The aims of the study were to investigate the incidence of C-shaped root canal systems in mandibular second molars in a native Chinese population using radiography and clinical examination under microscope and to comp...The aims of the study were to investigate the incidence of C-shaped root canal systems in mandibular second molars in a native Chinese population using radiography and clinical examination under microscope and to compare the relative efficacies of these methods. For the recognition of C-shaped root canal system, 1 146 mandibular second molars were selected and examined. Teeth with C-shaped canal systems were categorized by using the radiographic classification criteria and the modified Melton＇s method. C-shaped canals were identified in 397 （34.64%） mandibular second molars by radiography （type I, 31.23%; type II, 38.29%; type III, 30.48%）. Clinical examination showed that 449 （39.18%） cases exhibited C-shaped canal systems （C1, 22.94%; C2, 48.11%; C3a, 15.59%; C3b, 13.36%）. As for the result of the radiographic and clinical combined examination, C-shaped root canals were found in 473 （41.27%） mandibular second molars （C1, 21.78%; C2, 45.67%; C3a, 16.70%; C3b, 15.86%）. The incidence of C-shaped root canal diagnosed by radiographic method was statistically different from that by clinical examination and the combined examination （P〈O.05）. The study indicated a high incidence of C-shaped canal system in a Chinese population. The combination of microscopic and radiographic examination is an effective method in identifying the C-shaped root canal system.展开更多
BACKGROUND The incidence rate of severely curved root canals in mandibular molars is low,and the root canal treatment of mandibular molars with this aberrant canal anatomy may be technically challenging.CASE SUMMARY A...BACKGROUND The incidence rate of severely curved root canals in mandibular molars is low,and the root canal treatment of mandibular molars with this aberrant canal anatomy may be technically challenging.CASE SUMMARY A 26-year-old Chinese female patient presented with intermittent and occlusal pain in the left mandibular second molar.The patient had undergone filling restoration for caries before endodontic consultation.With the aid of cone beam computed tomography(CBCT),a large periapical radiolucency was observed,and curved root canals in a mandibular second molar were confirmed,depicting a severe and curved distolingual root.Nonsurgical treatments,including novel individualized preparation skills and techniques and the use of bioceramic materials as an apical barrier,were performed,and complete healing of the periapical lesion and a satisfactory effect were achieved.CONCLUSION A case of severely curved root canals in a mandibular second molar was successfully treated and are reported herein.The complex anatomy of the tooth and the postoperative effect were also evaluated via the three-dimensional reconstruction of CBCT images,which accurately identified the aberrant canal morphology.New devices and biomaterial applications combined with novel synthesis techniques can increase the success rate of intractable endodontic treatment.展开更多
