Department of Pediatric Dentistry, Faculty of Dental Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria.
Department of Dental Public Health, Faculty of Dental Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria.
J Clin Pediatr Dent. 2024 May;48(3):139-145. doi: 10.22514/jocpd.2024.067. Epub 2024 May 3.
The endodontic treatment of immature permanent teeth with necrotic pulp is a significant clinical challenge. The success of regenerative endodontic procedure is highly dependent on disinfection of the root canal and an accurate anatomical knowledge of the root canal. The aim of this study was to use micro-computed tomography (micro-CT) analysis to investigate the configuration of root canals in the upper permanent third maxillary molars with incomplete root development in their coronal, apical and middle third portions. Thirty immature third permanent maxillary molars were scanned using a micro-CT system. Then, we measured the diameters and areas of the root canal in the coronal, middle and apical third of the roots. The ratio between the long and short diameter of each root canal was then calculated and the canals were divided into several groups: round, oval, long oval, flat and irregular. The round configuration was not observed in the distobuccal and mesiobuccal roots in any of their anatomical regions. Oval and long oval canals predominated in the distobuccal root. The greatest variations were observed in the mesiobuccal root, with the ribbon-shaped canal predominating in the middle region and an irregular shape in the apical region. In the coronal region of the palatal canal, the round configuration predominated; in the middle third, we observed an almost equivalent distribution between round and oval configurations; apically, the oval shape predominated. In conclusion, we observed significant complexity and variation in the morphology and configuration of root canals in immature permanent molars, thus generating additional obstacles for the success of regenerative endodontics.
牙髓坏死后的年轻恒牙的根管治疗是一个重大的临床挑战。再生性根管治疗程序的成功高度依赖于根管的消毒和对根管解剖结构的准确了解。本研究旨在使用微计算机断层扫描（micro-CT）分析来研究上颌第三磨牙未完全发育的恒磨牙的根管形态，包括牙冠、根尖和中部。使用 micro-CT 系统对 30 颗未成熟的第三恒磨牙进行扫描。然后，我们测量了根尖 1/3、根中 1/3 和牙冠 1/3 处的根管直径和面积。然后计算每个根管的长径与短径的比值，并将根管分为几类：圆形、椭圆形、长椭圆形、扁形和不规则形。在任何解剖区域，远颊根和近颊根都没有观察到圆形根管。椭圆形和长椭圆形根管在远颊根中占主导地位。变化最大的是近颊根，在中部区域以带状根管为主，在根尖区域以不规则形状为主。腭侧根管在牙冠区域以圆形为主；在根中 1/3 处，我们观察到圆形和椭圆形的分布几乎相等；在根尖 1/3 处，椭圆形占主导地位。总之，我们观察到未成熟恒磨牙的根管形态和结构存在显著的复杂性和变异性，这为再生性根管治疗的成功带来了额外的障碍。
