DOI QR코드

DOI QR Code

Root and Canal Morphology of Maxillary Primary Molar using CBCT and 3D CT

CBCT 및 3D CT를 활용한 상악 유구치 치근과 근관 형태

  • Kim, Joon Hee (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Kim, Hyuntae (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Shin, Teo Jeon (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Hyun, Hong-Keun (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Kim, Young-Jae (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Kim, Jung-Wook (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Jang, Ki-Taeg (Department of Pediatric Dentistry, School of Dentistry, Seoul National University) ;
  • Song, Ji-Soo (Department of Pediatric Dentistry, School of Dentistry, Seoul National University)
  • 김준희 (서울대학교 치의학대학원 소아치과학교실) ;
  • 김현태 (서울대학교 치의학대학원 소아치과학교실) ;
  • 신터전 (서울대학교 치의학대학원 소아치과학교실) ;
  • 현홍근 (서울대학교 치의학대학원 소아치과학교실) ;
  • 김영재 (서울대학교 치의학대학원 소아치과학교실) ;
  • 김정욱 (서울대학교 치의학대학원 소아치과학교실) ;
  • 장기택 (서울대학교 치의학대학원 소아치과학교실) ;
  • 송지수 (서울대학교 치의학대학원 소아치과학교실)
  • Received : 2021.05.21
  • Accepted : 2021.06.29
  • Published : 2021.11.30

Abstract

The purpose of this study is to analyze morphological characteristics of maxillary primary molar's root and root canal. 268 children aged 3 - 7 years (175 boys, 93 girls) who had CBCT (152 children) and 3D CT (116 children) taken in Seoul National University Dental Hospital from January 2006 to April 2020 were included. The number of roots and root canals were analyzed in 1002 teeth without any root resorption or periapical pathologies. Curvature, angulation, length of root and root canal, as well as cross-sectional shapes of the root canal were analyzed in 218 teeth. By using Mimics and 3-Matics software, volume, surface area, and volume ratio of root canal was analyzed in 48 teeth. More than half of maxillary primary molars have 3 roots and 3 root canals. The degree of symmetry of root canal type was about 0.63 (Cohen's kappa coefficient). The most frequent shape of roots and canals was linear in 1st primary molars and curved in 2nd primary molars. Angulation, length of root and root canals was the largest on palatal roots. Most teeth showed ovoid or round shapes at apex. The largest root canal volume, surface area, volume ratio was found in the palatal roots.

이 연구의 목적은 상악 유구치의 치근 및 근관의 형태학적 특성을 분석하는 것이다. 2006년 1월부터 2020년 4월까지 서울대학교 치과병원에서 CBCT 및 3D CT를 촬영한 3 - 7세 환자 총 268명(남자 175명, 여자 93명)이 연구에 포함되었으며, 치근 흡수와 치수병변이 없는 총 1002개의 상악 유구치의 치근과 근관 수를 분석하였다. 218개의 치아에 대해 치근과 근관의 형태, 이개각도, 치근과 근관의 길이 및 근관의 단면 형태를 분석하였다. 48개의 치아에 대해서는 Mimics 및 3-Matics software를 사용하여 치근 치수의 부피와 표면적, 치근-치수 비를 측정하였다. 절반 이상이 3개의 치근과 3개의 근관을 가지고 있었다. 좌우측 치아의 대칭성(Cohen's kappa coefficient)은 약 0.63이었다. 치근과 근관의 형태는 상악 제1유구치에서는 직선형이, 제2유구치에서는 곡선형이 많이 관찰되었다. 치근의 이개 정도, 치근과 근관의 길이는 상악 제1, 2유구치 모두 구개측 치근에서 가장 크게 나타났다. 근단부에서 근관의 단면 형태는 주로 ovoid 혹은 round형이었다. 치근 치수의 부피와 표면적, 치근-치수 비는 상악 제1,2유구치 모두 구개측 치근 치수에서 가장 크게 나타났다.

