Bhargava Triveni, Jain Nimesh, Reddy Prashanthi, Vijaywargiya Neelam, Reddy Vanaja, Nigam Haritima
Oral and Maxillofacial Surgery, Government College of Dentistry, Indore, IND.
Oral Medicine and Radiology, College of Dental Science and Hospital, Indore, IND.
Cureus. 2024 Apr 14;16(4):e58265. doi: 10.7759/cureus.58265. eCollection 2024 Apr.
Owing to the complicated anatomical nature of maxillary molars, untreated root canals may directly affect the outcome of root canal therapy. Therefore, cone beam computed tomography (CBCT) scan is an important tool in the evaluation of root canal systems, particularly for the detection of the second mesiobuccal (MB2) canal in maxillary molars.
The current study was undertaken to detect and evaluate filled/unfilled MB2 canals in endodontically treated, asymptomatic maxillary molars, and its correlation with periapical pathology by utilizing cone beam computed tomography (CBCT).
A retrospective study of 80 CBCTs of patients underwent scanning for various treatment modalities, with asymptomatic endodontically treated permanent maxillary first molars selected. Data collection occurred between January and June 2023. CBCT machine used was KODAK 9000 (Rochester, NY: Carestream Health) (Complementary Metal Oxide Semiconductor {CMOS} sensor, continuous mode and 12-28 sec scan time, 90-500 μm voxel size, and 5x3.5 cm field of view {FOV}). The axial images at mid-root level were used to assess the presence of the MB2 canal.
The study included 39 (48.8%) right maxillary first molars and 41 (51.3%) left maxillary first molars. Overall, in 62 (77.5%) maxillary first molars, MB2 was missed by the practicing dentist, and in 13 (16.3%) maxillary first molars MB2 canal was not present. Of all the maxillary first molars with MB2 canal (n=67), 53 (79.1%) canals had a periapical infection, five (7.5%) showed widening of periodontal ligament space whereas nine (13.4%) had no abnormality.
MB2 canals were present in the majority of cases and most of the unfilled MB2 canals showed evidence of periapical radiolucencies and showed a direct impact on the prognosis.
由于上颌磨牙复杂的解剖结构，未经治疗的根管可能直接影响根管治疗的效果。因此，锥形束计算机断层扫描（CBCT）是评估根管系统的重要工具，特别是用于检测上颌磨牙的第二近中颊根（MB2）根管。
本研究旨在利用锥形束计算机断层扫描（CBCT）检测和评估经根管治疗的无症状上颌磨牙中已充填/未充填的MB2根管，并探讨其与根尖周病变的相关性。
对80例接受各种治疗方式扫描的患者的CBCT进行回顾性研究，选择无症状的经根管治疗的上颌第一恒磨牙。数据收集时间为2023年1月至6月。使用的CBCT机为柯达9000（纽约罗切斯特：Carestream Health）（互补金属氧化物半导体{CMOS}传感器，连续模式，扫描时间12 - 28秒，体素大小90 - 500μm，视野{FOV}为5×3.5 cm）。采用牙根中部水平的轴向图像评估MB2根管的存在情况。
本研究包括39颗（48.8%）右侧上颌第一磨牙和41颗（51.3%）左侧上颌第一磨牙。总体而言，62颗（77.5%）上颌第一磨牙的MB2根管被执业牙医遗漏，13颗（16.3%）上颌第一磨牙不存在MB2根管。在所有存在MB2根管的上颌第一磨牙（n = 67）中，53颗（79.1%）根管存在根尖周感染，5颗（7.5%）表现为牙周膜间隙增宽，而9颗（13.4%）无异常。
大多数病例中存在MB2根管，大多数未充填的MB2根管显示有根尖周透射区，对预后有直接影响。
