对根管进行充填。术后12个月，该牙无症状，未出现根尖周病变。CBCT和三维建模能够对异常根管系统进行术前评估，并有助于根管治疗。
