Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland.
Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Periodontology and Operative Dentistry, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
J Endod. 2022 Feb;48(2):234-239. doi: 10.1016/j.joen.2021.11.015. Epub 2021 Dec 11.
Bacteria and/or toxin residuals in the furcation areas of mandibular and maxillary molars can be the cause of persistent periapical tissue inflammation before or after an endodontic treatment.
The objective of this ex vivo study was to investigate the frequency of interradicular canals and diverticula in first and second mandibular and first and second maxillary molars by means of micro-computed tomographic imaging. Five hundred thirteen extracted molars, 211 mandibular molars and 302 maxillary molars, were included in this investigation. The area between the pulp chamber floor (PCF) and the furcation area was examined, and the data obtained were evaluated with imaging software that generated the corresponding 3-dimensional images. The results were analyzed by means of descriptive statistics.
Interradicular canals were observed in 2.8% and 0.3% of the mandibular and maxillary molars, respectively. The diverticula (blind-ended interradicular canals) originated either at the furcation area or at the PCF. The diverticula frequency observed in mandibular molars was 3.3% (PCF) and 4.3% (bifurcation). The maxillary molar diverticula frequency observed was 2.0% (trifurcation), with none of them originating at the PCF. Altogether (n = 513) diverticula originated more frequently from the PCF (59.1%) than from the furcation area (40.9%).
Although interradicular canals as well as diverticula were observed in a relatively small number of the investigated molars, practitioners should always be aware of their existence because without an adequate chemical debridement/disinfection of the pulp chamber root canal system, successful endodontic treatment could be compromised in up to 10% of the cases.
下颌和上颌磨牙分叉区的细菌和/或毒素残留可能是牙髓治疗前后根尖周组织持续炎症的原因。
本体外研究的目的是通过微计算机断层扫描成像来研究第一和第二下颌磨牙和第一和第二上颌磨牙的根间管和憩室的频率。本研究共纳入 513 颗离体磨牙,211 颗下颌磨牙和 302 颗上颌磨牙。检查牙髓室底(PCF)和分叉区之间的区域,并用生成相应 3 维图像的成像软件评估获得的数据。采用描述性统计方法对结果进行分析。
下颌和上颌磨牙分别观察到根间管的发生率为 2.8%和 0.3%。憩室(盲端根间管)起源于分叉区或 PCF。下颌磨牙观察到的憩室发生率为 3.3%(PCF)和 4.3%(分叉)。上颌磨牙观察到的憩室发生率为 2.0%(三分叉),均未起源于 PCF。总共(n=513),憩室起源于 PCF 的频率(59.1%)高于起源于分叉区的频率(40.9%)。
尽管在研究的磨牙中观察到数量相对较少的根间管和憩室,但临床医生应始终意识到它们的存在,因为如果不对牙髓室根管系统进行充分的化学清创/消毒,多达 10%的病例可能无法成功进行牙髓治疗。