Middle-mesial canals in mandibular molars are present in the population depending on age, sex and ethnicity. However, limited literature alludes to its prevalence. Troughing procedures may enhance identification, clea...Middle-mesial canals in mandibular molars are present in the population depending on age, sex and ethnicity. However, limited literature alludes to its prevalence. Troughing procedures may enhance identification, cleaning and shaping. This case report expresses the recognition and management of middle-mesial canal in a mandibular second molar of 24 years old Hispanic-Latino male.展开更多
Kissing molars (KMs) is a condition of occlusal molar surfaces in a single follicular space with roots extending in opposite directions. Here, we have reported a case of KMs in a 58-year-old woman. The patient complai...Kissing molars (KMs) is a condition of occlusal molar surfaces in a single follicular space with roots extending in opposite directions. Here, we have reported a case of KMs in a 58-year-old woman. The patient complained of pain in the right mandibular molar region and was diagnosed with KMs consisting of the right mandibular second and third molars. Because of the patient’s pain having subsided at the time of the visit and her unwillingness to undergo tooth extraction, the patient was followed up. KMs is classified into three classes (I-III) and is either true-KMs or pseudo-KMs and presents with or without cystic variants of dental follicles. The presents as true-KMs class II without a cystic variant. With reference to the literature and based on our analysis, the mean age of patients affected by this specific case of KMs is 31.7 years and unilateral KMs is relatively more common (85.7%). Histopathological findings of dentigerous cysts are more often indicated (42.9%). The treatment policy for KMs should therefore be based on the classification of KMs. Importantly, the focus should be on preserving the first and second molars as much as possible. The treatment approach, such as the employment of surgical removal or orthodontics, should be determined by considering the associated factors such as the crowns, tissues, and age of the patient.展开更多
目的:观察下颌阻生第三磨牙(impacted mandibular third molars,IM3Ms)拔除术后的自然转归及对邻近下颌第二磨牙(mandibular second molars,M2Ms)的影响。方法:选择下颌第三磨牙骨埋伏阻生的患者34例(51颗IM3Ms),使用超声骨刀、气动涡...目的:观察下颌阻生第三磨牙(impacted mandibular third molars,IM3Ms)拔除术后的自然转归及对邻近下颌第二磨牙(mandibular second molars,M2Ms)的影响。方法:选择下颌第三磨牙骨埋伏阻生的患者34例(51颗IM3Ms),使用超声骨刀、气动涡轮手机拔除患牙,分别于术前、术后1周及术后6个月随访,观察术后反应及M2Ms远中骨缺损情况。比较手术前后M2Ms远中骨缺损深度,并分析其影响因素。采用SPSS 29.0软件包对数据进行统计学分析。结果:术前M2Ms远中骨高度未见明显缺损,但拔除IM3Ms时,由于去骨拔牙等操作产生骨缺损。术后6个月,骨高度虽有所恢复,骨缺损率减少,但未达到术前水平。IM3Ms埋伏阻生深度是恢复率的主要影响因素。探诊深度较术前显著增加。术后24 h内患者疼痛感较重,术后1周缓解,但仍存在轻度开口受限及面部肿胀。拔除IM3Ms对患者日常生活、情绪、工作、睡眠影响较小。结论:下颌第三磨牙拔除术后,邻近第二磨牙远中骨高度部分恢复,但未达到术前水平。拔牙手术中需采取更加精细的手术技巧,以减少对邻近牙和骨组织的影响。同时,拔除IM3Ms后应给予镇痛药物,加强卫生宣教,提高患者术后舒适度。展开更多
