国际口腔医学杂志 ›› 2017, Vol. 44 ›› Issue (3): 261-266.doi: 10.7518/gjkq.2017.03.003

• 牙体牙髓专栏 • 上一篇    下一篇

恒牙根尖区解剖结构对根管治疗的影响

黄晓想, 张茹, 侯本祥   

  1. 首都医科大学附属北京口腔医院牙体牙髓病科 北京 100050
  • 收稿日期:2016-09-22 修回日期:2017-02-12 出版日期:2017-05-01 发布日期:2017-05-01
  • 通讯作者: 侯本祥,教授,博士,Email:houbenxiang@gmail.com
  • 作者简介:黄晓想,住院医师,硕士,Email:taodabendan124@163.com
  • 基金资助:
    北京市医院管理局“青苗”计划专项经费(QML20151403); 北京市医院管理局临床医学发展专项经费(XMLX201301)

The effect of anatomy of apical zone of permanent teeth on root canal therapy

Huang Xiaoxiang, Zhang Ru, Hou Benxiang.   

  1. Dept. of Conservative Dentistry and Endodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
  • Received:2016-09-22 Revised:2017-02-12 Online:2017-05-01 Published:2017-05-01
  • Supported by:
    This study was supported by Beijing Municipal Administration of Hospitals’ Youth Programme(QML20151403) and Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Fonding Support(XMLX201301).

摘要: 根管治疗的目的是彻底清除根管内感染物质,并严密充填根管,从而预防或治愈根尖周病变。恒牙根尖区解剖结构复杂,形态多样的根尖孔、弯曲根管、侧副根管等会对根管治疗各步骤产生影响,增加治疗难度,影响治疗效果。本文就恒牙根尖区解剖结构对根管治疗影响的研究进展进行综述。

关键词: 根尖区, 解剖结构, 根管治疗

Abstract: The purpose of the root canal therapy is to eliminate the inspection and obtain a perfect obturation of the root canal, so that to prevent and cure the periapical lesions. Complex variation of the apical third, including the different kinds of the apical foramens, the curve of the root canal, high presence of the lateral canals et al, will influence the every step of the root canal therapy, increases the difficulty of it and affect the prognosis consequently. This review highlights the effect of anatomy of apical third of permanent teeth on root canal therapy.

Key words: apical zone of root canal, anatomy, root canal therapy

中图分类号: 

