بررسي آناتومي كانال ريشه مزيوباكال دندان هاي مولر اول دائمي ماگزيلا با استفاده از CBCT در شهر رفسنجان در سال 1397: يك مطالعه توصيفي

A Survey on Anatomy of Mesiobucal Root Canal in Permanent Maxillary First Molar Using CBCT in Rafsanjan in 2018: A Descriptive Study

زﻣﯿﻨﻪ و ﻫﺪف: آﻧﺎﺗﻮﻣﯽ ﻣﻮﻟﺮﻫﺎي ﻣﺎﮔﺰﯾﻼ ﺧﯿﻠﯽ ﭘﯿﭽﯿﺪه اﺳﺖ و درﻣﺎن رﯾﺸﻪ ﺑﺮاي اﯾﻦ ﮔﺮوه ﺧﺎص از دﻧﺪانﻫﺎ ﯾﮏ ﭼﺎﻟﺶ ﺑﺰرگ ﺑﺮاي دﻧﺪانﭘﺰﺷﮏﻫﺎ ﻣﺤﺴﻮب ﻣﯽﮔﺮدد. ﺑﺎ ﺗﻮﺟﻪ ﺑﻪ ﻣﺤﺪودﯾﺖﻫﺎي ﺗﮑﻨﯿﮏﻫﺎي ﮐﺎﻧﻮﻧﺸﻨﺎل در ﭘﯿﺪا ﮐﺮدن ﮐﺎﻧﺎل دوم ﻣﺰﯾﻮﺑﺎﮐﺎل )2-(MB و ﺗﻔﺎوتﻫﺎي آﻧﺎﺗﻮﻣﯿﮏ ﻣﺸﺎﻫﺪه ﺷﺪه در ﻗﻮﻣﯿﺖﻫﺎي ﻣﺨﺘﻠﻒ، اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺎ ﻫﺪف ﺗﻌﯿﯿﻦ آﻧﺎﺗﻮﻣﯽ ﮐﺎﻧﺎل رﯾﺸﻪ ﻣﺰﯾﻮﺑﺎﮐﺎل در دﻧﺪانﻫﺎي ﻣﻮﻟﺮ اول داﺋﻤﯽ ﻣﺎﮔﺰﯾﻼ ﺑﺎ اﺳﺘﻔﺎده از Cone-beam computed tomography) CBCT( در ﺷﻬﺮ رﻓﺴﻨﺠﺎن اﻧﺠﺎم ﺷﺪ. ﻣﻮاد و روشﻫﺎ: در اﯾﻦ ﻣﻄﺎﻟﻌﻪ ﺗﻮﺻﯿﻔﯽ، ﺗﻌﺪاد 41 ﮐﻠﯿﺸﻪ رادﯾﻮﮔﺮاﻓﯽCBCT Promax 3D از ﺑﯿﻤﺎران ﺷﻬﺮ رﻓﺴﻨﺠﺎن در ﺳﺎل 1397 ﻣﻮرد ﺑﺮرﺳﯽ ﻗﺮار ﮔﺮﻓﺖ. ﺟﻬﺖ ﺑﺮرﺳﯽ ﻣﻮرﻓﻮﻟﻮژي رﯾﺸﻪ، ﺑﻌﺪ از ﺑﻪدﺳﺖ آوردن ﺗﺼﺎوﯾﺮ multiple planar reformation (MPR) در ﻣﻘﺎﻃﻊ ﺳﺎژﯾﺘﺎل و آﮔﺰﯾﺎل، ارزﯾﺎﺑﯽ ﺑﺮﺣﺴﺐ ﻃﺒﻘﻪﺑﻨﺪي ورﺗﻮﭼﯽ )Vertucci( اﻧﺠﺎم ﺷﺪ. دادهﻫﺎ ﺑﺎ اﺳﺘﻔﺎده از آزﻣﻮن ﻣﺠﺬور ﮐﺎي و ﯾﺎ آزﻣﻮن دﻗﯿﻖ ﻓﯿﺸﺮ ﺗﺠﺰﯾﻪ و ﺗﺤﻠﯿﻞ ﺷﺪ. ﯾﺎﻓﺘﻪﻫﺎ: از 41 ﮐﻠﯿﺸﻪ ﻣﻮرد ﺑﺮرﺳﯽ، در 15 ﮐﻠﯿﺸﻪ )36/6%( ﯾﮏ ﮐﺎﻧﺎل و در 26 ﮐﻠﯿﺸﻪ دﯾﮕﺮ )63/4%( دو ﮐﺎﻧﺎل در رﯾﺸﻪ ﻣﺰﯾﻮﺑﺎﮐﺎل ﻣﺸﺎﻫﺪه ﺷﺪ. در ﻣﯿﺎن رﯾﺸﻪﻫﺎي ﺣﺎوي دو ﮐﺎﻧﺎل، ﺗﺎﯾﭗ II ﻃﺒﻘﻪﺑﻨﺪي ورﺗﻮﭼﯽ، راﯾﺞﺗﺮﯾﻦ ﺗﺎﯾﭗ ﻣﺸﺎﻫﺪه ﺷﺪه ﺑﻮد. ﻻزم ﺑﻪ ذﮐﺮ اﺳﺖ ﮐﻪ ارﺗﺒﺎط ﻣﻌﻨﯽداري ﺑﯿﻦ ﺗﻌﺪاد ﮐﺎﻧﺎلﻫﺎ و ﻫﻢﭼﻨﯿﻦ ﺗﺎﯾﭗ ﮐﺎﻧﺎلﻫﺎ ﺑﺎ ﺟﻨﺴﯿﺖ )ﺑﻪ ﺗﺮﺗﯿﺐ، 0/495=P و 0/583=P( و ﮐﻮادوراﻧﺖ دﻧﺪان )ﺑﻪﺗﺮﺗﯿﺐ، 0/133=P و 0/669=P( ﻣﺸﺎﻫﺪه ﻧﺸﺪ. نتيجه گيري با توجه به نتايج مطالعه حاضر و ميزان دو كانال بودن ريشه مزيوباكال، مي توان گفت كه تهيه كليشه CBCT قبل از درمان ريشه در دندان مولر اول ماگزيلا جهت بررسي وجود و تعيين نوع كانال MB-2 مي تواند كمك كننده باشد.

The anatomy of maxillary molars is very complicated and root canal therapy for this specific group of teeth is a major challenge for dentists. Given the limitations of conventional techniques for finding the second mesiobuccal canal (MB-2) and anatomical differences observed in different ethnicities, this study aimed to determine the anatomy of mesiobuccal root canal in maxillary first permanent molars using CBCT (Cone-beam computed tomography) in Rafsanjan city. Materials and Methods: In this descriptive study, 41 promax 3D CBCT radiographs of patients in Rafsanjan in 2018 were studied. To investigate the root morphology, after obtaining multiple planar reformation (MPR) images in sagittal and axial planes, evaluation was done by Vertucci classification. Data were analyzed using chi-square test or Fisher’s exact test. Results: Of the 41 studied films, one canal was observed in mesiobuccal root in 15 (36.6%) films and two canals in the others 26 (63.4%) films. Among the roots containing two canals, second type of Vertucci classification was the most common type observed. It should be noted that there was no significant relationship between the number of canals and also the type of canals and gender (p=0.495 and p=0.583, respectively) and with quadrant of the tooth (respectively p=0.133 and p=0.669). Conclusion: According to the results of the present study and the amount of two-canal mesiobuccal roots, it can be said that the preparation of CBCT film before root canal therapy in maxillary first molar is necessary to verify the existence and type of MB-2 canal.