目的:评估牙根先脱位法拔除下颌骨埋伏第三磨牙(impacted lower third molar,ILTM)对邻近第二磨牙(mandibular second molar,M2M)远中成骨效果、牙髓状态和牙根外吸收(external root resorption,ERR)进展的影响。方法:选择2023年1月—2...目的:评估牙根先脱位法拔除下颌骨埋伏第三磨牙(impacted lower third molar,ILTM)对邻近第二磨牙(mandibular second molar,M2M)远中成骨效果、牙髓状态和牙根外吸收(external root resorption,ERR)进展的影响。方法:选择2023年1月—2023年10月于新疆医科大学第一附属医院进行ILTM拔除的患者64例,其中,32例采用牙根先脱位法拔除ILTM(实验组),32例采用牙冠先脱位法拔除ILTM(对照组)。术前、术后记录M2M松动度、牙髓状态、ERR情况、术后疼痛视觉模拟评分(VAS),术后3、6个月拍摄CBCT,测量M2M骨缺损深度、M2M骨高度、骨高度百分比和骨灰度等指标。采用SPSS 26.0软件包对数据进行统计学分析。结果:实验组术后第3天疼痛VAS评分显著低于对照组(P<0.05),手术时间、M2M牙髓活力和松动度两组均无显著差异(P>0.05);实验组去骨量显著少于对照组(P<0.05)。实验组术后即刻近中颊侧、远中舌侧PD显著低于对照组(P<0.05)。不同程度的ERR中,实验组术后3个月和6个月骨缺损深度、骨高度、骨高度百分比和骨灰度显著低于对照组(P<0.05)。不同阻生类型的2组术后骨缺损深度、骨高度、骨高度百分比和骨灰度比较,差异有统计学意义(P<0.05)。阻生深度与ERR严重程度比较,差异无统计学意义(P>0.05)。所有患者术后均未出现感染和神经损伤等并发症。结论:牙根先脱位法拔除ILTM对M2M远中成骨效果具有一定引导作用,对M2M远中牙周健康改善和术后反应均有效果。展开更多
目的 利用锥形束CT(cone beam computed technology,CBCT)分析下颌阻生第三磨牙(mandibular third molar,MTM)对第二磨牙(mandibular second molar,MSM)不同部位牙槽骨的影响,为临床MTM的拔除指征及MSM的诊断、治疗及预后提供理论依据...目的 利用锥形束CT(cone beam computed technology,CBCT)分析下颌阻生第三磨牙(mandibular third molar,MTM)对第二磨牙(mandibular second molar,MSM)不同部位牙槽骨的影响,为临床MTM的拔除指征及MSM的诊断、治疗及预后提供理论依据。方法 收集山西省人民医院口腔中心CBCT数据库中随机抽取18岁以上500例阻生MTM的CBCT图像,根据阻生深度及阻生角度分别确定PG及Winter分类,测量MTM与MSM釉牙骨质界之间(CEJ)的距离及第二磨牙颊侧、舌侧、近中、远中牙槽骨吸收的距离。采用Friedman秩和检验比较颊、舌、近中、远中牙槽骨吸收;采用非参数Kruskal Wallis检验、Mann-Whitney U检验分析不同阻生类型间牙槽骨吸收的差异;采用Spearman秩相关及多元线性回归分析各因素与牙槽骨吸收最大侧的关系。结果 远中牙槽骨吸收距离(distal alveolar bone loss of mandibular second molar,MSM-DBL)高于颊侧、舌侧及近中。在Winter分类中,牙槽骨吸收距离水平组最大,近中组次之,垂直组和远中组最小;在PG分类中,从低位、中位到高位牙槽骨吸收距离逐渐降低(P<0.001)。CEJ距离、阻生角度(11°~100°)以及阻生深度均为MSM-DBL的独立危险因素,前二者与MSM-DBL呈正相关(P<0.05)。本研究人群中,MSM-DBL男性高于女性(P<0.05),年龄与MSM-DBL不存在相关性(P>0.05)。结论 阻生MTM对MSM-DBL影响最大;CEJ距离、阻生角度、阻生深度、性别为MSM-DBL的影响因素。展开更多
基金supported by the grant from the Independent Innovation Foundation of Shandong University of China (No. 2011JC019)the grant of Science and Technique Development Foundation of Shandong province(2010G0020230)
文摘The aims of the study were to investigate the incidence of C-shaped root canal systems in mandibular second molars in a native Chinese population using radiography and clinical examination under microscope and to compare the relative efficacies of these methods. For the recognition of C-shaped root canal system, 1 146 mandibular second molars were selected and examined. Teeth with C-shaped canal systems were categorized by using the radiographic classification criteria and the modified Melton＇s method. C-shaped canals were identified in 397 （34.64%） mandibular second molars by radiography （type I, 31.23%; type II, 38.29%; type III, 30.48%）. Clinical examination showed that 449 （39.18%） cases exhibited C-shaped canal systems （C1, 22.94%; C2, 48.11%; C3a, 15.59%; C3b, 13.36%）. As for the result of the radiographic and clinical combined examination, C-shaped root canals were found in 473 （41.27%） mandibular second molars （C1, 21.78%; C2, 45.67%; C3a, 16.70%; C3b, 15.86%）. The incidence of C-shaped root canal diagnosed by radiographic method was statistically different from that by clinical examination and the combined examination （P〈O.05）. The study indicated a high incidence of C-shaped canal system in a Chinese population. The combination of microscopic and radiographic examination is an effective method in identifying the C-shaped root canal system.