  • R781.05
[1] Song M, Kim HC, Lee W, et al. Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic micro-surgery[J]. J Endod, 2011, 37(11):1516-1519.
[2] Liu N, Li XJ, Liu N, et al. A micro-computed tomography study of the root canal morphology of the mandibular first premolar in a population from Southwestern China[J]. Clin Oral Investig, 2013, 17 (3):999-1007.
[3] Ricucci D, Siqueira JF. Fate of the tissue in lateral canals and apical ramifications in response to patho-logic conditions and treatment procedures[J]. J Endod, 2010, 36(1):1-15.
[4] Jorge KM, De Carvalho RF, Vieira VL, et al. Calcium hydroxide dressing influences the obturation of simulated lateral canals[J]. J Contemp Dent Pract, 2015, 16(6):468-473.
[5] Marceliano-Alves M, Alves FR, Mendes Dde M, et al. Micro-computed tomography analysis of the root canal morphology of palatal roots of maxillary first molars[J]. J Endod, 2016, 42(2):280-283.
[6] 唐晓琳, 王贤辐. 恒牙根尖解剖结构的显微观测及临床意义[J]. 华西口腔医学杂志, 2004, 22(4):344- 345.
Tang XL, Wang XF. Evaluation the clinical values of the anatomy of apical third of permanent teeth by stereomicroscope[J]. West Chin J Stomatol, 2004, 22(4):344-345.
[7] Dummer PM, Mcginn JH, Rees DG. The position and topography of the apical canal constriction and apical foramen[J]. Int Endod J, 1984, 17(4):192-198.
[8] Arora S, Tewari S. The morphology of the apical foramen in posterior teeth in a North Indian popula-tion[J]. Int Endod J, 2009, 42(10):930-939.
[9] Yang HB, Tian C, Li GJ, et al. A cone-beam com-puted tomography study of the root canal morpho-logy of mandibular first premolars and the location of root canal orifices and apical foramina in a Chinese subpopulation[J]. J Endod, 2013, 39(4):435-438.
[10] Ding JF, Gutmann JL, Fan B, et al. Investigation of apex locators and related morphological factors[J]. J Endod, 2010, 36(8):1399-1403.
[11] Ebrahim AK, Wadachi R, Suda H. Ex vivo evalua-tion of the ability of four different electronic apex locators to determine the working length in teeth with various foramen diameters[J]. Aust Dent J, 2006, 51(3):258-262.
[12] Herrera M, Abalos C, Planas AJ, et al. Influence of apical constriction diameter on Root ZX apex locator precision[J]. J Endod, 2007, 33(8):995-998.
[13] Herrera M, Ábalos C, Lucena C, et al. Critical diameter of apical foramen and of file size using the Root ZX apex locator: an in vitro study[J]. J Endod, 2011, 37(9):1306-1309.
[14] 程磊, 苏勤, 黄云霞. 根尖孔大小对Root ZX准确性影响的体外研究[J]. 华西口腔医学杂志, 2008, 26 (1):56-59.
Cheng L, Su Q, Huang YX. In vitro evaluation of correlation between the size of apical foramen and the accuracy of Root ZX[J]. West Chin J Stomatol, 2008, 26(1):56-59.
[15] Angerame D, De Biasi M, Marigo L, et al. Influence of simulated apical resorption following orthodontic treatment on working length determination: an in vitro study[J]. Eur J Paediatr Dent, 2014, 15(3):288- 292.
[16] Wu MK, R’oris A, Barkis D, et al. Prevalence and extent of long oval canals in the apical third[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2000, 89(6):739-743.
[17] Paqué F, Zehnder M, Marending M. Apical fit of initial K-files in maxillary molars assessed by micro-computed tomography[J]. Int Endod J, 2010, 43(4): 328-335.
[18] Wu MK, Barkis D, Roris A, et al. Does the first file to bind correspond to the diameter of the canal in the apical region[J]. Int Endod J, 2002, 35(3):264-267.
[19] 韩怡, 岳林, 张杰. 第一恒磨牙根尖孔解剖及其与初锉的关系[J]. 现代口腔医学杂志, 2007, 21(4): 363-365.
Han Y, Yue L, Zhang J. The relationship between the apical anatomy of first permanent molars and initial apical file[J]. J Modern Stomatol, 2007, 21(4): 363-365.