Keywords

References

  1. Ozcan G, Sekerci AE, Dogan S, et al. : Evaluation of root canal morphology of human primary molars by using CBCT and comprehensive review of the literature. Acta Odontol Scand, 74:250-258, 2016. https://doi.org/10.3109/00016357.2015.1104721
  2. Carrotte P : Endodontics: Part 4 Morphology of the root canal system. British Dental Journal, 197:379-383, 2004. https://doi.org/10.1038/sj.bdj.4811711
  3. Cleghorn BM, Christie WH, Dong CC : The root and root canal morphology of the human mandibular first premolar: a literature review. J Endod, 33:509-516, 2007. https://doi.org/10.1016/j.joen.2006.12.004
  4. Peters OA, Laib A, Gohring TN, Barbakow F : Changes in root canal geometry after preparation assessed by highresolution computed tomography. J Endod, 27:1-6, 2001. https://doi.org/10.1097/00004770-200101000-00001
  5. Vertucci FJ : Root canal morphology and its relationship to endodontic procedures. Endod Topics, 10:3-29, 2005. https://doi.org/10.1111/j.1601-1546.2005.00129.x
  6. Barbizam JVB, Ribeiro RG, Tanomaru Filho M : Unusual anatomy of permanent maxillary molars. J Endod, 30:668-671, 2004. https://doi.org/10.1097/01.DON.0000121618.45515.5A
  7. Balani P, Niazi F, Rashid H : A brief review of the methods used to determine the curvature of root canals. J Res Dent, 3:57, 2015. https://doi.org/10.4103/2321-4619.168733
  8. Gunday M, Sazak H, Garip Y : A comparative study of three different root canal curvature measurement techniques and measuring the canal access angle in curved canals. J Endod, 31:796-798, 2005. https://doi.org/10.1097/01.don.0000158232.77240.01
  9. Omer O, Al Shalabi R, Claffey N, et al. : A comparison between clearing and radiographic techniques in the study of the root-canal anatomy of maxillary first and second molars. Int Endod J, 37:291-296, 2004. https://doi.org/10.1111/j.0143-2885.2004.00731.x
  10. Plotino G, Grande NM, Somma F, et al. : Three-dimensional imaging using microcomputed tomography for studying tooth macromorphology. J Am Dent Assoc, 137:1555-1561, 2006. https://doi.org/10.14219/jada.archive.2006.0091
  11. Aminabadi NA, Farahani RM, Gajan EB : Study of root canal accessibility in human primary molars. J Oral Sci, 50:69-74, 2008. https://doi.org/10.2334/josnusd.50.69
  12. Cleghorn BM, Boorberg NB, Christie WH : Primary human teeth and their root canal systems. Endod Topics, 23:6-33, 2010. https://doi.org/10.1111/etp.12000
  13. Fumes A, Sousa-Neto M, Consolaro A, et al. : Root canal morphology of primary molars: a micro-computed tomography study. Eur Arch Paediatr Dent, 15:317-326, 2014. https://doi.org/10.1007/s40368-014-0117-0
  14. Kim YJ, Jeong TS, Kim S : The Radiographical measurement of root canal curvature of mandibular primary 2nd molars. J Korean Acad Pediatr Dent, 30:637-642, 2003.
  15. Bawazir OA, Salama FS : Clinical evaluation of root canal obturation methods in primary teeth. Pediatr Dent, 28:39-47, 2006.
  16. Kim CG, Hong SS, Lee SH, et al. : The second mesiobuccal canal of upper primary molar: Case report. J Korean Acad Pediatr Dent, 29:139-145, 2002.
  17. Tu MG, Liu JF, Huang HL, et al. : Prevalence of three-rooted primary mandibular first molars in Taiwan. J Formos Med Assoc, 109:69-74, 2010. https://doi.org/10.1016/S0929-6646(10)60023-X
  18. Sim DH, Mah YJ : A Study of Root canals Morphology in Primary Molars Using Computerized Tomography. J Korean Acad Pediatr Dent, 46:400-408, 2019. https://doi.org/10.5933/JKAPD.2019.46.4.400
  19. Choi Y, Kim S, Choi N : Assessment of Root and Root Canal Morphology of Human Primary Molars using CBCT. J Korean Acad Pediatr Dent, 47:25-35, 2020. https://doi.org/10.5933/JKAPD.2020.47.1.25
  20. Reddy NV, Daneswari V, Niharika P, et al. : Three-dimensional assessment of root canal morphology of human deciduous molars using cone beam computed tomography: An In vitro Study. Int J Pedod Rehabil, 3:36-41, 2018. https://doi.org/10.4103/ijpr.ijpr_21_17
