国际口腔医学杂志 ›› 2017, Vol. 44 ›› Issue (3): 279-283.doi: 10.7518/gjkq.2017.03.006

• 牙体牙髓专栏 • 上一篇    下一篇

钙化根管的诊断与治疗

吴杉杉, 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:2016-10-22 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:吴杉杉,硕士,Email:lucky533@126.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)

Diagnosis and therapy for calcified root canals

Wu Shanshan, Zhang Ru, Hou Benxiang.   

  1. Dept. of Conservative Dentistry and Endodontics, Beijing Stomatological Hospital, Capital Medical University, Beijing 100050, China
  • Received:2016-10-22 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: 牙髓钙化是导致根管预备困难的重要原因之一。病因尚不清楚,主要有年龄、外伤和微生物等因素。诊断牙髓钙化的主要手段有X线片、锥形束CT、显微镜观察以及组织切片等方法,临床上将手术显微镜和超声技术结合处理牙髓钙化的根管,可以提高根管治疗的成功率。本文对牙髓钙化的病因、影响因素、诊断方法和处理措施等研究进展进行综述。

关键词: 牙髓钙化, 牙髓病, 锥形束CT, 根管预备

Abstract: Pulp calcification is one of important factors that make root canal preparation difficult. The pathogency is not clear. Many factors could promote its progression, including age, trauma and microorganisms and so on. Diagnosis methods usually include X-ray radiography, cone beam computer tomography, observation under an operative microscope and histologic sections. Applying an operative microscope and ultrasonic together in dealing with calcified canals during root canal treatment could raise the success rate. This paper reviews the causes, influence factors, diagnosis and treatment methods of pulp calcification.

Key words: pulp calcification, pulposis, cone beam computer tomography, root canal preparation

中图分类号: 

