การเปรียบเทียบสัดส่วนของโพรงเนื้อเยื่อในฟันต่อเนื้อฟันและความหนาของเนื้อฟันบริเวณง่ามรากฟันของฟันกรามแท้ล่างซี่ที่ 1 ในแต่ละช่วงอายุ โดยใช้ภาพรังสีส่วนตัดอาศัยคอมพิวเตอร์ลารังสีรูปกรวย

Abstract

Mandibular first molar is a posterior permanent tooth that first present in the mouth. It frequently requires endodontic treatment due to its anatomy with deep pit and fissures that prone to dental caries and periapical pathology. Increasing age has been observed to change of pulp-dentin complex and root canal morphologies. Understanding age-related changes is essential for successful endodontic and restorative treatments. This study aimed to compare pulp/tooth area ratio and dentin thickness in permanent mandibular first molars in different age groups via one hundred axial Cone-Beam Computed Tomography (CBCT) images. The images were divided into five groups; age 20–29, 30–39, 40–49, 50–59 and 60 years old and older. Pulp/tooth area ratio was determined at 3 levels of each roots; furcation (A), between levels A and C (B), half distance between the furcation and apex of the root (C). Dentin thickness was determined at 2 and 3 mm under furcation by using Image J program. ANOVA was used to determine differences among age groups (p < 0.05). As per our findings, pulp/tooth area ratio was determined to reduce as age increases, showing a significant difference among the age groups at Levels A, B, and C of both roots (p < 0.05). The minimum dentin thickness was found to increase with age, demonstrating a significant difference among the age groups of mesiobuccal and mesiolingual canal (p < 0.05). No statistically significant difference was observed in the mesial dentin thickness of distal canal at 2 and 3 mm under furcation. The results of this study revealed that the pulp canal obliteration and the increasing dentin thickness have been confirmed to be associated with advanced age. Clinically, root canal treatment in old patient should be more concern in locating and negotiating the calcified canals; meanwhile, in young patients, strip perforation must be carefully considered during root canal and post space preparation. Thus, accuracy and reliability of preoperative radiographs play an essential role in evaluating root canal morphologies in order to avoid iatrogenic errors.