a牙髓腔解剖

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 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 Legend: A, Pulp cavity; B, Dentin; C, Odontoblasts Pulp The pulp cavity occupies the central area of the tooth enclosed by dentin. The pulp has the cellular, fibrous, neural and vascular components of typical loose connective tissue. The main function of the pulp is the production and maintenance of the dentin. 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 floor of pulp chamber 与髓室顶相对的髓室壁。 Pulp chamber 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-shaped extension of the pulp cavity extending in towards the cusp or the incisal margins. Pulp chamber 根管口 Root Canal Orifice The opening of the root canal on the floor of pulp chamber. Pulp chamber 根管 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 type Root canal system 侧副管 lateral accesssory canal 为根管系统中除根管以外的一切管道 ：包括管间吻合，根管侧支，根尖分歧 ，根尖分叉及副根管。诊疗和科研意义 。 Root canal system 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 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 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。 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 侧副管 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 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 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 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%分唇舌双根管 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， 接近冠中1/3 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 近远中根管壁薄 CCS 上颌中切牙 下颌中切牙 MaxCI ManCI 上颌侧切牙的髓腔形态与上颌中 切牙相似，但略小。常为单根，偶 有双根。 下颌侧切牙的髓腔形态与下颌中 切牙相似，但略大。双根者约占2% 。 尖牙的髓腔形态 上颌尖牙 下颌尖牙 Maxillary Canine Mandibular Canine General LLS MDS 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% 根尖孔多位于根尖顶 根尖孔多位于根尖顶 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 Maxillary 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 Mandibular 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 颊髓角稍长 舌髓角较短 BLS 44 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 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