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上颌第一磨牙第二颊根管应用锥形束 CT、直接牙合面通路和冠状面磨除技术的检出率。

Prevalence of Second Mesiobuccal Canals in Maxillary First Molars Detected Using Cone-beam Computed Tomography, Direct Occlusal Access, and Coronal Plane Grinding.

机构信息

Department of Endodontics, Loma Linda University School of Dentistry, Loma Linda, California.

Department of Endodontics, Loma Linda University School of Dentistry, Loma Linda, California.

出版信息

J Endod. 2017 Oct;43(10):1711-1715. doi: 10.1016/j.joen.2017.05.011. Epub 2017 Jul 20.

Abstract

INTRODUCTION

The purpose of this study was to determine the prevalence of the second mesiobuccal canal (MB2) in 100 maxillary first molars using 3 independent methods and a combination method.

METHODS

One hundred extracted human maxillary first molars were collected. The teeth were mounted in the maxillary first molar extraction sockets of a human cadaver head. A cone-beam computed tomographic (CBCT) scan was taken of each tooth. Two radiology faculty independently evaluated the CBCT volume for the presence of an MB2 canal. Additionally, teeth were accessed. If a canal was not found, a preoperative CBCT scan was viewed followed by a second attempt to locate an MB2 canal. Lastly, the mesiobuccal root was dissected by grinding in a coronal plane.

RESULTS

A review of CBCT volumes found the presence of an MB2 canal 69% of the time. Accessing the tooth led to an MB2 detection of 78%. When a CBCT scan was viewed, this brought the access detection rate up to 87%. Coronal plane root grinding had an MB2 canal detection rate of 92%. Differences between each method were statistically significant.

CONCLUSIONS

The results of this study show that an MB2 canal is present up to 92% of the time. Direct access of teeth found statistically significant more MB2 canals than viewing CBCT volumes alone (P = .032). Therefore, exposing every patient to a preoperative CBCT scan may not be appropriate. However, taking a CBCT scan when an MB2 canal is not found clinically can significantly increase the chances of finding an MB2 canal (P < .001).

摘要

简介

本研究的目的是使用 3 种独立方法和一种组合方法,确定 100 颗上颌第一磨牙中第二近中颊根管(MB2)的发生率。

方法

收集 100 颗离体上颌第一磨牙。将牙齿安装在人类尸体头颅的上颌第一磨牙拔牙窝中。对每个牙齿进行锥形束 CT(CBCT)扫描。两位放射学教师独立评估 CBCT 容积中是否存在 MB2 管腔。此外,还检查了牙齿。如果未发现根管,则先进行术前 CBCT 扫描,然后再次尝试定位 MB2 根管。最后,通过在冠状面研磨将近颊根解剖。

结果

CBCT 容积复查发现 MB2 管腔的存在率为 69%。对牙齿进行探查导致 MB2 检测率为 78%。当查看 CBCT 扫描时,该检测率提高到 87%。冠状面根磨的 MB2 根管检测率为 92%。各方法之间的差异具有统计学意义。

结论

本研究结果表明,MB2 根管的存在率高达 92%。与单独查看 CBCT 容积相比,直接探查牙齿发现的 MB2 根管具有统计学意义(P=.032)。因此,并非所有患者都需要接受术前 CBCT 扫描。然而,当临床上未发现 MB2 根管时,拍摄 CBCT 扫描可以显著增加发现 MB2 根管的机会(P<.001)。

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