Mandibular molar dişlerde kanal duvarı kalınlığının dental volümetrik tomografi ile değerlendirilmesi

Year 2021, , 14 - 18, 01.01.2021

Erinc Önem , Güniz Baksi Şen , R. Irmak Turhal Bilge Hakan Şen

https://doi.org/10.17214/gaziaot.739408

Abstract

Amaç: Bu çalışmanın amacı, mandibular 1. ve 2. molar dişlere ait kanalların interradiküler bölgeye olan uzaklığını dental volümetrik tomografi (DVT) üzerinde ölçmektir.

Gereç ve Yöntem: Seksen hastaya ait mandibular DVT görüntülerindeki 50 adet 1. molar ve 50 adet 2. molar diş retrospektif olarak incelendi. Aksiyel kesitlerde bifurkasyon seviyesinin 2 mm altından, tüm kanalların dış sınırından interradiküler bölgeye olan en kısa mesafe kanal duvar kalınlığı ölçülerek kaydedildi. Ölçümler 2 radyolog tarafından yapıldı ve her alan için aritmetik ortalama alındı. Gruplar arasındaki farklar iki yönlü varyans analizi kullanılarak karşılaştırıldı. İkili karşılaştırmalar için ise Tukey HSD testi kullanıldı (p=0.05).

Bulgular: Mandibular 1. ve 2. molar diş kanallarına ait ölçümler grup olarak değerlendirildiğinde aralarındaki farkın istatistiksel olarak anlamlı olduğu gözlendi (p=0.009). Buna göre, 1. molar dişlerin kanalları interradiküler bölgeye, 2. molar dişlere göre daha yakındı. Kanal duvarı kalınlıkları, her bir molar grubunun kendi içerisinde birbirleriyle ikili olarak karşılaştırıldığında, meziobukkal (MB) kanalın en düşük değere sahip olduğu gözlendi (p<0.05). Distal kanalın bifurkasyona uzaklığı MB ve meziolingual (ML) kanallardan daha fazlaydı (p=0.000). Distobukkal (DB) ve distolingual (DL) kanallar arasında ise herhangi bir istatistiksel fark saptanmadı (p>0.05).

Sonuç: Mandibular 1. molar dişlerin kanallarının interradiküler bölgeye ortalama uzaklıkları, 2. molar dişlere göre daha azdı. Tüm mandibular molar dişlerdeki kanalların interradiküler bölgeye ortalama uzaklık değerleri açısından sıralanışları MB<ML<DL<DB<D şeklindedir. Buna göre, strip perforasyon ve vertikal kırık gibi komplikasyonları önlemek için yüksek açılı ve çaplı döner aletlerin kullanımından kaçınılmalıdır.

Keywords

endodonti, mandibula, molar, kök kanal tedavisi

Evaluation of root canal wall thickness of mandibular molar teeth by dental volumetric tomography

Abstract

Objective: This study aims to measure the distance between the root canals and inter-radicular region of mandibular 1st and 2nd molars using dental volumetric tomography (DVT).

Materials and Method: Mandibular DVT images of 50 first-molar teeth and 50 second-molar teeth of 80 patients were examined retrospectively. The shortest distance from the root canal wall to the inter-radicular region was measured at 2 mm below the bifurcation level at axial sections. Measurements were made by 2 radiologists, and arithmetic means were calculated for each area. The differences between the groups were analyzed with two-way ANOVA. Besides, Tukey HSD test was used for pairwise comparisons (p=0.05).

Results: The root canals of the 1st molar teeth were closer to the inter-radicular region than those of the 2nd molar teeth (p=0.009). When the thickness of root canal walls of different types of molars was compared pairwise, the mesiobuccal canal had the lowest measurement (p<0.05). The distance of the distal canal to the bifurcation area was higher than that of the mesiobuccal and mesiolingual canals (p=0.000). There was no statistically significant difference between the distobuccal and distolingual canals (p>0.05).

Conclusion: The root canals of the 1st molar teeth were closer to the inter-radicular region than those of the 2nd molar teeth. Measurements of different root canals of the 1st and 2nd molar teeth revealed differences in thickness. Overall, the order was MB<ML<DL<DB<D. Accordingly, over-instrumentation should be avoided particularly in mesial canals to avoid complications such as strip perforation and vertical fracture.

Keywords

endodontics, mandible, molar, root canal therapy

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