基金Supported by Natural Science Foundation of Hunan Province,No.S2021JJQNJJ1682Changsha Municipal Natural Science Foundation,No.kq 2014215.
文摘BACKGROUND The incidence rate of severely curved root canals in mandibular molars is low,and the root canal treatment of mandibular molars with this aberrant canal anatomy may be technically challenging.CASE SUMMARY A 26-year-old Chinese female patient presented with intermittent and occlusal pain in the left mandibular second molar.The patient had undergone filling restoration for caries before endodontic consultation.With the aid of cone beam computed tomography(CBCT),a large periapical radiolucency was observed,and curved root canals in a mandibular second molar were confirmed,depicting a severe and curved distolingual root.Nonsurgical treatments,including novel individualized preparation skills and techniques and the use of bioceramic materials as an apical barrier,were performed,and complete healing of the periapical lesion and a satisfactory effect were achieved.CONCLUSION A case of severely curved root canals in a mandibular second molar was successfully treated and are reported herein.The complex anatomy of the tooth and the postoperative effect were also evaluated via the three-dimensional reconstruction of CBCT images,which accurately identified the aberrant canal morphology.New devices and biomaterial applications combined with novel synthesis techniques can increase the success rate of intractable endodontic treatment.
文摘Middle-mesial canals in mandibular molars are present in the population depending on age, sex and ethnicity. However, limited literature alludes to its prevalence. Troughing procedures may enhance identification, cleaning and shaping. This case report expresses the recognition and management of middle-mesial canal in a mandibular second molar of 24 years old Hispanic-Latino male.
文摘Kissing molars (KMs) is a condition of occlusal molar surfaces in a single follicular space with roots extending in opposite directions. Here, we have reported a case of KMs in a 58-year-old woman. The patient complained of pain in the right mandibular molar region and was diagnosed with KMs consisting of the right mandibular second and third molars. Because of the patient’s pain having subsided at the time of the visit and her unwillingness to undergo tooth extraction, the patient was followed up. KMs is classified into three classes (I-III) and is either true-KMs or pseudo-KMs and presents with or without cystic variants of dental follicles. The presents as true-KMs class II without a cystic variant. With reference to the literature and based on our analysis, the mean age of patients affected by this specific case of KMs is 31.7 years and unilateral KMs is relatively more common (85.7%). Histopathological findings of dentigerous cysts are more often indicated (42.9%). The treatment policy for KMs should therefore be based on the classification of KMs. Importantly, the focus should be on preserving the first and second molars as much as possible. The treatment approach, such as the employment of surgical removal or orthodontics, should be determined by considering the associated factors such as the crowns, tissues, and age of the patient.
