Морфологические особенности строения корневых каналов премоляров и моляров верхней челюсти на основании конусно-лучевой компьютерной томографии

Abstract

The key issue for dentists of all specialties is the fight against foci of chronic odontogenic infection. Much attention is paid to the introduction of operations that preserve teeth performed at an outpatient surgical appointment, but specialists rarely use them and often remove teeth. The purpose of the study is to determine the morphological features of the structure of the root canals of the premolars and molars of the upper jaw on the basis of cone-beam computed tomography of the jaws, to assess the quality of previously performed endodontic treatment and the frequency of destructive processes in the long-term follow-up. Materials and methods. Anatomical features of the structure of the premolars and molars of the upper jaw were retrospectively studied on the basis of cone-beam computed tomography data in 97 patients aged 26-71 years. 97 teeth (premolars and molars) of the upper jaw were examined in this number of patients. Depending on the belonging to the jaw segments, all the teeth of patients whose anatomical features of the root canals were analyzed, were divided into 4 groups: the first premolars – n=6; the second premolars – n=15; the first molars – n=54; the second molars – n=22. Results and discussion. The study of the morphology of the root canals of the first and second premolars of the upper jaw did not reveal statistically significant differences in the angle of inclination of the root canals, the number of roots and root canals. The analysis of the morphology of the root canals of the first and second molars of the upper jaw also found no significant differences in the angle of inclination of the root canals. At the same time, the share of unsatisfactory endodontic treatment in the analyzed groups of teeth was 82.5%. In addition, destructive bone processes in the periapical region were detected in all molars and premolars of the upper jaw, regardless of the quality of endodontic treatment. Conclusion. Each of the above results as well as all of them together, convincingly demonstrate: 1) insufficient effectiveness of the use of endodontic treatment alone in order to sanitize the foci of chronic odontogenic infection located in the apices of the roots of the molars and premolars of the upper jaw which is largely justified by the features of the anatomical structure of the latter; 2) the need to develop a system of differentiated use of surgical methods of treatment for the rehabilitation of foci of chronic odontogenic infection of the specified localization, taking into account the variant anatomy of the root canals of the premolars and molars of the upper jaw