Department of Medical Education, Jagiellonian University Medical College, 16 Lazarza Street, 31-530 Krakow, Poland; Tomaszewska Private Dental Practice, al. Slowackiego 58/4, Krakow, Poland.
Department of Medical Physics, Jagiellonian University, ul. prof. Stanislawa Lojasiewicza 11, 30-348 Krakow, Poland.
Ann Anat. 2018 Jan;215:83-92. doi: 10.1016/j.aanat.2017.09.003. Epub 2017 Sep 24.
The aim of this study was to analyze the root canal morphology of maxillary third molars (MTMs) using micro-computed tomography (micro-CT).
Seventy-eight consecutively-extracted human MTMs were scanned using micro-CT (spatial resolution=13.68μm per pixel). Dedicated software (SkyScan) was used to create virtual reconstructions and perform 3D-analysis. A range of anatomical features were assessed; externally (root number, length, fusion, curvature, apex), within the pulp chamber (distance between canal orifices, floor thickness) and within the root canal system (root canal number, classification, ramifications, isthmuses, apical constriction).
The donor age ranged from 19 to 73 years (mean±SD 32.3±16.5years). MTMs possessed one or three roots, which principally curved buccally/palatally (75.9%), had 1-4 root canals and typically no apical constriction (84.4%). The average external root length was 11.89±1.53mm, while root canal length was 10.18±0.35mm. The root canal diameter 1mm from the apex was 0.37±0.23mm and negatively correlated with donor's age (r=-0.76; p=0.01), while pulp chamber thickness positively correlated with age (r=0.58; p=0.035). Significantly, furcation canals, canal loops and root canal calcifications were sporadic findings.
In some cases the anatomy of MTMs may not be as complicated as previously documented, being similar to the reported anatomy of other maxillary molars. During root canal treatment of MTMs, the frequent deviation of the apical foramen from the radiographic apex should be considered, as should the absence of an apical constriction in the majority of cases. In addition, buccal/palatal root curvature, often undiagnosed radiographically, is the most common root curvature in MTMs.
本研究旨在使用微计算机断层扫描（micro-CT）分析上颌第三磨牙（MTM）的根管形态。
连续提取的 78 个人上颌第三磨牙使用 micro-CT（像素空间分辨率=13.68μm）进行扫描。专用软件（SkyScan）用于创建虚拟重建和进行 3D 分析。评估了一系列解剖特征；外部（根数量、长度、融合、曲率、根尖）、牙髓腔（根管口之间的距离、底部厚度）和根管系统内（根数量、分类、分支、峡部、根尖缩窄）。
供体年龄范围为 19-73 岁（平均±标准差 32.3±16.5 岁）。MTM 有一个或三个根，主要向颊侧/腭侧弯曲（75.9%），有 1-4 个根管，通常没有根尖缩窄（84.4%）。平均外部根长为 11.89±1.53mm，而根管长度为 10.18±0.35mm。根尖 1mm 处的根管直径为 0.37±0.23mm，与供体年龄呈负相关（r=-0.76；p=0.01），而牙髓腔厚度与年龄呈正相关（r=0.58；p=0.035）。值得注意的是，分叉根管、根管弯曲和根管钙化是零星发现的。
在某些情况下，MTM 的解剖结构可能不像以前记录的那样复杂，与其他上颌磨牙的报告解剖结构相似。在 MTM 的根管治疗中，应考虑根尖孔经常偏离放射学根尖，并且在大多数情况下不存在根尖缩窄。此外，颊侧/腭侧根弯曲，通常在影像学上无法诊断，是 MTM 中最常见的根弯曲。
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