[20] Vera J, Arias A, Romero M. Dynamic movement of intracanal gas bubbles during cleaning and shaping procedures: the effect of maintaining apical patency on their presence in the middle and cervical thirds of human root canals—an in vivo study[J]. J Endod, 2012, 38(2):200-203.
[21] Hsieh YD, Gau CH, Kung Wu SF, et al. Dynamic recording of irrigating fluid distribution in root canals using thermal image analysis[J]. Int Endod J, 2007, 40(1):11-17.
[22] Sedgley CM, Nagel AC, Hall D, et al. Influence of irrigant needle depth in removing bioluminescent bacteria inoculated into instrumented root canals using real-time imaging in vitro [J]. Int Endod J, 2005, 38(2):97-104.
[23] Adorno CG, Yoshioka T, Suda H. Incidence of ac-cessory canals in Japanese anterior maxillary teeth following root canal filling ex vivo [J]. Int Endod J, 2010, 43(5):370-376.
[24] Villas-Bôas MH, Bernardineli N, Cavenago BC, et al. Micro-computed tomography study of the internal anatomy of mesial root canals of mandibular molars [J]. J Endod, 2011, 37(12):1682-1686.
[25] Weng XL, Yu SB, Zhao SL, et al. Root canal morphology of permanent maxillary teeth in the Han nationality in Chinese Guanzhong area: a new modi-fied root canal staining technique[J]. J Endod, 2009, 35(5):651-656.
[26] Sert S, Bayirli GS. Evaluation of the root canal con-figurations of the mandibular and maxillary permanent teeth by gender in the Turkish population[J]. J Endod, 2004, 30(6):391-398.
[27] Hülsmann M, Peters OA, Dummer PH. Mechanical preparation of root canals: shaping goals, techniques and means[J]. Endod Topics, 2005, 10(1):30-76.
[28] Ricucci D, Siqueira JF, Bate AL, et al. Histologic investigation of root canal-treated teeth with apical periodontitis: a retrospective study from twenty-four patients[J]. J Endod, 2009, 35(4):493-502.
[29] Burleson A, Nusstein J, Reader A, et al. The in vivo evaluation of hand/rotary/ultrasound instrumentation in necrotic, human mandibular molars[J]. J Endod, 2007, 33(7):782-787.
[30] Nair PN, Henry S, Cano V, et al. Microbial status of apical root canal system of human mandibular first molars with primary apical periodontitis after “one-visit” endodontic treatment[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2005, 99(2):231- 252.
[31] de Gregorio C, Estevez R, Cisneros R, et al. Effect of EDTA, sonic, and ultrasonic activation on the penetration of sodium hypochlorite into simulated lateral canals: an in vitro study[J]. J Endod, 2009, 35(6):891-895.
[32] Adorno CG, Fretes VR, Ortiz CP, et al. Comparison of two negative pressure systems and syringe irriga-tion for root canal irrigation: an ex vivo study[J]. Int Endod J, 2016, 49(2):174-183.
[33] Chandurkar A, Kalburge V, Kalburge J. Obturation of the radicular space[M]. Germany: Lambert Aca-demic Publishing, 2013:571-688.
[34] Gordon MP, Love RM, Chandler NP. An evaluation of .06 tapered gutta-percha cones for filling of .06 taper prepared curved root canals[J]. Int Endod J, 2005, 38(2):87-96.
[35] Gillen BM, Looney SW, Gu LS, et al. Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta-analysis[J]. J Endod, 2011, 37(7):895-902.
[36] Moeller L, Wenzel A, Wegge-Larsen AM, et al. Quality of root fillings performed with two root filling techniques. An in vitro study using micro-CT[J]. Acta Odontol Scand, 2013, 71(3/4):689-696.
[37] Xu T, Tay FR, Gutmann JL, et al. Micro-computed tomography assessment of apical accessory canal morphologies[J]. J Endod, 2016, 42(5):798-802.
[38] Venturi M, Di Lenarda R, Prati C, et al. An in vitro model to investigate filling of lateral canals[J]. J Endod, 2005, 31(12):877-881.
[39] Barthel CR, Zimmer S, Trope M. Relationship of radiologic and histologic signs of inflammation in human root-filled teeth[J]. J Endod, 2004, 30(2):75- 79.
