Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
İstmus Tiplerinin Değerlendirildiği Bir Retrospektif Çalışma
A Retrospective Study Evaluating Isthmus Types
Bilge ÖZCANa, Bade SONATb
aAnkara Medipol Üniversitesi Diş Hekimiği Fakültesi, Endodonti ABD, Ankara, Türkiye
bAnkara Üniversitesi Diş Hekimliği Fakültesi, Endodonti ABD, Ankara, Türkiye
Turkiye Klinikleri J Dental Sci. 2022;28(3):633-40
doi: 10.5336/dentalsci.2021-87099
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışmanın amacı, arşiv taraması yapılarak alt ve üst 1. azı dişlerinin mesiyal köklerini inceleyerek ilave kanal varlığına bakılıp, bu ka- nalların 3 boyutlu konumlarını değerlendimek ve mesiyal kökün istmus ti- pini sınıflandırarak görülme sıklığını ortaya koymaktır. Gereç ve Yöntemler: Çalışmada konik ışıklı bilgisayarlı tomografi (KIBT) görüntüleri retrospektif olarak incelenmiştir. Üst çene 1. Büyük azı dişinde MB2 kanal varlığına ve bu kanalın MB1-MB2 mesafesinin ölçümü yapılmıştır ve alt çenede ise mesiyoortanca (MO) kanal varlığı değerlendirilmiştir. Ayrıca mesiyal kökteki kanallar arasındaki istmus varlığına bakılıp, hangi tip olduğu sınıflandırılmıştır. Bulgular: Üst 1. büyük azı dişinde MB2 kanal varlığı %90,6 olarak bulunmuştur. MB2 kanalı MB1 kanalına göre ortalama 2,6 mm daha palatinalde yer aldığı tespit edilmiştir. Alt 1. büyük azı dişinde MO kanal varlığı %12,2 olarak elde edilmiştir. İstmus varlığı üst 1. büyük azı dişinde %72, alt 1. büyük azı dişinde %99 olarak ölçülmüştür. Üst 1. büyük azı dişlerinde %41,9 olmak üzere en çok Tip 1'e ve %0,9 oranında en az Tip 3'e rastlanılmıştır (p<0,001). Tip 3 anlamlı olarak en az bulunmuştur. Alt 1. büyük azı dişlerinde %47,5 olmak üzere en çok Tip 5, %2,3 oranında en az Tip 3'e rastlanılmıştır. Sonuç: Anatomik varyasyonlardan olan ilave kanallar ve istmuslar çevresel ve genetik faktörlere bağlı olarak farklı oranlarda ve tiplerde görülmektedir. İstmus tiplerinin görülme oranları toplumlar değiştikçe farklılıklar göstermektedir. Ancak bunun yanında ilave kanalların ana kanallara göre olan 3 boyutlu geometrik lokasyonlarının benzer olması bu mesafenin, genetik ve çevresel faktörlerden bağımsız olduğunu düşündürmektedir.

Anahtar Kelimeler: Azı dişi; diş apeksi; diş pulpası
ABSTRACT
 Objective: The aim of this study is to examine the mesial roots of the lower and upper first molars, to examine the presence of additional canals, to evaluate the three-dimensional positions of these canals, and to classify the isthmus type of the mesial root and reveal its incidence. Material and Methods: In the study, cone beam computed tomography (CBCT) images were analyzed retrospectively. The presence of MB2 canal in the maxillary first molar and the MB1-MB2 distance of this canal were measured and the presence of the mesiomedian (MO) canal in the mandible was evaluated. In addition, the presence of isthmus between the canals in the mesial root was examined and the type was classified. Results: The presence of MB2 canal in the maxillary first molar was 90.6%. It was determined that the MB2 channel is located on average 2.6 mm more palatal than the MB1 channel. The presence of MO channel in the mandibular first molar was 12.2%. The presence of isthmus was measured as 72% in the maxillary first molar and 99% in the mandibular first molar. In maxillary first molars, Type 1 was the most common (41.9%) and Type 3 was found at least with a rate of 0.9% (p<0.001). Type 3 was found to be the least significant. In the mandibular first molars, mostly Type 5, 47.5%, and at least Type 3, 2.3%, were found. Conclusion: Additional channels and isthmuses from anatomical variations are seen in different proportions and types depending on environmental and genetic factors. The incidence of isthmus types varies as societies change. However, the fact that the threedimensional geometric locations of the additional channels with respect to the main channels are similar suggests that this distance is independent of genetic and environmental factors.

Keywords: Molar; tooth apex; dental pulp
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