1、髓腔形态 The Pulp Cavity,讲授 胡延佳 讲师,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
2、words.,References,Dental 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 Pulp Cavity,The entire central cavity of a tooth,both root and crown, which contains the pulp tissue during
3、the life of the pulp. The outline of the pulp cavity generally corresponds to the external contour of the tooth.,髓 室 Pulp Chamber,The portion of the pulp cavity which is located roughly in the anatomical crown of the tooth.,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
4、室顶 roof of pulp chamber,与牙合面或切嵴相对应的髓室壁。,髓室底 floor of pulp chamber,与髓室顶相对的髓室壁。,髓室高度,髓室顶底间距离为髓室高度,Pulp chamber,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 Pulp Horn,The portion of the pulp chamber which often cor-responds to lobes, or cusps, of the crown of the tooth.Horn-sh
5、aped extension of the pulp cavity extending in towards the cusp or the incisal margins.,根管口 Root Canal Orifice,The opening of the root canal on the floor of pulp chamber.,根 管 Root Canal,The portion of the pulp cavity which is located basically in the anatomical root of the tooth.,根管形式,单管型 single-can
6、al type 双管型 bicanal type 单双混合型 single-bicanal type 三管型 tricanal type,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 intercanal Anastomoses,An extra canal branch which extends mainly in a horizontal direction , connecting pulp canals with each other,or with supple-mentar
7、y canals.,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.,根尖分歧 apical ramification,根管在根尖分出的细小分支。premolar and molar多见。,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。,副根管 accessory root canal,为发自髓室底至根分叉处的管道。多见于molar。,根
8、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。,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.,髓腔各部名称,髓室顶与髓室底 髓室壁 髓角 根管口根管管间吻合根管侧支根尖分歧根尖分叉副根管根尖孔,髓室,根管系统,髓腔,解剖性根尖孔： 生理性根尖孔：,髓腔
9、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 i
10、n 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 i
11、ndividuals 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 Pu
12、lp Cavity,mesiodistal section (MDS) 近远中切面 labiolingual section (LLS) 唇舌切面（前牙） buccolingual section（BLS） 颊舌切面（后牙） cross sections through the cervical line area (CSC） 牙颈横切面 cross sections through the mid-root (CSM) 根中横切面,The outline of the pulp cavity corresponds, in general, to the external contour o
13、f 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 下颌中切牙Maxillary Central Incisor Mandibular Central Incisors General LLS MDS CCS,上颌中切牙 下颌中切牙 MaxCI ManCI,髓腔较大，根管较粗 髓腔体积最小，唇舌径大于近远中径 单根管 根管多为窄而扁的单根管， 4%分唇舌双根
14、管根尖孔约58%位于 根尖孔约75%位于根尖顶根尖顶,General,上颌中切牙 下颌中切牙 MaxCI ManCI,髓腔呈梭形 髓腔中部的唇舌径较大， 平颈缘处最厚 两端较小髓室顶缩小成尖 髓室顶呈尖形，近冠中1/3接近冠中1/3,LLS,髓腔呈三角形 髓腔呈狭长的三角形顶为三角形底，最宽 顶为三角形底，略宽接近牙冠中1/3处 接近冠中1/3,MDS,上颌中切牙 下颌中切牙 MaxCI ManCI,与外形相似 1：圆三角形， 椭圆形，唇舌径大于 唇侧宽于舌侧 近远中径 2：椭圆形或圆形,CCS,上颌中切牙 下颌中切牙 MaxCI ManCI,尖牙的髓腔形态,上颌尖牙 下颌尖牙Maxillar
15、y Canine Mandibular CanineGeneralLLSMDS CCS,上颌尖牙 下颌尖牙 Maxillary Canine Mandibular Canine,单根管 髓室和根管较上尖牙窄 唇舌径远大于近远中径 髓角较圆，根管为双管者占4% 根尖孔约54%位于根尖顶 根尖孔约68%位于根尖顶,General,上颌尖牙 下颌尖牙 Maxillary Canine Mandibular Canine,顶窄而尖，近冠中1/3 唇舌径较大 切端2/3很厚，近根尖1/3渐窄 最大位于牙冠及牙根颈部 根尖孔比切牙者大 髓角呈尖形，接近牙冠中1/3处,LLS,上颌尖牙 下颌尖牙 Maxil
16、lary Canine Mandibular Canine,髓腔较窄，两端均呈尖形 髓腔较窄 髓角近牙冠中1/3 髓角圆钝，接近冠中1/3处髓角以下到牙根中部一段略宽，向根尖渐细,MDS,上颌尖牙 下颌尖牙 Maxillary Canine Mandibular Canine,髓腔较大，约呈圆三角形 髓腔约呈卵圆形，唇舌径较大 唇侧宽于舌侧，唇舌径大 于近远中径,CCS,前磨牙的髓腔形态,上颌前磨牙 下颌前磨牙 Maxillary Premolar Mandibular Premolar,General,BLS,MDS,CCS,上颌前磨牙 下颌前磨牙 Maxillary Premolar Ma
17、ndibular Premolar,髓室类似长立方形，颊舌径 颊舌径与近远中径相近 大于近远中径 髓室位于牙冠颈部及根柱内 多与单根管相通髓室顶凹，最凹处约与颈缘平齐,General,上颌前磨牙 下颌前磨牙 Maxillary Premolar Mandibular Premolar,颊高 冠中1/3 颊髓角 近冠中1/3舌低 颈部 舌侧髓角短圆而不明显，位 髓室底有1-3个根管口 于牙冠颈部 根尖孔约50% 颊髓角稍长 位于根尖顶 舌髓角较短,BLS,4,4,5,位于颈1/3,上颌前磨牙 下颌前磨牙 Maxillary Premolar Mandibular Premolar,与尖牙略相似
18、形似尖牙， 髓室和根管均较窄小 但很狭窄,MDS,上颌前磨牙 下颌前磨牙 Maxillary Premolar Mandibular Premolar,成长条形，颊舌两端圆钝 较长的椭圆形 颊舌径近远中径 颊舌径近远中径 部分髓室颊舌向中份缩小 呈肾形,CCS,The Pulp Cavities of the Maxillary Molars,上颌第一磨牙,髓室似矮立方形，颊舌径近远中径髓室高度,髓室顶凹向下,最凹处约与颈缘平齐。 近中颊舌髓角高,均近冠中1/3；远中颊舌髓角较低，位于冠颈部处。,髓室底可见3-4个根管口，排列呈颊舌径长，近远中径短的四边形或三角形。,上颌第二磨牙,髓腔形态与上
19、颌第一磨牙相类似，但较小。近颊根分根管者约30%，远颊根及舌根管均为单根管。,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,髓室为矮立方形，近远中径颊舌径髓室高度（1mm）；髓室顶最凹处与颈缘平齐。 近远中舌髓角高度相近，近冠中1/3。近远颊髓角和远中髓角较低，位于冠颈部或颈缘附近。,下颌第一磨牙,髓室底有2-4个根管口；近中根约87%为双管型或单双混合型。远中根约40%分根管。,下颌第二磨牙,1、与下颌第一磨牙相近；近中根约64%分根，远中根约18%分根。 2、近远中根在颊侧融合，根管横断面呈“C” 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,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。 2按比例来说，比恒牙髓腔大，髓壁薄，髓角高，根管粗，根尖孔大，根管方向斜度较大。,Thank you！,
