口腔疾病防治 ›› 2021, Vol. 29 ›› Issue (1): 11-19.DOI: 10.12016/j.issn.2096-1456.2021.01.002

• 专家论坛 • 上一篇    下一篇

根管峡区的定位、发生率及临床意义

孙书昱(),王贺   

  1. 南方医科大学口腔医院牙体牙髓科,广东 广州(510280)
  • 收稿日期:2020-03-17 修回日期:2020-06-11 出版日期:2021-01-20 发布日期:2020-11-18
  • 通讯作者: 孙书昱
  • 基金资助:
    国家自然科学基金(82000994)

Location, incidence and clinical implications of the root canal isthmus

SUN Shuyu(),WANG He   

  1. Department of Endodontics, Stomatological Hospital , Southern Medical University, Guangzhou 510280, China
  • Received:2020-03-17 Revised:2020-06-11 Online:2021-01-20 Published:2020-11-18
  • Contact: Shuyu SUN
  • Supported by:
    National Natural Science Foundation of China(82000994)

摘要:

根管峡区(root canal isthmus,RCI)是位于同一牙根内、根管之间含有牙髓或牙髓衍生组织,呈现为带状狭窄的连接或含有交通支及横向吻合的解剖学结构,它常存在于含有两个根管的牙根中,解剖结构复杂。不同牙位的RCI发生率不尽相同,发生率最高的部位是下颌第一磨牙近中根和上颌第一磨牙近中颊根。RCI的存在增加了根管治疗的难度,并给患牙治疗带来了预后的不确定性。临床上,对于可能存在RCI的患牙建议使用锥形束CT及牙科显微镜进行识别;同时,对含RCI患牙治疗时应考虑选择合适的器械以及超声辅助下加强根管冲洗,有助于提高根管治疗以及根尖手术的成功率。目前的技术对于RCI的清理和充填仍存在一定的局限性,相应技术设备的研发改进是目前的研究热点,也是未来的研究方向。

关键词: 根管峡区, 根管解剖, 根管预备, 根管充填, 根管冲洗, 恒磨牙, 锥形束计算机断层扫描

Abstract:

Root canal isthmus(RCI) is defined as a narrow, ribbon-shaped communication between two root canals that contains pulp or tissue derived from pulp. Any root that contains two or more root canals has the potential to contain an isthmus. The incidence of RCI from different tooth positions varies, with the highest RCI incidences usually found in the mesial root of the mandibular first molar and the mesiobuccal root of the maxillary first molar. The presence of RCI increases the difficulty of root canal therapy and introduces uncertainty regarding the prognosis for dental treatment. It is recommended to use CBCT and dental microscopy to identify teeth with suspected RCI in clinical practice. At the same time, for treatment of teeth with RCI, appropriate instruments should be selected, and enhanced root canal irrigation assisted by ultrasound should be considered to improve the success rate of root canal treatment and endodontic root-end surgery. The current technology still has some limitations regarding the cleaning and filling of RCI and additional research and development. Improvement of the corresponding technology and equipment is a current research hotspot and a future research direction.

Key words: root canal isthmus, root canal anatomy, root canal preparation, root canal filling, root canal irrigation, permanent molar, cone-beam computed tomography

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