Department of Endodontics, Loma Linda University School of Dentistry, Loma Linda, California.
Department of Endodontics, Loma Linda University School of Dentistry, Loma Linda, California.
J Endod. 2017 Oct;43(10):1711-1715. doi: 10.1016/j.joen.2017.05.011. Epub 2017 Jul 20.
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.
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.
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.
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).
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。
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。
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。
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)。