前磨牙C形根管诊断治疗.pdf

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1、临床口腔医学杂志2009年5月第25卷第5期JClinStomatol,Mar,2009,Vol.25,No.5·289·下颌前磨牙C形根管的诊断和治疗*12**方溢云，林正梅（1．佛山市第一人民医院口腔医学中心广东佛山528000；2．中山大学光华口腔医学院附属口腔医院牙体牙髓科广东广州510055）［摘要］目的：探讨下颌前磨牙C形根管的发现率及其诊治方法。方法：选取需要根管治疗的下颌前磨牙300个，拍摄术前正位和偏位X线牙片。多根管牙插诊断丝摄片。结合C形根管的诊断标准，诊断为C形根管的患牙，记录髓室底形态和X线影像类型。所有患牙

2、使用镍钛机动根管器械预备，侧方加压法充填根管。根据术前、术中和术后X线片评价根管预备和充填效果。结果：第一和第二前磨牙C形根管的发现率依次为5．56％和2．50％。髓室底以C2型多见，X线影像以尖部融合型多见。治疗中无根管堵塞等并发症的发生。根管充填效果，13例C形根管中有5例超充，8例恰充。结论：髓腔探察和插诊断丝拍片是诊断下颌前磨牙C形根管的有效方法。［关键词］下颌前磨牙；C形根管；根管治疗［中图分类号］R781.05［文献标识码］A［文章编号］1003－1634（2009）05-0289-03Thediagnosisandtre

3、atmentofmandibularpremolarswithC－shapedcanalsystem．FANGYi－yun1，LINZheng－mei2．1．DepartmentofStomatology，FoshanFirstPeople＇sHospital，GuangdongFoshan528000，China；2．Depat－mentofEndodontics，GuanghuaSchoolofStomatology，SunYat－senUniversity，GuangdongGuangzhou510055，China［Abstr

4、act］Objective：ToinvestigatethemorphologicalcharacteristicsofC－shapedcanalsysteminmandibularfirstpremolars．Method：Atotalof300mandibularfirstpremolarsweretreatedendodontically．Twopreoperativeradiographsweretakenrespectively，usingstraightprojectionandeccentricprojection．Af

5、teraccessopening，thefileswereplacedinthecanalsandtwootherradiographsweretaken．Therootcanalmorphologyofthepremolarswithc－shapedsystemwereclass－fiedandrecorded．TheteethwereshapedusingNiTirotaryinstrumentsandobturatedwithlateralcondensationmethod．Theefficiencyofpreparation

6、andobturationwasanalyzedwithradiographsbefore，duringandafteroperation．Result：Theinci－denceofc－shapedcanalsystemwas5．5％inmandibularfirstpremolarsand2．5％inmandibularsecondpremolars．TypeC2andthetypewhichcanalsmerciedinapicalwerethemostcommoninc－shapedsystemofmandibularprem

7、olars．Therewerenotransportation，andapicalblockageinallcases．In13casesofC－shapedcanalsystem，8teethwerefilledwell，5wereslightover－filling．Conclusion：ThemandibularfirstpremolarshadahighfrequencyC－shapedcanalsystem．UsingExploringandradiographswithfileisausefulwayinjudgingth

8、ecanalcategories．［Keywords］mandibularpremolar；C－shapedcanalsystem；rootcanaltreatment根管预备不充分可导致根管治疗失败。在根管预2治疗方法