牙髓腔解剖英文.ppt

髓腔形态髓腔形态The Pulp Cavity 讲授 胡延佳 讲师目的要求目的要求 1.To grasp the pulp cavities of the permanent teeth.2.To grasp the basial conceptions and theories of the pulp cavity.3.To understand the changes of the pulp cavities depending on the age and the history of trauma of the teeth.4.To grasp some professional english words.ReferencesDental anatomy,physiology and occlusion.Dental anatomy and morphology.Concise illustrated dental dictionary.Conception of the Pulp Cavity髓腔各部名称髓腔的增龄变化和病理变化髓腔解剖的临床意义 髓腔髓腔 Pulp Cavity The entire central cavity of a tooth,both root and crown,which contains the pulp tissue during the life of the pulp.The outline of the pulp cavity generally corresponds to the external contour of the tooth.髓髓 室室Pulp Chamber The portion of the pulp cavity which is located roughly in the anatomical crown of the tooth.根管系统根管系统root canal system 髓腔除髓室以外的部分，包括根管，管间吻合，根管侧支，根尖分歧，根尖分叉及副根管，它们共同组成根管系统。髓室顶髓室顶roof of pulp chamber与牙合面或切嵴相对应的髓室壁。Pulp chamber髓室底髓室底floor of pulp chamber 与髓室顶相对的髓室壁。与髓室顶相对的髓室壁。Pulp chamber髓室高度髓室高度 髓室顶底间距离为髓室高度Pulp chamber髓室壁髓室壁wall of pulp chamber 与轴面相对应的髓腔牙本质壁。分近远中髓壁，唇颊和舌侧髓壁。Pulp chamber髓角髓角Pulp Horn The portion of the pulp chamber which often cor-responds to lobes,or cusps,of the crown of the tooth.Horn-shaped extension of the pulp cavity extending in towards the cusp or the incisal margins.Pulp chamber根管口根管口Root Canal Orifice The opening of the root canal on the floor of pulp chamber.Pulp chamber根根 管管Root Canal The portion of the pulp cavity which is located basically in the anatomical root of the tooth.Root canal system根管形式单管型 single-canal type 双管型 bicanal type单双混合型 single-bicanal type三管型 tricanal typeRoot canal systemRoot canal system侧副管侧副管lateral accessory canal 为根管系统中除根管外的一切管道，包括：管间吻合、根管侧支、根尖分歧、根尖分叉及副根管。管间吻合管间吻合 intercanal Anastomoses An extra canal branch which extends mainly in a horizontal direction,connecting pulp canals with each other,or with supple-mentary canals.Root canal system根管侧支 lateral branch of root canal Minute canals which extend mainly in a lateral direction,from the pulp to the periodontal membrane.Root canal system根尖分歧apical ramification 根管在根尖分出的 细 小 分 支。premolar and molar多见。Root canal system根尖分叉根尖分叉apical furcation 根管在根尖分散成两个或两个以上的细小分支。Root canal system副根管 accessory root canal 为发自髓室底至根分叉处的管道。多见于molar。Root canal system根管系统内部连接处的名称：根管口，副根管口，根管侧支口，根尖分歧口，根尖分叉口。根管系统在牙根表面开口的名称：根尖孔，副孔，侧孔。