  21. Wang YL, Chang HH, Lin CP, et al. : A study on the root canal morphology of primary molars by high-resolution computed tomography. J Dent Sci, 8:321-327, 2013. https://doi.org/10.1016/j.jds.2013.04.002
  22. Zoremchhingi, Joseph T, Varma B, Mungara J : A study of root canal morphology of human primary molars using computerised tomography: an in vitro study. J Indian Soc Pedod Prev Dent, 23:7-12, 2005. https://doi.org/10.4103/0970-4388.16019
  23. Siqueira Jr JF, Alves FR, Rocas IN, et al. : Ability of chemomechanical preparation with either rotary instruments or self-adjusting file to disinfect oval-shaped root canals. J Endod, 36:1860-1865, 2010. https://doi.org/10.1016/j.joen.2010.08.001
  24. Versiani MA, Leoni GB, de Sousa-Neto MD, et al. : Microcomputed tomography study of oval-shaped canals prepared with the Self-adjusting File, Reciproc, WaveOne, and Protaper Universal systems. J Endod, 39:1060-1066, 2013. https://doi.org/10.1016/j.joen.2013.04.009
  25. Versiani MA, Pecora JD, de Sousa-Neto MD : Flat-oval root canal preparation with self-adjusting file instrument: a micro-computed tomography study. J Endod, 37:1002-1007, 2011. https://doi.org/10.1016/j.joen.2011.03.017
  26. Asif MK, Nambiar P, Khan IM, et al. : Three-dimensional image analysis of developing mandibular third molars apices for age estimation: a study using CBCT data enhanced with Mimics & 3-Matics software. Leg Med, 39:9-14, 2019. https://doi.org/10.1016/j.legalmed.2019.05.003
  27. Asif MK, Nambiar P, Sukumaran P, et al. : Dental age estimation employing CBCT scans enhanced with Mimics software: Comparison of two different approaches using pulp/ tooth volumetric analysis. J Forensic Leg Med, 54:53-61, 2018. https://doi.org/10.1016/j.jflm.2017.12.010
  28. Leonardi R, Muraglie S, Spampinato C, et al. : Three-dimensional analysis of mandibular functional units in adult patients with unilateral posterior crossbite: A cone beam study with the use of mirroring and surface-to-surface matching techniques. Angle Orthod, 89:590-596, 2019. https://doi.org/10.2319/081718-607.1
  29. Liu H, Liu Dx, Zhao Z, et al. : Accuracy of surgical positioning of orthodontic miniscrews with a computer-aided design and manufacturing template. Am J Orthod Dentofacial Orthop, 137:728.e1-728, 2010. https://doi.org/10.1016/j.ajodo.2009.12.025
  30. Reynolds M, Reynolds M, Adeeb S, El-Bialy T : 3-d volumetric evaluation of human mandibular growth. Open Biomed Eng J, 5:83-89, 2011. https://doi.org/10.2174/1874120701105010083
  31. Robiony M, Salvo I, Filippi S, et al. : Accuracy of virtual reality and stereolithographic models in maxillo-facial surgical planning. J Craniofac Surg, 19:482-489, 2018. https://doi.org/10.1097/SCS.0b013e31814fb5c1
  32. Peters OA, Laib A, Ruegsegger P, Barbakow F : Three-dimensional analysis of root canal geometry by high-resolution computed tomography. J Dent Res, 79:1405-1409, 2000. https://doi.org/10.1177/00220345000790060901
  33. Maret D, Molinier F, Treil J, et al. : Accuracy of 3D reconstructions based on cone beam computed tomography. J Dent Res, 89:1465-1469, 2010. https://doi.org/10.1177/0022034510378011
  34. Wang Y, He S, Chen S, et al. : Accuracy of volumetric measurement of teeth in vivo based on cone beam computer tomography. Orthod Craniofac Res, 14:206-212, 2011. https://doi.org/10.1111/j.1601-6343.2011.01525.x
  35. Chugal NM, Clive JM, Spangberg LS : Endodontic infection: some biologic and treatment factors associated with outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 96:81-90, 2003. https://doi.org/10.1016/S1079-2104(02)91703-8
  36. Bagherian A, Kalhori KA, Parisay I, et al. : An in vitro study of root and canal morphology of human deciduous molars in an Iranian population. J Oral Sci, 52:397-403, 2010. https://doi.org/10.2334/josnusd.52.397
  37. Gaurav V, Srivastava N, Rana V, Adlakha VK : A study of root canal morphology of human primary incisors and molars using cone beam computerized tomography: An in vitro study. J Indian Soc Pedod Prev Dent, 31:254-259, 2013. https://doi.org/10.4103/0970-4388.121827