[40] Weine FS. The enigma of the lateral canal[J]. Dent Clin North Am, 1984, 28(4):833-852.
[41] Nair PN. On the causes of persistent apical periodon-titis: a review[J]. Int Endod J, 2006, 39(4):249-281.
[42] Arnold M, Ricucci D, Siqueira JF. Infection in a complex network of apical ramifications as the cause of persistent apical periodontitis: a case report[J]. J Endod, 2013, 39(9):1179-1184.
[43] Ricucci D, Loghin S, Siqueira JF. Exuberant biofilm infection in a lateral canal as the cause of short-term endodontic treatment failure: report of a case[J]. J Endod, 2013, 39(5):712-718.
[44] Michelotto AL, Moura-Netto C, Araki AT, et al. Penetration of a resin-based filling material into lateral root canals and quality of obturation by dif-ferent techniques[J]. Braz Oral Res, 2015, 29(1):1-5.
[45] Estrela C, Bueno MR, Barletta FB, et al. Identification of apical and cervical curvature radius of human molars[J]. Braz Dent J, 2015, 26(4):351-356.
[46] 张文, 彭彬, 陈智, 等. 487颗下颌前牙根管的弯曲情况研究[J]. 口腔医学研究, 2005, 21(1):47-49.
Zhang W, Peng B, Chen Z, et al. Study of canal curvatures in 487 human mandibular anteriors[J]. J Oral Sci Res, 2005, 21(1):47-49.
[47] Ungerechts C, Bårdsen A, Fristad I. Instrument fra-cture in root canals-where, why, when and what? A study from a student clinic[J]. Int Endod J, 2014, 47 (2):183-190.
[48] Eleftheriadis GI, Lambrianidis TP. Technical quality of root canal treatment and detection of iatrogenic errors in an undergraduate dental clinic[J]. Int Endod J, 2005, 38(10):725-734.
[49] Freire LG, Gavini G, Cunha RS, et al. Assessing apical transportation in curved canals: comparison between cross-sections and micro-computed tomo-graphy[J]. Braz Oral Res, 2012, 26(3):222-227.
[50] Boutsioukis C, Gogos C, Verhaagen B, et al. The effect of apical preparation size on irrigant flow in root canals evaluated using an unsteady Computa-tional Fluid Dynamics model[J]. Int Endod J, 2010, 43(10):874-881.
[51] Peng L, Ye L, Tan H, et al. Outcome of root canal obturation by warm gutta-percha versus cold lateral condensation: a meta-analysis[J]. J Endod, 2007, 33(2):106-109.
[52] Celikten B, F Uzuntas C, I Orhan A, et al. Micro-CT assessment of the sealing ability of three root canal filling techniques[J]. J Oral Sci, 2015, 57(4):361- 366.
[53] Angerame D, De Biasi M, Pecci R, et al. Analysis of single point and continuous wave of condensation root filling techniques by micro-computed tomo-graphy[J]. Ann Ist Super Sanita, 2012, 48(1):35-41.
[54] De-Deus G, Murad C, Paciornik S, et al. The effect of the canal-filled area on the bacterial leakage of oval-shaped canals[J]. Int Endod J, 2008, 41(3): 183-190.
[55] Goldberg F, Artaza LP, De S. Influence of calcium hydroxide dressing on the obturation of simulated lateral canals[J]. J Endod, 2002, 28(2):99-101.
[56] 钟素兰, 尹仕海, 陈朝辉, 等. Micro-CT评价不同弯曲度根管预备后根尖偏移的实验研究[J]. 国际口腔医学杂志, 2009, 36(6):657-660.
Zhong SL, Yin SH, Chen ZH, et al. Evaluation of apical transportation after shaping different curved root canals by Micro-CT[J]. Inter J Stomatol, 2009, 36(6):657-660.
[57] Kapalas A, Lambrianidis T. Factors associated with root canal ledging during instrumentation[J]. Endod Dent Traumatol, 2000, 16(5):229-231.
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[3] 王昆润. 咀嚼口香糖对牙周组织微循环的影响[J]. 国际口腔医学杂志, 1999, 26(06): .
[4] 宋红. 青少年牙周炎外周血分叶核粒细胞的趋化功能[J]. 国际口腔医学杂志, 1999, 26(06): .
[5] 高卫民,李幸红. 发达国家牙医学院口腔种植学教学现状[J]. 国际口腔医学杂志, 1999, 26(06): .
[6] 侯锐. 正畸患者釉白斑损害的纵向激光荧光研究[J]. 国际口腔医学杂志, 1999, 26(05): .
[7] 轩东英. 不同赋形剂对氢氧化钙抗菌效果的影响[J]. 国际口腔医学杂志, 1999, 26(05): .
[8] 房兵. 唇腭裂新生儿前颌骨矫正方法及对上颌骨生长发育的影响[J]. 国际口腔医学杂志, 1999, 26(05): .
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