Sun Yu, Lu Tzu-Yi, Chen Yi-Chen, Yang Shue-Fen
Department of Dentistry, Division of Endodontics, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei, Taiwan.
Division of Endodontics, Konichiwa Dental Clinic, Tainan, Taiwan.
J Dent Sci. 2016 Jun;11(2):175-181. doi: 10.1016/j.jds.2016.01.003. Epub 2016 Apr 12.
BACKGROUND/PURPOSE: There is large variation in root canal morphology and undetected canals and incomplete instrumentation are reasons for root canal treatment failure. The purpose of this study was to determine the best radiographic method for determining root canal morphology in mandibular first premolars in Chinese descendants in Taiwan.
Mandibular first premolars extracted due to caries, periodontal diseases, trauma, or for orthodontic reasons were used. Four indices were examined: (1) root canal bifurcation observed in the buccolingual view; (2) root canal continuity in the buccolingual view; (3) double root outline in the buccolingual view; and (4) Vertucci canal classification in the mesiodistal view.
A total of 82 left and right mandibular first premolars were included, a complicated root canal was confirmed in 38 (46.3%) by cross-sectional imaging and a single root canal was found in 44 (53.7%). Bifurcation identified on the mesiodistal view exhibited the highest sensitivity (94.7%) and second highest specificity (88.6%) for identifying a complicated root canal; however, this view is not possible to obtain clinically. Canal bifurcation on the buccolingual view was the most specific (93.2%), but had the lowest sensitivity (73.7%). Canal continuity on the buccolingual view had a sensitivity of 94.7%, and specificity of 70.5%.
Combined X-ray analyses, such as performing the buccolingual view for identification of canal bifurcation and canal continuity, may increase the accuracy of identifying complex root canal morphology.
背景/目的：根管形态存在很大差异，未检测到的根管和根管预备不完善是根管治疗失败的原因。本研究的目的是确定在台湾华裔后代的下颌第一前磨牙中确定根管形态的最佳影像学方法。
使用因龋齿、牙周疾病、外伤或正畸原因拔除的下颌第一前磨牙。检查了四个指标：（1）在颊舌向视图中观察到的根管分叉；（2）颊舌向视图中的根管连续性；（3）颊舌向视图中的双根轮廓；（4）近远中向视图中的维尔图奇根管分类。
共纳入82颗左右下颌第一前磨牙，横断面成像证实38颗（46.3%）存在复杂根管，44颗（53.7%）为单根管。近远中向视图中识别出的分叉对复杂根管的识别具有最高的敏感性（94.7%）和第二高的特异性（88.6%）；然而，临床上无法获得此视图。颊舌向视图中的根管分叉特异性最高（93.2%），但敏感性最低（73.7%）。颊舌向视图中的根管连续性敏感性为94.7%，特异性为70.5%。
联合X线分析，如采用颊舌向视图来识别根管分叉和根管连续性，可能会提高识别复杂根管形态的准确性。
