以錐狀射束電腦斷層掃描輔助進行根管治療－案例報告

放射線攝影一直是牙髓治療中的重要診斷工具。牙髓治療的成功需要徹底了解內部和外部牙齒解剖結構及其變化。在下顎正中門齒的根管系統中，大部分為單根管型態，較少部分的門齒可能有雙根管；下顎第一大臼齒的遠心牙根最常見的解剖型態是具有一個牙根及一個橢圓形的根管，然而也有多於一個根管的案例。若根管解剖學知識不足或對其他根管的研究不充分，遺漏的根管會造成牙髓治療失敗。傳統根尖周放射線攝影（periapical radiography）和單獨的臨床檢查常無法提供足夠的信息，因此透過錐狀射束電腦斷層掃描（cone-beam computed tomography, CBCT）可輔助診斷並進一步治療複雜的牙髓病。在本病例報告中，我們使用CBCT確認下顎門齒的根管數目及形態、下顎第一大臼齒近心牙根垂直斷裂的裂痕與遠心牙根的根管數目及形態，輔助牙醫師完成根管治療。

關鍵字

牙髓治療；下顎正中門齒；下顎第一大臼齒；牙根垂直斷裂；根管；根尖周放射線攝影；錐狀射束電腦斷層掃描

並列摘要

Radiography has long been an important diagnostic tool in root canal treatment. The success of root canal treatment requires a thoroug understanding of the internal and external anatomy of the tooth. Typically, most mandibular central incisors manifest as a single canal system, while a few may present with two canals. The distal roots of mandibular first molars have a high prevalence for single canal; however, there have been reports of these single canals leaving the chamber then dividing into two separate canals. Inadequate understanding of the internal anatomy without comprehensive consideration of the root canal system may lead to missing canals and failure of endodontic treatment. Conventional periapical radiography and clinical examination provide limited information of the root canal system. In our case report, we verified the number and anatomy of the root canal in the mandibular incisor, along with the vertical root fracture on the mesial root of the mandibular first molar, and the distal root of mandibular first molar using cone-beam computed tomography (CBCT). The results indicate that CBCT can aid dentists in reaching a correct diagnosis which in turn allows us to complete more complicated root canal treatments.

並列關鍵字

endodontic treatment ； mandibular central incisors ； mandibular first molars ； vertical root fracture ； root canal ； periapical radiography ； cone-beam computed tomography

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以錐狀射束電腦斷層掃描輔助進行根管治療－案例報告

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