Root canal system 根尖孔Apical Foramen The constricted opening(s),at or near the root apex,through which the main nutrient and nervous supply to the pulp enter and exit.Root canal system髓腔各部名称髓腔各部名称髓室顶与髓室底髓室顶与髓室底 髓室壁髓室壁 髓角髓角根管口根管口 根管根管 管间吻合管间吻合 根管侧支根管侧支 根尖分歧根尖分歧 根尖分叉根尖分叉 副根管副根管 根尖孔根尖孔髓室髓室根管系统根管系统髓髓腔腔解剖性根尖孔：生理性根尖孔：髓腔的增龄性变化和病理变化 As previously indicated,the pulp tissue retains the ability to produce dentin throughout its lifetime.This is secondary dentin,as contrasted to the primary dentin produced during tooth development.Secondary dentin production reduces the dimensions of the pulp cavity.This may be either in the form of a general reduction in size,or specific to an area of irritation(reparative).髓腔的增龄性变化和病理变化 When one,or both of these factors is occurring,there are changes in pulp cavity dimensions with age.With age,the pulp horns are blunted,and often obliterated,so that the teeth of older individuals may not exhibit pulp horns at all.The same is true of the remainder of the pulp chamber,as well as the pulp canal;as aging occurs the entire pulp cavity normally decreases in size.髓腔解剖的临床意义 口内：牙体，牙髓，牙周病治疗的重要依据。修复：牙体预备,桩冠等。The pulp cavities of the permanent teeth Sectioning of the Pulp Cavitymesiodistal section(MDS)近远中切面近远中切面 labiolingual section(LLS)唇舌切面（前牙）唇舌切面（前牙）buccolingual section（BLS）颊舌切面（后牙）颊舌切面（后牙）cross sections through the cervical line area(CSC）牙颈横切面牙颈横切面cross sections through the mid-root(CSM)根中横切面根中横切面 The outline of the pulp cavity corresponds,in general,to the external contour of the tooth.This is a very important fact,since it provides some idea of the shape of the pulp cavity without direct vision of it.切牙的髓腔形态 上颌中切牙上颌中切牙 下颌中切牙下颌中切牙 Maxillary Central Incisor Mandibular Central IncisorsGeneral LLSMDSCCS 上颌中切牙上颌中切牙 下颌中切牙下颌中切牙 MaxCI ManCI 髓腔髓腔较大较大，根管，根管较粗较粗 髓腔髓腔体积最小体积最小，唇舌径大于近远中径，唇舌径大于近远中径 单根管单根管 根管多为根管多为窄而扁窄而扁的单根管，的单根管，4%分唇舌双根管分唇舌双根管 根尖孔约根尖孔约58%位于位于 根尖孔约根尖孔约75%位于根尖顶位于根尖顶 根尖顶根尖顶 General 上颌中切牙上颌中切牙 下颌中切牙下颌中切牙 MaxCI ManCI 髓腔呈梭形髓腔呈梭形 髓髓腔中部的唇舌径较大，腔中部的唇舌径较大，平颈缘处最厚平颈缘处最厚 两两端较小端较小 髓室顶缩小成尖髓室顶缩小成尖 髓髓室顶呈尖形，近冠中室顶呈尖形，近冠中1/3 接近冠中接近冠中1/3 LLS 髓腔呈三角形髓腔呈三角形 髓腔呈狭长的三角形髓腔呈狭长的三角形 顶为三角形底，最宽顶为三角形底，最宽 顶为三角形底，略宽顶为三角形底，略宽 接近牙冠中接近牙冠中1/3处处 接近冠中接近冠中1/3 MDS 上颌中切牙上颌中切牙 下颌中切牙下颌中切牙 MaxCI ManCI与外形相似与外形相似1：圆三角形圆三角形，椭圆形，椭圆形，唇舌径大于唇舌径大于 唇侧宽于舌侧唇侧宽于舌侧 近远中径近远中径2：椭圆形或圆形：椭圆形或圆形CCS 上颌中切牙上颌中切牙 下颌中切牙下颌中切牙 MaxCI ManCI尖牙的髓腔形态 上颌尖牙上颌尖牙 下颌尖牙下颌尖牙 Maxillary Canine Mandibular Canine General LLS MDS CCS 上颌尖牙上颌尖牙 