  • R781.05
[1] Şener S, Cobankara FK, Akgünlü F. Calcifications of the pulp chamber: prevalence and implicated fac-tors[J]. Clin Oral Investig, 2009, 13(2):209-215.
[2] Tang L, Sun TQ, Gao XJ, et al. Tooth anatomy risk factors influencing root canal working length ac-cessibility[J]. Int J Oral Sci, 2011, 3(3):135-140.
[3] Negishi J, Kawanami M, Ogami E. Risk analysis of failure of root canal treatment for teeth with inac-cessible apical constriction[J]. J Dent, 2005, 33(5): 399-404.
[4] 毛学理, 凌均棨, 林正梅, 等. 锥形束CT结合显微超声技术处理钙化根管的效果评价[J]. 中华口腔医学研究杂志(电子版), 2011, 5(6):594-599.
Mao XL, Ling JQ, Lin ZM, et al. Evaluation of cone beam computed tomography combining with dental microscopy and ultrasonic instrument in the treat-ment of canal calcification[J]. Chin J Stomatol Res (Electr Ed), 2011, 5(6):594-599.
[5] Arys A, Philippart C, Dourov N. Microradiography and light microscopy of mineralization in the pulp of undemineralized human primary molars[J]. J Oral Pathol Med, 1993, 22(2):49-53.
[6] Tjäderhane L, Carrilho MR, Breschi L, et al. Dentin basic structure and composition—an overview[J]. Endod Topics, 2009, 20(1):3-29.
[7] Nanjannawar GS, Vagarali H, Nanjannawar LG, et al. Pulp stone—an endodontic challenge: successful retrieval of exceptionally long pulp stones measuring 14 and 9.5 mm from the palatal roots of maxillary molars[J]. J Contemp Dent Pract, 2012, 13(5):719- 722.
[8] McCabe PS, Dummer PM. Pulp canal obliteration: an endodontic diagnosis and treatment challenge[J]. Int Endod J, 2012, 45(2):177-197.
[9] Tomczyk J, Komarnitki J, Zalewska M, et al. The prevalence of pulp stones in historical populations from the middle Euphrates valley(Syria)[J]. Am J Phys Anthropol, 2014, 153(1):103-115.
[10] Mass E, Zilberman U. Long-term radiologic pulp evaluation after partial pulpotomy in young per-manent molars[J]. Quintessence Int, 2011, 42(7): 547-554.
[11] Bogen G, Kim JS, Bakland LK. Direct pulp capping with mineral trioxide aggregate: an observational study[J]. J Am Dent Assoc, 2008, 139(3):305-315.
[12] Witherspoon DE. Vital pulp therapy with new materials: new directions and treatment perspec- tives—permanent teeth[J]. Pediatr Dent, 2008, 30(3):220-224.
[13] Bains SK, Bhatia A, Singh HP, et al. Prevalence of coronal pulp stones and its relation with systemic disorders in northern Indian central punjabi popu-lation[J]. ISRN Dent, 2014, 2014:617590.
[14] Çolak H, Çelebi AA, Hamidi MM, et al. Assessment of the prevalence of pulp stones in a sample of Turkish Central Anatolian population[J]. Sci World J, 2012, 2012:804278.
[15] Gulsahi A, Cebeci AI, Ozden S. A radiographic as-sessment of the prevalence of pulp stones in a group of Turkish dental patients[J]. Int Endod J, 2009, 42 (8):735-739.
[16] Nayak M, Kumar J, Prasad LK. A radiographic correlation between systemic disorders and pulp stones[J]. Indian J Dent Res, 2010, 21(3):369-373.
[17] Talla HV, Kommineni NK, Yalamancheli S, et al. A study on pulp stones in a group of the population in Andhra Pradesh, India: An institutional study[J]. J Conserv Dent, 2014, 17(2): 111-114.
[18] Sisman Y, Aktan AM, Tarim-Ertas E, et al. The prevalence of pulp stones in a Turkish population. A radiographic survey[J]. Med Oral Patol Oral Cir Bucal, 2012, 17(2):e212-e217.
[19] Ranjitkar S, Taylor JA, Townsend GC. A radio-graphic assessment of the prevalence of pulp stones in Australians[J]. Aust Dent J, 2002, 47(1):36-40.
[20] Park JW, Lee JK, Ha BH, et al. Three-dimensional analysis of maxillary first molar mesiobuccal root canal configuration and curvature using micro-com-puted tomography[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2009, 108(3):437-442.
[21] Yoshioka T, Kikuchi I, Fukumoto Y, et al. Detection of the second mesiobuccal canal in mesiobuccal roots of maxillary molar teeth ex vivo [J]. Int Endod J, 2005, 38(2):124-128.
