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上颌第一磨牙牙根及根管形态的评估:一项在日本人群中使用两种分类系统的锥形束计算机断层扫描研究。

Evaluation of root and root canal morphology in maxillary first molar teeth: A cone-beam computed tomography study using two classification systems in a Japanese population.

作者信息

Watanabe Satoshi, Yabumoto Sonoko, Ikeda Shota, Okiji Takashi

机构信息

Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, (Tokyo Medical and Dental University), Tokyo, Japan.

出版信息

J Dent Sci. 2025 Jul;20(3):1554-1561. doi: 10.1016/j.jds.2024.12.005. Epub 2024 Dec 14.

DOI:10.1016/j.jds.2024.12.005
PMID:40654430
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12254801/
Abstract

BACKGROUND/PURPOSE: Inadequate understanding of tooth morphology can lead to missing root canals and procedural errors during root canal treatment. This study assessed the root and root canal morphology of maxillary first molars in a Japanese population, employing two classification systems and utilizing cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

The study included CBCT scans of 833 maxillary first molars from 642 Japanese individuals aged 16-80 years. The evaluations used the Vertucci and Ahmed classification systems to assess root and root canal morphologies and fusions. Data were statistically analyzed based on gender and age using the chi-square test ( < 0.05).

RESULTS

Ninety-seven percent of maxillary first molars had three separate roots. The second mesiobuccal canal (MB2) was identified in 52.9 % of teeth. Six root types and 17 tooth types were identified with the Vertucci and Ahmed classifications, respectively. The most common configuration of the mesiobuccal root having the MB2 was Vertucci type IV (31.2 %) followed by type II (15.3 %). A higher occurrence of MB2 was noted among males (58.9 %) and individuals in their 21-40 years (56.8 %) ( < 0.05). Root fusion, root canal fusion, and C-shaped root canals, which were unclassifiable by the Vertucci classification, were identified in 2.8 %, 0.9 %, and 0.7 %, respectively.

CONCLUSION

Maxillary first molar in the Japanese population displayed notable anatomical variations, underscoring the importance of recognizing age- and gender-related anatomical characteristics. The Ahmed classification offered a more detailed depiction of morphological diversities, enhancing the understanding and treatment of complex root canal systems.

摘要

背景/目的:对牙齿形态的认识不足可能导致根管治疗过程中遗漏根管和操作失误。本研究采用两种分类系统并利用锥形束计算机断层扫描(CBCT)评估了日本人群上颌第一磨牙的牙根和根管形态。

材料与方法

本研究纳入了642名年龄在16 - 80岁的日本人的833颗上颌第一磨牙的CBCT扫描图像。评估采用韦尔图奇(Vertucci)和艾哈迈德(Ahmed)分类系统来评估牙根和根管形态以及融合情况。使用卡方检验(<0.05)对基于性别和年龄的数据进行统计学分析。

结果

97%的上颌第一磨牙有三根独立的牙根。在52.9%的牙齿中发现了第二近中颊根管(MB2)。分别用韦尔图奇和艾哈迈德分类法确定了六种牙根类型和十七种牙型。近中颊根伴有MB2的最常见形态是韦尔图奇IV型(31.2%),其次是II型(15.3%)。男性(58.9%)和21 - 40岁的个体(56.8%)中MB2的发生率较高(<0.05)。韦尔图奇分类法无法分类的牙根融合、根管融合和C形根管分别占2.8%、0.9%和0.7%。

结论

日本人群中的上颌第一磨牙表现出显著的解剖变异,凸显了认识年龄和性别相关解剖特征的重要性。艾哈迈德分类法对形态多样性的描述更为详细,有助于增强对复杂根管系统的理解和治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eed/12254801/f72aab0791ff/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eed/12254801/bad987f027b0/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eed/12254801/7b5924f97318/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eed/12254801/09b3cfcef13f/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eed/12254801/f72aab0791ff/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eed/12254801/bad987f027b0/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eed/12254801/7b5924f97318/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eed/12254801/09b3cfcef13f/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1eed/12254801/f72aab0791ff/gr4.jpg

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本文引用的文献

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J Dent Sci. 2025 Apr;20(2):927-935. doi: 10.1016/j.jds.2024.08.024. Epub 2024 Sep 8.
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Root canal morphology of anterior permanent teeth in Jordanian population using two classification systems: a cone-beam computed tomography study.使用两种分类系统对约旦人群的前恒牙根管形态进行锥形束 CT 研究。
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A New Methodology to Determine the Orifice for Root Canal Configurations in First Permanent Molar Root and Canal Morphologies Using Micro-Computed Tomography.
一种使用微型计算机断层扫描确定第一恒磨牙根管形态根管口的新方法
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