下颌尖牙下颌尖牙Maxillary Canine Mandibular Canine单根管单根管 髓室和根管较上尖牙窄髓室和根管较上尖牙窄唇舌径远大于近远中径唇舌径远大于近远中径 髓角较圆，根管为双管者占髓角较圆，根管为双管者占4%根尖孔约根尖孔约54%位于根尖顶位于根尖顶 根尖孔约根尖孔约68%位于根尖顶位于根尖顶General 上颌尖牙上颌尖牙 下颌尖牙下颌尖牙 Maxillary Canine Mandibular Canine顶窄而尖，近冠中顶窄而尖，近冠中1/3 唇舌径较大唇舌径较大切端切端2/3很厚，近根尖很厚，近根尖1/3渐窄渐窄 最大位于牙冠及牙根颈部最大位于牙冠及牙根颈部根尖孔比切牙者大根尖孔比切牙者大 髓角呈尖形，接近牙冠中髓角呈尖形，接近牙冠中1/3处处LLS 上颌尖牙上颌尖牙 下颌尖牙下颌尖牙Maxillary Canine Mandibular Canine 髓腔较窄，两端均呈尖形髓腔较窄，两端均呈尖形 髓腔较窄髓腔较窄 髓角近牙冠中髓角近牙冠中1/3 髓角圆钝，接近冠中髓角圆钝，接近冠中1/3处处 髓角以下到牙根中部一段髓角以下到牙根中部一段 略宽，向根尖渐细略宽，向根尖渐细MDS 上颌尖牙上颌尖牙 下颌尖牙下颌尖牙 Maxillary Canine Mandibular Canine髓腔较大，约呈髓腔较大，约呈圆三角形圆三角形 髓腔约呈髓腔约呈卵圆形卵圆形，唇舌径较大唇舌径较大 唇侧宽于舌侧，唇舌径大唇侧宽于舌侧，唇舌径大于近远中径于近远中径CCS前磨牙的髓腔形态 上颌前磨牙上颌前磨牙 下颌前磨牙下颌前磨牙Maxillary Premolar Mandibular PremolarGeneralBLSMDS CCS 上颌前磨牙上颌前磨牙 下颌前磨牙下颌前磨牙Maxillary Premolar Mandibular Premolar 髓室类似长立方形，颊舌径髓室类似长立方形，颊舌径 颊舌径与近远中径颊舌径与近远中径相近相近大于大于近远中径近远中径髓室位于牙冠颈部及根柱内髓室位于牙冠颈部及根柱内 多与单根管相通多与单根管相通 髓室顶凹髓室顶凹，最凹处约与颈缘平齐，最凹处约与颈缘平齐 General 上颌前磨牙上颌前磨牙 下颌前磨牙下颌前磨牙 Maxillary Premolar Mandibular Premolar 颊高颊高 冠中冠中1/3 颊髓角颊髓角 近冠中近冠中1/3 舌低舌低 颈部颈部 舌侧髓角舌侧髓角短圆而不明显短圆而不明显，位，位 髓室底有髓室底有1-3个根管口个根管口 于牙冠颈部于牙冠颈部 根尖孔约根尖孔约50%颊髓角稍长颊髓角稍长 位于根尖顶位于根尖顶 舌髓角较短舌髓角较短 BLS445位于颈位于颈1/3 上颌前磨牙上颌前磨牙 下颌前磨牙下颌前磨牙 Maxillary Premolar Mandibular Premolar 与尖牙略相似与尖牙略相似 形似尖牙，形似尖牙，髓室和根管均髓室和根管均较较窄小窄小 但但很很狭窄狭窄MDS 上颌前磨牙上颌前磨牙 下颌前磨牙下颌前磨牙Maxillary Premolar Mandibular Premolar 成长条形，颊舌两端圆钝成长条形，颊舌两端圆钝 较长的椭圆形较长的椭圆形颊舌径颊舌径近远中径近远中径 颊舌径颊舌径近远中径近远中径 部分髓室颊舌向中份缩小部分髓室颊舌向中份缩小呈呈肾形肾形CCS上颌第一前磨牙第二前磨牙单根单管型28%48%单根双管型31%19%单根单双管型27%29%双根双管型14%4%The Pulp Cavities of the Maxillary Molars上颌第一磨牙髓髓室室似似矮矮立立方方形形，颊颊舌舌径径近近远远中中径径髓髓室室高高度度,髓髓室室顶顶凹凹向下向下,最凹处约与颈缘平齐。最凹处约与颈缘平齐。近近中中颊颊舌舌髓髓角角高高,均均近近冠冠中中1/3；远远中中颊颊舌舌髓髓角角较较低低，位位于于冠颈部处。冠颈部处。髓室底可见髓室底可见3-4个根管口，排列呈个根管口，排列呈颊颊舌径长，近远中径短舌径长，近远中径短的四边形或三角形。的四边形或三角形。上颌第二磨牙 髓髓腔腔形形态态与与上上颌颌第第一一磨磨牙牙相相类类似似，但较小。但较小。近近颊颊根根分分根根管管者者约约30%，远远颊颊根根及及舌根管均为单根管。舌根管均为单根管。上颌第三磨牙髓室大，根管粗和髓角较低。The Pulp Cavities of the Mandibular Molars下颌第一磨牙髓髓室室为为矮矮立立方方形形，近近远远中中径径颊颊舌舌径径髓髓室室高高度度（1mm）；髓髓室室顶顶最最凹凹处与颈缘平齐。处与颈缘平齐。近近远远中中舌舌髓髓角角高高度度相相近近，近近冠冠中中1/3。近近远远颊颊髓髓角角和和远远中中髓髓角角较较低低，位位于于冠冠颈部或颈缘附近。颈部或颈缘附近。下颌第一磨牙髓室底有髓室底有2-4个根管口；近中根约个根管口；近中根约87%为双管型或为双管型或单双混合型。远中根约单双混合型。远中根约40%分根管。分根管。下颌第二磨牙1、与与下下颌颌第第一一磨磨牙牙相相近近；近近中中根根约约64%分根，远中根约分根，远中根约18%分根。分根。2、近近远远中中根根在在颊颊侧侧融融合合，根根管管横横断断面面呈呈“C”形者占形者占10%。下颌第三磨牙因外形不同而异，变异较多。恒牙髓腔应用解剖恒牙髓腔应用解剖 The Pulp Cavities of the Deciduous Teeth 乳牙髓腔特点1乳牙的髓腔形态与相应乳牙外形一致。乳牙的髓腔形态与相应乳牙外形一致。2按按比比例例来来说说，比比恒恒牙牙髓髓腔腔大大，髓髓壁壁薄薄，髓髓角角高高，根管根管粗粗，根尖孔，根尖孔大大，根管方向根管方向斜度较大斜度较大。Thank you！