Department of Oral and Maxillo-Facial Sciences, La Sapienza University, Rome, Italy.
Division of Endodontics, University at Buffalo, Buffalo, NY, USA.
Int Endod J. 2018 Mar;51(3):259-268. doi: 10.1111/iej.12845. Epub 2017 Sep 18.
To investigate in vivo the complexity of canals within mesial roots of mandibular molars using 3D Endo™ software linked to CBCT images.
The CBCT images of 100 mandibular first molars were analysed using the 3D Endo™ software. The number of canals in the mesial roots, the presence of apical confluences, the canal lengths and the canal configurations using Vertucci's classification were evaluated in buccolingual (BL) and mesiodistal (MD) views. The software allowed the visualization of canal trajectories in three dimensions using a coloured outline, which was used to develop a new objective scoring system to provide an overall assessment of canal complexity. Data were analysed statistically using anova and t-tests with the significance set at P < 0.05.
Vertucci type IV canals were found in 44% of the cases, whilst 54% were type II. The mean distance from the apical foramen to the orifice was 13.15 mm (±1.21) and that between a confluence and the foramen, 2.81 mm (±1.13). The number of curvatures and the canal complexity scores in the MD view were significantly higher than in the BL view (P < 0.05). The scores were not directly correlated to the canal (MB versus ML), to the canal length or to the presence of confluences.
3D Endo software features the automatic detection and measurement of several anatomical canal parameters, and is a promising tool for the study of canal complexity in vivo. The unpredictable anatomy of the mesial roots of mandibular molars highlights the value of a three-dimensional preoperative evaluation of each case. The proposed scoring system aims to provide the clinician with an overall assessment of canal complexity.
使用与 CBCT 图像相关联的 3D Endo™软件，研究下颌磨牙近中根内根管的复杂性。
使用 3D Endo™软件分析 100 颗下颌第一磨牙的 CBCT 图像。在颊舌（BL）和近远中（MD）视图中，评估近中根内的根管数量、根尖汇合的存在、根管长度和使用 Vertucci 分类的根管形态。该软件允许使用彩色轮廓在三维中可视化根管轨迹，使用该轮廓开发了新的客观评分系统，以提供根管复杂性的整体评估。使用方差分析和 t 检验对数据进行统计学分析，显著性水平设为 P<0.05。
发现 44%的病例为 Vertucci Ⅳ型根管，54%为Ⅱ型。根尖孔至口的平均距离为 13.15mm（±1.21），汇合处与孔之间的距离为 2.81mm（±1.13）。MD 视图中的根管弯曲数和根管复杂性评分明显高于 BL 视图（P<0.05）。评分与根管（MB 与 ML）、根管长度或汇合处的存在无直接相关性。
3D Endo 软件具有自动检测和测量多个解剖根管参数的功能，是研究体内根管复杂性的有前途的工具。下颌磨牙近中根的不可预测解剖结构突出了对每个病例进行三维术前评估的价值。所提出的评分系统旨在为临床医生提供根管复杂性的整体评估。