文摘目的:观察下颌阻生第三磨牙(impacted mandibular third molars,IM3Ms)拔除术后的自然转归及对邻近下颌第二磨牙(mandibular second molars,M2Ms)的影响。方法:选择下颌第三磨牙骨埋伏阻生的患者34例(51颗IM3Ms),使用超声骨刀、气动涡轮手机拔除患牙,分别于术前、术后1周及术后6个月随访,观察术后反应及M2Ms远中骨缺损情况。比较手术前后M2Ms远中骨缺损深度,并分析其影响因素。采用SPSS 29.0软件包对数据进行统计学分析。结果:术前M2Ms远中骨高度未见明显缺损,但拔除IM3Ms时,由于去骨拔牙等操作产生骨缺损。术后6个月,骨高度虽有所恢复,骨缺损率减少,但未达到术前水平。IM3Ms埋伏阻生深度是恢复率的主要影响因素。探诊深度较术前显著增加。术后24 h内患者疼痛感较重,术后1周缓解,但仍存在轻度开口受限及面部肿胀。拔除IM3Ms对患者日常生活、情绪、工作、睡眠影响较小。结论:下颌第三磨牙拔除术后,邻近第二磨牙远中骨高度部分恢复,但未达到术前水平。拔牙手术中需采取更加精细的手术技巧,以减少对邻近牙和骨组织的影响。同时,拔除IM3Ms后应给予镇痛药物,加强卫生宣教,提高患者术后舒适度。
文摘目的:评估牙根先脱位法拔除下颌骨埋伏第三磨牙(impacted lower third molar,ILTM)对邻近第二磨牙(mandibular second molar,M2M)远中成骨效果、牙髓状态和牙根外吸收(external root resorption,ERR)进展的影响。方法:选择2023年1月—2023年10月于新疆医科大学第一附属医院进行ILTM拔除的患者64例,其中,32例采用牙根先脱位法拔除ILTM(实验组),32例采用牙冠先脱位法拔除ILTM(对照组)。术前、术后记录M2M松动度、牙髓状态、ERR情况、术后疼痛视觉模拟评分(VAS),术后3、6个月拍摄CBCT,测量M2M骨缺损深度、M2M骨高度、骨高度百分比和骨灰度等指标。采用SPSS 26.0软件包对数据进行统计学分析。结果:实验组术后第3天疼痛VAS评分显著低于对照组(P<0.05),手术时间、M2M牙髓活力和松动度两组均无显著差异(P>0.05);实验组去骨量显著少于对照组(P<0.05)。实验组术后即刻近中颊侧、远中舌侧PD显著低于对照组(P<0.05)。不同程度的ERR中,实验组术后3个月和6个月骨缺损深度、骨高度、骨高度百分比和骨灰度显著低于对照组(P<0.05)。不同阻生类型的2组术后骨缺损深度、骨高度、骨高度百分比和骨灰度比较,差异有统计学意义(P<0.05)。阻生深度与ERR严重程度比较,差异无统计学意义(P>0.05)。所有患者术后均未出现感染和神经损伤等并发症。结论:牙根先脱位法拔除ILTM对M2M远中成骨效果具有一定引导作用,对M2M远中牙周健康改善和术后反应均有效果。
文摘目的 利用锥形束CT(cone beam computed technology,CBCT)分析下颌阻生第三磨牙(mandibular third molar,MTM)对第二磨牙(mandibular second molar,MSM)不同部位牙槽骨的影响,为临床MTM的拔除指征及MSM的诊断、治疗及预后提供理论依据。方法 收集山西省人民医院口腔中心CBCT数据库中随机抽取18岁以上500例阻生MTM的CBCT图像,根据阻生深度及阻生角度分别确定PG及Winter分类,测量MTM与MSM釉牙骨质界之间(CEJ)的距离及第二磨牙颊侧、舌侧、近中、远中牙槽骨吸收的距离。采用Friedman秩和检验比较颊、舌、近中、远中牙槽骨吸收;采用非参数Kruskal Wallis检验、Mann-Whitney U检验分析不同阻生类型间牙槽骨吸收的差异;采用Spearman秩相关及多元线性回归分析各因素与牙槽骨吸收最大侧的关系。结果 远中牙槽骨吸收距离(distal alveolar bone loss of mandibular second molar,MSM-DBL)高于颊侧、舌侧及近中。在Winter分类中,牙槽骨吸收距离水平组最大,近中组次之,垂直组和远中组最小;在PG分类中,从低位、中位到高位牙槽骨吸收距离逐渐降低(P<0.001)。CEJ距离、阻生角度(11°~100°)以及阻生深度均为MSM-DBL的独立危险因素,前二者与MSM-DBL呈正相关(P<0.05)。本研究人群中,MSM-DBL男性高于女性(P<0.05),年龄与MSM-DBL不存在相关性(P>0.05)。结论 阻生MTM对MSM-DBL影响最大;CEJ距离、阻生角度、阻生深度、性别为MSM-DBL的影响因素。