[22] 黄定明, 谭红, 张富华, 等. 下颌恒切牙根管形态的影像学研究[J]. 牙体牙髓牙周病学杂志, 2006, 16 (8):434-437.
Huang DM, Tan H, Zhang FH, et al. Anatomy and morphology of root canal of mandibular permanent incisors of Chinese in radiography[J]. Chin J Con-serv Dent, 2006, 16(8):434-437.
[23] Zeng J, Yang F, Zhang W, et al. Association between dental pulp stones and calcifying nanoparticles[J]. Int J Nanomedicine, 2011, 6:109-118.
[24] Yang F, Zeng J, Zhang W, et al. Evaluation of the interaction between calcifying nanoparticles and human dental pulp cells: a preliminary investiga-tion[J]. Int J Nanomedicine, 2010, 6:13-18.
[25] Marwaha M, Chopra R, Chaudhuri P, et al. Multiple pulp stones in primary and developing permanent dentition: a report of 4 cases[J]. Case Rep Dent, 2012, 2012:408045.
[26] Parekh S, Kyriazidou A, Bloch-Zupan A, et al. Multiple pulp stones and shortened roots of unknown etiology[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2006, 101(6):e139-e142.
[27] Zuza EP, Carrareto AL, Lia RC, et al. Histopatho-logical features of dental pulp in teeth with different levels of chronic periodontitis severity[J]. ISRN Dent, 2012, 2012:271350.
[28] Horsley SH, Beckstrom B, Clark SJ, et al. Prevalence of carotid and pulp calcifications: a correlation using digital panoramic radiographs[J]. Int J Comput Assist Radiol Surg, 2009, 4(2):169-173.
[29] Ee J, Fayad MI, Johnson BR. Comparison of endo-dontic diagnosis and treatment planning decisions using cone-beam volumetric tomography versus periapical radiography[J]. J Endod, 2014, 40(7):910- 916.
[30] Ball RL, Barbizam JV, Cohenca N. Intraoperative endodontic applications of cone-beam computed tomography[J]. J Endod, 2013, 39(4):548-557.
[31] 牛晓枫, 李桂红. 锥体束CT结合显微超声技术在治疗上颌第一磨牙钙化MB2根管中的应用研究[J]. 现代口腔医学杂志, 2010, 24(6):412-414.
Niu XF, Li GH. Clinical application of cone beam CT combined with dental operatingmicroscope and ultrasonic instruments in negotiation of calcified MB2 canals in the maxillary first molars[J]. J Mo-dern Stomatol, 2010, 24(6):412-414.
[32] Wu D, Shi W, Wu J, et al. The clinical treatment of complicated root canal therapy with the aid of a den-tal operating microscope[J]. Int Dent J, 2011, 61(5): 261-266.
[1] 黄昕,许晓杰,张荣华,赵媛. 牙髓钙化及其治疗方法的研究进展[J]. 国际口腔医学杂志, 2024, 51(1): 82-90.
[2] 杨雨楠,刘鹏,王虎,游梦. 上颌窦黏膜增厚的锥形束CT影像分析[J]. 国际口腔医学杂志, 2023, 50(3): 302-307.
[3] 吴文智,冯达兴,陈垂壮,周丽鹃. 海口地区下颌第一恒磨牙近中中央根管发生率及相关因素[J]. 国际口腔医学杂志, 2022, 49(4): 420-425.
[4] 叶泽林,刘璐,龙虎,游梦. 弯曲前牙的影像评价及治疗的研究进展[J]. 国际口腔医学杂志, 2022, 49(2): 173-181.
[5] 田浩楠,林敏,谢丛蔓,任嫒姝. 上颌腭侧阻生尖牙与寰椎后桥相关性的锥形束CT研究[J]. 国际口腔医学杂志, 2021, 48(5): 536-540.
[6] 施丹妮,杨鑫,吴建勇. 锥形束CT三维头影测量参考坐标系的研究进展[J]. 国际口腔医学杂志, 2021, 48(4): 398-404.
[7] 丁张帆,郭陟永,苗诚,李春洁,宣鸣,王晓毅,张壮. 基于锥形束CT的三维可视化技术在颌骨囊性病变手术中的应用[J]. 国际口腔医学杂志, 2021, 48(2): 180-186.
[8] 王奔,许喆桢,韦曦. 数字化微创技术在牙髓根尖周病学中的应用与进展[J]. 国际口腔医学杂志, 2021, 48(1): 110-118.
[9] 唐蓓,赵文俊,王虎,郑广宁,游梦. 根管超填导致下牙槽神经损伤2例[J]. 国际口腔医学杂志, 2020, 47(3): 293-296.
[10] 章婷婷,胡常红,彭燕,周文翘,张慧聪,刘蝶. 300例不同年龄段有牙颌人群上唇软组织侧貌的锥形束CT三维测量分析[J]. 国际口腔医学杂志, 2020, 47(2): 182-188.
[11] 王春林,刘从华,宋思吟,周丽淑,林丽佳. 运用锥形束CT诊断上下颌横向发育不调的研究进展[J]. 国际口腔医学杂志, 2020, 47(1): 121-124.
[12] 黎祺, 黄少宏. 岭南地区广府民系人群下颌第二恒磨牙牙根和根管形态的锥形束CT研究[J]. 国际口腔医学杂志, 2019, 46(6): 640-649.
[13] 刘彤曦,柯星,杨健. 磁共振成像及其在牙体牙髓专业中的应用[J]. 国际口腔医学杂志, 2019, 46(6): 693-698.
[14] 卢妍,吴宾,闫卉. 4种根管预备系统根尖推出物和冠方带出物的比较研究[J]. 国际口腔医学杂志, 2019, 46(5): 503-508.
[15] 曹焜,李家锋,孙玉华,鲍强,卢秋宁,唐巍. 下颌下窝的锥形束CT影像分析[J]. 国际口腔医学杂志, 2019, 46(2): 209-212.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] 王昆润. 修补颌骨缺损的新型生物学相容材料[J]. 国际口腔医学杂志, 1999, 26(06): .
[2] 陆加梅. 不可复性关节盘移位患者术前张口度与关节镜术后疗效的相关性[J]. 国际口腔医学杂志, 1999, 26(06): .
[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): .
[9] 杨美祥. 前牙厚度在预测上下颌牙量协调性中的作用[J]. 国际口腔医学杂志, 1999, 26(04): .
[10] 赵艳丽. 手术刀、电凝、CO_2和KTP激光对大鼠舌部创口的作用[J]. 国际口腔医学杂志, 1999, 26(04): .