Lobo Natalia Siqueira, Wanderley Victor Aquino, Nejaim Yuri, Gomes Amanda Farias, Zaia Alexandre Augusto
Department of Restorative Dentistry, Endodontic Division, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil.
Braz Dent J. 2020 Sep-Oct;31(5):505-510. doi: 10.1590/0103-6440202003430.
The present study used microcomputed tomography (micro-CT) images to assess the prevalence, number, and location of apical ramifications (ARs) in the root canals of different dental groups in a Brazilian population. Three hundred and sixty-seven extracted human teeth, totaling 475 roots, were scanned by micro-CT at 19.6 µm spatial resolution. The obtained images were evaluated by two observers in consensus, and a descriptive analysis was performed to verify the prevalence, number, and location of ARs in each dental group. Chi-square test was used to compare the prevalence of ARs in different types of roots, and one-way analysis of variance compared the number of ARs in the apical 1 mm, 2 mm, and 3 mm of the root. Significance level was established at 5% (α=0.05). ARs were present in 253 (53.3%) of the 475 roots evaluated. A total of 607 ARs were detected, with the vast majority (530) located at one and two millimeters from the main foramen. The highest prevalence of ARs was observed in maxillary canines (65%); maxillary premolars - single-rooted (83.3%), buccal root (80%), and palatine root (73.3%); mandibular premolars (64.2%); mesiobuccal root of maxillary molars (76.6%); and mesial root of mandibular molars (66.6%). For the Brazilian population, most of the ARs are located in the apical 1 and 2 mm of the root, with greater prevalence in the posterior teeth and maxillary canines. These findings suggest the need for additional attention while planning endodontic treatments, including strategies to effectively clean and fill the apical region.
本研究使用微计算机断层扫描（micro-CT）图像来评估巴西人群中不同牙组根管内根尖分支（ARs）的患病率、数量和位置。对367颗拔除的人类牙齿（共475个牙根）进行了空间分辨率为19.6µm的micro-CT扫描。由两名观察者对获得的图像进行一致评估，并进行描述性分析以验证每个牙组中ARs的患病率、数量和位置。采用卡方检验比较不同类型牙根中ARs的患病率，采用单因素方差分析比较牙根根尖1mm、2mm和3mm处ARs的数量。显著性水平设定为5%（α=0.05）。在评估的475个牙根中，有253个（53.3%）存在ARs。共检测到607个ARs，绝大多数（530个）位于距主根尖孔1至2毫米处。ARs患病率最高的是上颌尖牙（65%）；上颌前磨牙——单根（83.3%）、颊根（80%）和腭根（73.3%）；下颌前磨牙（64.2%）；上颌磨牙近中颊根（76.6%）；以及下颌磨牙近中根（66.6%）。对于巴西人群，大多数ARs位于牙根根尖1和2mm处，后牙和上颌尖牙的患病率更高。这些发现表明，在规划牙髓治疗时需要格外关注，包括有效清洁和充填根尖区域的策略。
