国际口腔医学杂志 ›› 2019, Vol. 46 ›› Issue (5): 509-515.doi: 10.7518/gjkq.2019063

• 牙体牙髓专栏 • 上一篇    下一篇

牛牙症的诊断与治疗

冷沙,黄定明(),高原,张岚,徐玮哲,傅裕杰   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院牙体牙髓病科 成都 610041
  • 收稿日期:2018-09-22 修回日期:2019-04-05 出版日期:2019-09-01 发布日期:2019-09-10
  • 通讯作者: 黄定明 E-mail:dingminghuang@163.com
  • 作者简介:冷沙,硕士,Email: 1074110240@qq.com
  • 基金资助:
    四川省科技支撑计划(2017JY0068)

Diagnosis and treatment of taurodontism

Leng Sha,Huang Dingming(),Gao Yuan,Zhang Lan,Xu Weizhe,Fu Yujie   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2018-09-22 Revised:2019-04-05 Online:2019-09-01 Published:2019-09-10
  • Contact: Dingming Huang E-mail:dingminghuang@163.com
  • Supported by:
    This study was supported by Science & Technology Support Program of Sichuan Province(2017JY0068)

摘要:

掌握根管形态至关重要,利于患牙根管治疗的清理、成形及严密充填。但牙齿的发生发育受遗传因素的调控和后天因素的影响。牛牙症是一种少见的、以髓腔增大为主要特征的牙齿形态变异,因髓室底低,根分叉移向根尖段,根管数目变异,导致根管治疗难度极高,预后不确切,增加临床诊治难度,故牛牙症的诊断和治疗非常重要。本文就牛牙症的发生机制及发生率、诊断分型和鉴别诊断、治疗原则及预后,进行总结归纳,以期能帮助临床医生诊治此类疾病。

关键词: 髓腔形态变异, 牛牙症, Shifman诊断标准, 牛牙症指数

Abstract:

Understanding the root-canal system is vital and benefits canal cleanliness, shape, and block when performing root canal treatment. However, tooth genesis and development are regulated by genes and affected by the environment. Taurodontism, a rare tooth anomaly, is featured with enlarged pulp chamber, apical displacement of the pulp floor, root bifurcation, and variations in root canal. Dealing with this disease through root canal treatment is challenging and prognosis is uncertain. Thus, taurodontism diagnosis and treatment are important. This article focuses on taurodontism pathogenesis, diagnosis, classification, differential diagnosis, treatment, and prognosis and summarizes some views for dentists.

Key words: canal anomaly, taurodontism, Shifman’s diagnostic criteria;, taurodontic index

中图分类号: 

  • R781.05

图 1

牛牙症家庭聚集现象A:患儿74、84为牛牙症;B:患儿哥哥84、85为牛牙症;C:患儿姐姐84为牛牙症;D:患儿母亲46为牛牙症。"

图 2

Shifman诊断标准当AB/AC≥0.2,BD>2.5 mm时,即可诊断为牛牙症。"

图 3

牛牙症分型 a:低度牛牙症:髓室中等程度向根尖延伸;b:中度牛牙症:髓室大幅度向根尖延伸,但存在根分叉,牙根独立;c:高度牛牙症:髓室呈棱柱状或圆柱状,延伸至根尖处,无明显根分叉。"

图 4

TIa:TI=0~19.9,为犬牙状牛牙症;b:TI=20~29.9,为轻度牛牙症;c:TI=30~39.9,为中度牛牙症;d:TI=40~75,为重度牛牙症。"

图 5

牛牙症的临床诊治路径"

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